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MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY resumed treatment untill 4 weeks after the end of the first course then continued at a dosage 0.1mg/kg/day. Instill 1 drop of a 0.5% Chloramphenicol 0.5% Eye solution every 2 hr. Increase Drops S01AA01000D2001X Broad spectrum antibiotic in dosage interval upon305 X C superficial eye infections improvement. To continue treatment for at least 48 hr after complete healing Treatment of ocular ADULT and CHILD : Apply to Chloramphenicol 1% Eye S01AA01000G5101 infections involving the the conjunctiva, a thin strip306 Ointment XX C conjunctiva and/or cornea (approximately 1 cm) of caused by chloramphenicol ointment every 3 hours or susceptible organisms more frequently CHILD: 25 - 50 mg/kg/day in 4 divided doses. Severe307 Chloramphenicol 125 mg/5 J01BA01126L8001X B Typhoid fever, salmonella infections, premature& full- ml Suspension X infections, meningitis, term infants less than 2 cholera, anaerobic and weeks: 25mg/kg/day in rickettsial infections divided doses. Full-term infants more than 2 weeks: up to 50mg/kg/day in divided doses308 Chloramphenicol 250 mg J01BA01126C1001X B Treatment of typhoid, ADULT: 500 mg 4 times daily Capsule X paratyphoid fevers, or 50 mg/kg/day in 4 divided bronchopneumonia and doses. Maximum dose: 4 enteric infection g/day. CHILD: 25 - 100 mg/kg/day in 4 divided doses309 Chloramphenicol 5% w/v S02AA01000D1001X C Acute otitis media, otitis Apply 2 - 3 drops into the ear Ear Drops X externa with perforation 2 - 3 times daily. Not to be used for long term Adult: 50 to 100 mg/kg/day in 4 divided doses. Premature Chloramphenicol Sodium Treatment of typhoid, and full-term neonates: 25 Succinate 1 g Injection J01BA01520P4001X paratyphoid fevers, mg/kg/day in 4 divided310 X B bronchopneumonia and doses. Full-term infants >2 enteric infection wk: 50 mg/kg/day in 4 divided doses. Children: 50-100 mg/kg/day in 4 divided doses311 Chlorhexidine Gluconate R02AA05137M2001 C As a gargle Rinse mouth with 10 ml for 0.2 % Mouthwash XX about 1 minute twice daily Skin Preparation: Use Chlorhexidine Gluconate 2% in Isopropyl Alcohol 70% and312 Chlorhexidine Gluconate D08AC52137L9902X C Use as disinfectant in central allow to dry. Catheter 2% in Alcohol 70% Solution X venous catheter care bundle acces:Apply to catheter ports or hubs prior to accessing the line for administering fluids or injections Surgical hand disinfection: Apply 5ml to clean hands and313 Chlorhexidine Gluconate D08AC02137M9901 C+ Surgical hand forearms for 1 min. Rinse 4% Scrub XX scrub/disinfection, pre-op and repeat with another 5ml skin preparation for a further 2 mins and then rinse and dry. General skinUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 51 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY disinfection: Apply appropriate quantity to wet area and scrub for 1 min. Rinse thoroughly & dry314 Chlorhexidine Gluconate D08AC02137L9901X C+ i) Preoperative skin i) & iii) 1 : 10 in 70 % Alcohol 5% Solution X disinfection ii) 1 : 100 ii) Wounds or burns Chlorhexidine Gluconate iii) Emergency disinfection of Pre-op surgical hand instruments disinfection: Spread 5ml315 5% Solution 1:10 in 70% D08AC52137L9901X C+ throughly over both hands alcohol with lanolin as X To be used undiluted for and forearms, rubbing hand and skin disinfections vigorously. When dry apply a emollient further 5ml and repeat Antiseptic and disinfectants procedure. Antiseptic hand316 Chlorinated Lime Powder V07AV00000F9901X C Wound or ulcer disinfection on the ward: X C Spread 3ml throughly over Treatment of malaria - acute the hands and wrist rubbing317 Chlorinated Lime Solution & D08A000999G9901X attack vigorously until dry. Buffered Acetate Solution X Disinfection of patient's skin: Allergic conditions Prior to surgery, apply to a318 Chloroquine Phosphate 250 P01BA01162T1001X C Symptomatic treatment of sterile swab and rub mg Tablet (150 mg X allergic conditions responsive thoroughly over the operation Chloroquine base) to antihistamine site for a minimum of 2 mins Symptomatic treatment of319 Chlorpheniramine Maleate R06AB04253P3001X B allergic conditions responsive Not applicable 10 mg/ml Injection X to antihistamines Apply to affected areas320 Chlorpheniramine Maleate R06AB04253L9001X C undiluted as a cleansing 2 mg/5 ml Syrup X C agent ADULT 600 mg base stat,321 Chlorpheniramine Maleate R06AB04253T1001X 300 mg 6 - 8 hours later and 4 mg Tablet X a further 300 mg on each of 2 following days. CHILD 3 - 4 years: 150 mg base stat, 75 mg 6 hours later, then 75 mg daily for 2 days. CHILD 5 - 8 years : 300 mg stat, 150 mg 6 hours later, then 150 mg daily for 2 days 10 - 20 mg IM or SC, repeated if required. Not to exceed 40 mg in 24 hours. 10 - 20 mg over 1 minute by slow IV CHILD 2 - 5 years : 1 mg every 4 - 6 hours (maximum 6 mg daily) 6 - 12 years : 2 mg every 4 - 6 hours (maximum 12 mg daily) ADULT: 4 mg every 4 - 6 hours. Maximum 24 mg daily. CHILD 2 - 5 years : 1 mg every 4 - 6 hours (maximumUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 52 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY 6 mg daily) 6 - 12 years : 2 mg every 4 - 6 hours (maximum 12 mg daily) ADULT: Initial dose - 25 mg 3 times daily according to response up to 1 g daily. PAEDIATRIC: Up to 5 years:322 Chlorpromazine HCl 100 N05AA01110T1002X B Psychosis mania and 0.5 mg/kg body weight every mg Tablet X agitation 4 - 6 hours (Maximum 40 mg daily). CHILD 6 - 12 years: A third to half adult dose (Maximum 75 mg daily) ADULT: Initial dose - 25 mg 3 times daily according to response up to 1 g daily.323 Chlorpromazine HCl 25 mg N05AA01110T1001X B Psychosis mania and PAEDIATRIC: Up to 5 years: Tablet X agitation 0.5 mg/kg body weight every 4 - 6 hours (Maximum 40 mg daily). CHILD 6 - 12 years: A third to half adult dose (Maximum 75 mg daily) Apply thin strip324 Chlortetracycline 1% Eye S01AA02000G5101 B Eye infections requiring a (approximately 1 cm) to the Ointment XX broad spectrum antibiotic conjuctiva 2 to 4 hourly or more frequently. Chlortetracycline 1-3 % D06AA02000G1001 Apply directly to affected325 Cream XX B Bacterial skin infections area twice daily as required for 1 - 2 weeks Prophylactic ADULT: First dose of 0.5 ml SC/IM followed after 1 - 4 weeks by a second dose of 1 ml. CHILD: 1 - 5 years: 0.1 ml J07AE01000P3001X (1st dose), 0.3 ml (2nd dose). X CHILD; 5 - 10 years: 0.3 ml326 Cholera Vaccine B Immunisation of cholera (1st dose), 0.5ml (2nd dose). Booster: For optimum long- term protection, a booster dose is recommended for adults after 2 years. Children 2-6 years should receive a booster dose after 6 months. i) Hypercholesterolemia ii) Familial hypercholesterolemia - Hypercholesterolemia: heterozygous Adjunct: initial, 4 g orally 1-2327 Cholestyramine Resin 4 G C10AC01000M4001 A iii) Generalized times daily, maintenance, 8 XX atherosclerosis to 16 g in divided doses, max iv) Diarrhoea due to bile acid 24 g daily CHILD: 50 - 150 malabsorption mg/ kg 6 - 8 hourly oral v) Pruritus of skin associated with partial biliary obstruction Choline Salicylate 8.7%, N02BA03900G3001 B For relief of the pain and Apply to area 4 times daily328 Cetylkonium Chloride XX discomfort in mouth ulcers and sores, infant teething 0.01% Dental Gel and denture irritationUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 53 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) Women undergoing superovulation prior to 250 mcg 24-48 hour after the Choriogonadotropin Alfa G03GA01000P5001 A* assisted reproductive last administration of an FSH329 250 mcg/0.5 ml Injection in XX techniques such as in-vitro or hMG preparation, when fertilization (IVF) optimal stimulation of Prefilled Syringe ii) Anovulatory or oligo- follicular growth is achieved. ovulatory women i) & ii) Induction of ovulation: Chorionic Gonadotrophin G03GA01000P4001 A* i)Treatment of infertile 5000 - 10,000 units one day330 Human (HCG) 5000 IU XX women to induce ovulation following last dose of ii) As a luteal support in menotropin. Up to 3 repeat Injection controlled ovarian injections of 5000 units each hyperstimulation cycles may be given within the following 9 days to prevent insufficiency corpus luteum331 Ciclesonide 160mcg Inhaler R03BA08000A2101X A* Prophylactic treatment of For adults and adolescents X asthma in adults, over 12 years of age with adolescents and children mild to moderate asthma is over 6 years (follow current 160 to 640mcg per day: indication) Not meant for 6 severe asthma dose may be yo) increased to 1280mcg per day. i & ii) Initially 12.5 - 15 mg/kg/day, beginning on the day before transplant. Maintenance approx 12.5 mg/kg/day for 3 - 6 months Only for: i) Patients in whom before being tapered off to donor specific transplantation zero by 1 year of cannot be carried out and in transplantation young children to minimise iii) 3 mg/kg/day in 2 divided side-effects of steroids doses for first 6 weeks. May ii) Follow-up cases of bone increased gradually to marrow transplant maximum 5 mg/kg. iii) Patients with severe Treatment withdrawn if no rheumatoid arthritis not response after 3 months responding to other second iv) ADULT: 5 mg/kg/day in 2332 Ciclosporin 100 mg Capsule L04AD01000C1002X A* line drugs divided doses. CHILD: 6 X iv) Patients with idiopathic mg/kg/day in 2 divided nephrotic syndrome who are doses. Patients with steroid toxic or poor permitted levels of kidney response to failure, the starting dose must cyclophosphamide not more than 2.5 mg/kg/day v) Severe aplastic anemia, v) 12 mg/kg/day. pure red cell aplasia vi) 2.5 mg/kg/day in 2 divided vi) Cases of recalcitrant doses increasing if there is psoriasis and atopic eczema no improvement after 4 vii) Treatment of chronic weeks by 0.5 -1 mg/kg/month ocular inflammatory up to maximum 5 mg/kg/day disorders/uveitis vii) 5 mg/kg/day in 2 divided doses, may increase to 7 mg/kg/day in resistant cases. Maintenance: Less than 5 mg/kg/day especially during remissionUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 54 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i & ii) Initially 12.5 - 15 mg/kg/day, beginning on the day before transplant. Maintenance approx 12.5 Only for : i) Patients in whom mg/kg/day for 3 - 6 months donor specific transplantation before being tapered off to cannot be carried out and in zero by 1 year of young children to minimise transplantation iii) 3 side-effects of steroids mg/kg/day in 2 divided doses ii) Follow-up cases of bone for first 6 weeks. May marrow transplant increased gradually to iii) Patients with severe maximum 5 mg/kg. Rheumatoid arthritis not Treatment withdrawn if no333 Ciclosporin 100 mg/ml Drink L04AD01000L5002X A* responding to other second response after 3 months Solution X line drugs iv) ADULT: 5 mg/kg/day in 2 iv) Patients with idiopathic divided doses. CHILD: 6 nephrotic syndrome who are mg/kg/day in 2 divided steroid toxic or poor doses. Patients with response to permitted levels of kidney cyclophosphamide failure, the starting dose must v) Severe aplastic anaemia, not more than 2.5 mg/kg/day pure red cell aplasia v) 12 mg/kg/day vi) Cases of recalcitrant vi) 2.5 mg/kg/day in 2 divided psoriasis and atopic eczema doses increasing if there is no improvement after 4 weeks by 0.5 -1 mg/kg/month up to maximum 5 mg/kg/day334 Ciclosporin 25 mg Capsule L04AD01000C1001X A* Only for: i) Patients in whom i & ii) Initially 12.5 - 15 X donor specific transplantation mg/kg/day, beginning on the cannot be carried out and in day before transplant. young children to minimise Maintenance approx 12.5 side-effects of steroids mg/kg/day for 3 - 6 months ii) Follow-up cases of bone before being tapered off to marrow transplant zero by 1 year of iii) Patients with severe transplantation rheumatoid arthritis not iii) 3 mg/kg/day in 2 divided responding to other second doses for first 6 weeks. May line drugs increased gradually to maximum 5 mg/kg. iv) Patients with idiopathic Treatment withdrawn if no nephrotic syndrome who are response after 3 months steroid toxic or poor iv) ADULT: 5 mg/kg/day in 2 response to divided doses. CHILD: 6 cyclophosphamide mg/kg/day in 2 divided v) Severe aplastic anemia, doses. Patients with pure red cell aplasia permitted levels of kidney vi) Cases of recalcitrant failure, the starting dose must psoriasis and atopic eczema not more than 2.5 mg/kg/day vii) Treatment of chronic v) 12 mg/kg/day ocular inflammatory vi) 2.5 mg/kg/day in 2 divided disorders/uveitis doses increasing if there is no improvement after 4 weeks by 0.5 -1 mg/kg/month up to maximum 5 mg/kg/day vii) 5 mg/kg/day in 2 divided doses, may increase to 7 mg/kg/day in resistant cases.Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 55 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Maintenance: Less than 5 mg/kg/day especially during remission i) 3 - 5 mg/kg/day until i) Post bone marrow tolerate orally335 Ciclosporin 50 mg/ml L04AD01000P3001X A* transplant ii) 2 - 3 mg/kg/day for Injection X ii) Solid organ transplant recipients who are unable to take orally Improvement of the maximal and pain-free walking distances in patients with336 Cilostazol 100 mg Tablet B01AC00000T1002X A* intermittent claudication, who 100 mg twice daily X do not have rest pain and who do not have evidence of peripheral tissue necrosis. Cimicifuga Racemosa HG03WA5001T1001 A Traditionally used for the 20 mg twice daily337 Rhizome Extract 20 mg XX relief of hot flushes, sweating, restlessness Tablet associated with menopause338 Cinnarizine 25 mg Tablet N07CA02000T1001X B Vestibular disorders One tablet 3 times daily X ADULT: the dosage range is 100-400mg twice daily Gonorrhoea: 100mg single dose Upper and Lower Urinary Tract Infection:339 Ciprofloxacin 100 mg/50 ml J01MA02125P3001X A Treatment of infections due 100mg bd Upper and Lower Injection X to susceptible bacterial Respiratory Tract Infection: strains 200mg bd-400mg twice daily Cystic Fibrosis with psuedomonal Lower RTI: 400mg bd Others: 200- 400mg bd inhalation Anthrax: 400mg bdUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 56 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Suggest to rephrase ADULT: the dosage range is 100- 400mg twice daily Gonorrhoea: 100mg single dose Upper and Lower340 Ciprofloxacin 200 mg/100 J01MA02125P3002X A Treatment of infections due Urinary Tract Infection: ml Injection X to susceptible bacterial 100mg bd Upper and Lower strains Respiratory Tract Infection: 200mg bd-400mg twice daily Cystic Fibrosis with psuedomonal Lower RTI: 400mg bd Others: 200- 400mg bd inhalation Anthrax: 400mg bd341 Ciprofloxacin 250 mg Tablet J01MA02110T1001X A Treatment of infections due ADULT: 125-750 mg twice X to susceptible bacterial daily. Acute gonorrhoea: a strains single dose of 250 mg342 Ciprofloxacin 500 mg Tablet J01MA02110T1002X A Treatment of infections due ADULT: 125-750 mg twice X to susceptible bacterial daily. Acute gonorrhoea: a strains single dose of 250 mg i) 2 drops every 15 minutes for the first 6 hours, then 2 drops every 30 minutes for the rest of the first day. Second day: 2 drops every343 Ciprofloxacin HCl 0.3% S01AX13110D2001X A* Treatment of bacterial hour. Subsequent days (3rd - Ophthalmic Solution X infections caused by 14th day): 2 drops every 4 susceptible strains in i) corneal ulcers hours. Treatment may be ii) bacterial conjunctivitis continued after 14 days if corneal re-epithelialization has not occured ii) 1 - 2 drops every 2 hours into the conjunctival sac while awake for 2 days and 1-2 drops every 4 hours while awake for the next 5 days Administered as bolus intravenous injection. May be As an adjunct to general administered as infusion in anaesthesia to facilitate ICU patients at a rate of endotracheal intubation, to 3mcg/kg/min. Adult dose:344 Cisatracurium Besylate 2 M03AC11197P3001 provide skeletal muscle a) Induction: 0.15mg/kg over mg/ml Injection XX A* relaxation during surgery and 5-10 secs, to facilitate mechanical b) Maintenance: 0.03 mg/kg. ventilation. Restricted to patients with lung problem Children 2-12 years: such as asthma. a) Induction: 0.1 mg/kg over 5-10 secs, b) Maintenance: 0.02 mg/kgUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 57 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Germ cell tumours: 20 mg/m2 daily for 5 days every 3 weeks for 3 - 4 courses. Ovarian tumours: 75 mg/m2 once every 3 weeks as part of combination therapy with paclitaxel or 50-60mg/m2 IV Germ cell tumours, ovarian once every 3 weeks as a tumours, adult solid tumours, single agent. Baseline345 Cisplatin 10 mg Injection L01XA01000P3001X A lymphomas creatinine clearance, X pretreatment hydration and forced diuresis are mandatory. CHILD: 100mg/m2 over 6 hours once every 3 weeks. Lymphomas: Refer to protocols CHILD: 100mg/m2 over 6 hours once every 3 weeks. Lymphomas: Refer to protocols Germ cell tumours: 20 mg/m2 daily for 5 days every 3 weeks for 3 - 4 courses. Ovarian tumours: 75 mg/m2 once every 3 weeks as part of combination therapy or 100 mg/m2 IV once every 3346 Cisplatin 50 mg Injection L01XA01000P3002X A Germ cell tumours, ovarian weeks as a single agent. X tumours, adult solid tumours, Baseline creatinine lymphomas clearance, pretreatment hydration and forced diuresis are mandatory. CHILD: 100mg/m2 over 6 hours once every 3 weeks. Lymphomas: Refer to protocols CHILD: 100mg/m2 over 6 hours once every 3 weeks. Lymphomas: Refer to protocols CHILD: 8 - 12 years: 30 - 40 kg 10 mL, 4 - 8 years: 20 - 29347 Clarithromycin 125 mg/5 ml J01FA09000F1001X A* Treatment of complicated kg 7.5 mL, 2 - 4 years: 12 - Granules X respiratory tract infections not 19 kg 5 mL, 1 - 2 years: 8 - responding to standard 11 kg 2.5 mL, less than 8 kg: macrolides 7.5 mg/kg. To be given twice daily. Maximum dose: 1g/day Only for i) treatment of complicated i) 250 - 500 mg twice daily.348 Clarithromycin 250 mg J01FA09000T1001X A* respiratory tract infection not Up to 6 - 14 days Tablet X responding to standard ii) 500 mg twice daily with macrolides omeprazole & amoxicillin. Up ii) eradication of Helicobacter to 2 weeks pylori infectionUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 58 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Susceptible infections Adult: 500 mg bid for 2-5 days. Dose to be infused over 60 minutes in a 0.2% solution;349 Clarithromycin 500 mg J01FA09000P3001X A* Only for treatment of revert to oral therapy Injection X complicated respiratory tract whenever possible. Child: 1 infection not responding to mth-12 yr: 7.5 mg/kg every standard macrolides 12 hr. Dose to be given via infusion into proximal vein. Dosage Recommendation CrCl (ml/min)<30 : Half the dosage or double dosing interval i) ADULT: 150 - 300 mg every 6 hours; up to 450 mg i) Skin and soft tissue every 6 hours in severe infections, bone& joint infections; Max: 1.8g/day infections CHILD: 3 - 6 mg/kg every 6350 Clindamycin HCl 300 mg J01FF01110C1001X A* ii) Cerebral toxoplasmosis hours. Children weighing <10 Capsule X iii) Children less than 8 years kg should receive at least old:Treatment and 37.5 mg every 8 hr. prophylaxis of malaria in ii) 600 mg 6 hourly for 6 combination with quinine, as weeks iii) 10mg/kg twice a an alternative to doxycline day, in combination with quinine. The combination to be given for 7 days i) ADULT: 0.6 - 2.7 g daily (in 2 - 4 divided doses); up to 4.8 g daily; i) Skin and soft tissue CHILD over 1 month, 20 - 40 Clindamycin Phosphate 150 J01FF01162P3001X infections, bone & joint mg/kg/day or 350 mg/m2/day351 A* infections in 3 - 4 divided doses mg/ml Injection X ii) Cerebral toxoplasmosis ii) 1200 mg every 6 hours for 3 weeks followed by 300 mg orally every 6 hours for another 3 weeks The initial dose in adults and adolescents >15 yr should be low (5 to15mg daily), if necessary, increased As adjunctive therapy in gradually to a maximum daily dose of about 80mg. Doses352 Clobazam 10 mg tablet N05BA09000T1001X A* patients with epilepsy not of up to 30mg may be taken X adequately stabilised with as a single dose in the their basic medication. evening. The initial dose in children from 3 to15 yr is normally 5mg. A maintenance dose of 0.3 to 1.0mg/kg body weight daily is usually sufficient.353 Clobetasol Propionate D07AD01133G1001 A Short term treatment only of Apply sparingly once or twice 0.05% Cream XX more resistant dermatoses daily, changing to lower eg. psoriasis, recalcitrant potency therapy as soon as eczemas, lichen planus, condition is controlled. For discoid lupus erythematosus mild to moderate use and other conditions which maximum for 2 weeks. For moderate to severeUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 59 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY do not respond satisfactorily maximum duration 4 to less potent steroids consecutive weeks. Max: 50 g/week Apply sparingly once or twice Short term treatment only of daily, changing to lower more resistant dermatoses potency therapy as soon as eg. psoriasis, recalcitrant condition is controlled. For354 Clobetasol Propionate D07AD01133G5001 A eczemas, lichen planus, mild to moderate use 0.05% Ointment XX discoid lupus erythematosus maximum for 2 weeks. For and other conditions which moderate to severe do not respond satisfactorily maximum duration 4 to less potent steroids consecutive weeks. Max:50 g/week355 Clobetasone Butyrate D07AB01255G1001 A/KK Eczema and dermatitis of all Apply up to four times daily 0.05% Cream XX types until condition improves, then reduce frequency356 Clobetasone Butyrate D07AB01255G5001 A Eczema and dermatitis of all Apply up to four times daily 0.05% Ointment XX types until condition improves, then reduce frequency357 Clodronate 800 mg Tablet M05BA02011T1011 A* Treatment of hypercalcaemia 2 tablets in single or two XX due to malignancy divided doses i) ADULT: 100 mg each other day or 50 mg daily with 100mg Dapsone & 300mg once a month with 600mg rifampicin under supervision. Maximum: 200 mg/day.358 Clofazimine 100 mg J04BA01000C1002X B i) Previously untreated CHILD: 10-14 yr: 50mg Capsule X leprosy patients clofazimine on alternate days ii) Leprosy patients resistant with 50mg dapsone & 150 to sulphones mg clofazimine with 450 mg iii) Suppression of lepra rifampicin once a reactions month.Maximum: 100 mg/day. ii) 100 mg daily iii) 200-300mg usually effective. Treatment with minimum suppression dose continued for at least 6 months i) ADULT: 100 mg each other day or 50 mg daily with 100mg Dapsone & 300mg once a month with 600mg rifampicin under supervision. Maximum: 200 mg/day.359 Clofazimine 50 mg Capsule J04BA01000C1001X B i) Previously untreated CHILD: 10-14 yr: 50mg X leprosy patients clofazimine on alternate days ii) Leprosy patients resistant with 50mg dapsone & 150 to sulphones mg clofazimine with 450 mg iii) Suppression of lepra rifampicin once a reactions month.Maximum: 100 mg/day. ii) 100 mg daily iii) 200-300mg usually effective. Treatment with minimum suppression doseUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 60 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY continued for at least 6 months360 Clomiphene Citrate 50mg G03GB02136T1001 A Anovulatory infertility 50 mg daily from 2nd - 6th or Tablet XX 5th - 9th day of menstrual Depression, obsessive- cycle. Increase dose361 Clomipramine HCI 25 mg N06AA04110T1001X A compulsive disorder. gradually by increments of 50 Tablet X mg if there is no response i) Epilepsy until a dosage of 200 mg362 Clonazepam 0.5 mg Tablet N03AE01000T1001X B ii) Non-epileptic myoclonus daily is achieved (starting as X i) Epilepsy early as 30 days afer the ii) Non-epileptic myoclonus previous course). Further363 Clonazepam 2 mg Tablet N03AE01000T1002X B treatment may not be X recommended if pregnancy has not occurred after a totalUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) of 6 treatment cycles. Initially 10 mg daily, increased gradually as necessary to 30 - 150 mg daily in divided doses or as a single dose at bedtime; max 250 mg daily. ELDERLY initially 10 mg daily increased carefully over approximately 10 days to 30 - 75 mg daily; Child: ≥10 yr: Initially, 25 mg daily, increased gradually over 2 wk. Max: 3 mg/kg/day or 100 mg daily, whichever is smaller. Give in divided doses. Once titrated, dose may be given as a single dose at bedtime. i) & ii) ADULT: Initial dose should not exceed 1.5mg/day divided into 3 doses, may be increased in increments of 0.5mg every 3 days until seizures are controlled. Maintenance dose: 3- 6mg/day. Maximum: 20mg/day. CHILD up to 10 years: initial dose 0.01-0.03 mg/kg/day in 2-3 divided doses, increased by no more than 0.25-0.5mg every third day, maximum 0.2mg/kg/day. CHILD 10-16 years: initial dose 1-1.5mg/day in 2-3 divided dose, may be increased by 0.25-0.5mg every third day until individual maintenance dose of 3- 6mg/day is reached. i) & ii) ADULT: Initial dose should not exceed 1.5mg/day 61 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY divided into 3 doses, may be increased in increments of 0.5mg every 3 days until seizures are controlled. Maintenance dose: 3- 6mg/day. Maximum: 20mg/day. CHILD up to 10 years: initial dose 0.01-0.03 mg/kg/day in 2-3 divided doses, increased by no more than 0.25-0.5mg every third day, maximum 0.2mg/kg/day. CHILD 10-16 years: initial dose 1-1.5mg/day in 2-3 divided dose, may be increased by 0.25-0.5mg every third day until individual maintenance dose of 3- 6mg/day is reached. Rapid detoxification in 4-5 days (use with naltrexone): 6 mcg/kg ORALLY divided in 3 doses 6 to 8 hours apart the364 Clonidine HCl 0.025 mg N02CX02110T1001X A Rapid opiod detoxification first day, increasing to 11 Tablet X combination use with mcg/kg divided in 3 doses naltrexone given day two, tapering to 0.6 mcg/kg the third day. Rapid opioid detoxification for 7 days (use with naltrexone) : 0.1 to 0.2 mg every 4 hours as needed Prevention of myocardial infarct, stroke or established B01AC04192T1001X peripheral arterial disease. X365 Clopidogrel 75 mg Tablet A* As second/third line 75 mg once daily treatment in patients who are sensitive to acetylsalicylic acid & intolerant to ticlopidine i) Focal dystonias366 Clostridium Botulinum Toxin M03AX01000P4001 A* ii) Hemifacial spasm 20 - 200 units 3 months once Type A 100 units XX iii) Spasticity including cerebral palsy Initially 20 U/kg divided between both calf muscles. May be titrated 10-30 U/kg Clostridium Botulinum Type i) Focal dystonias up to max of not >1000 U/patient. Should only be367 A toxin haemagglutinin M03AX01000P4003 A* ii) Hemifacial spasm used in children > 2 years of complex 300 units/vial XX iii) Spasticity including age. Repeat injections given powder for injection cerebral palsy not less than 3 months from previous injection. Clostridium botulinum Type i) Focal dystonias Initially 20 U/kg divided between both calf muscles.368 A toxin haemagglutinin M03AX01000P4002 A* ii) Hemifacial spasm May be titrated 10-30 U/kg complex 500U/vial powder XX iii) Spasticity including up to max of not >1000 U/patient. Should only be for injection cerebral palsyUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 62 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY used in children > 2 years of age. Repeat injections given not less than 3 months from previous injection. Rub in gently onto affected and surrounding skin 2 or 3369 Clotrimazole 1% Cream D01AC01000G1001 B Cutaneous candidiasis, Tinea times daily continuing for XX corporis, Tinea cruris, Tinea about 2 weeks beyond the pedis and Tinea versicolor dissapearance of all symptoms370 Clotrimazole 1% Ear Drop S02AA00000D1002X B Otomycosis; concomitant 4 to 5 drops 3 to 4 times daily X therapy with antibiotics and corticosteroid ear drops371 Clotrimazole 1% Solution D01AC01000L6001X A Cutaneous candidiasis, tinea Apply gently onto affected X orporis, tinea cruris, tinea and surrounding skin area 2 pedis and tinea versicolor or 3 times daily continuing for 2-4 weeks372 Clotrimazole 200 mg G01AF02000S1002X B Vaginal candidiasis 200 mg once daily, preferably Vaginal Tablet X at bedtime for three consecutive days373 Clotrimazole 500 mg G01AF02000S1003X B Vaginal candidiasis 500 mg as a single one-time Vaginal Tablet X dose Cloxacillin Sodium 125 J01CF02520L8001X Treatment of susceptible Child: 50-100 mg/kg in mg/5 ml Suspension X bacterial infections, notably divided doses every 6 hr374 B penicillinase-producing staphylococci375 Cloxacillin Sodium 250 mg J01CF02520C1001X B Treatment of susceptible ADULT: 250 - 500 mg every Capsule X bacterial infections, notably 6 hours. Child: 50-100 mg/kg penicillinase-producing in divided doses every 6 hr. staphylococci ADULT: 250 to 500 mg every J01CF02520P4001X Treatment of susceptible 6 hours depending on type Cloxacillin Sodium 250 mg X bacterial infections, notably and severity of infection.376 Injection B penicillinase-producing CHILD less than 20 kg: 25 to staphylococci infections 50 mg/kg/day in equally divided doses every 6 hours377 Cloxacillin Sodium 500 mg J01CF02520C1002X B Treatment of susceptible ADULT: 250 - 500 mg every Capsule X bacterial infections, notably 6 hours. Child: 50-100 mg/kg penicillinase-producing in divided doses every 6 hr. staphylococci ADULT: 250 to 500 mg every Treatment of susceptible 6 hours depending on type378 Cloxacillin Sodium 500 mg J01CF02520P4002X B bacterial infections, notably and severity of infection. Injection X penicillinase-producing CHILD less than 20 kg: 25 to staphylococci infections 50 mg/kg/day in equally divided doses every 6 hours Initial dose: 12.5 mg (once or twice) daily, increase slowly379 Clozapine 100 mg Tablet N05AH02000T1002X A Treatment of resistant in steps of 25 - 50 mg up to X schizophrenia 300 mg daily within 2 - 3 weeks. Maximum 900 mg/dayUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 63 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Initial dose: 12.5 mg (once or twice) daily, increase slowly380 Clozapine 25 mg Tablet N05AH02000T1001X A Treatment of resistant in steps of 25 - 50 mg up to X schizophrenia 300 mg daily within 2 - 3 weeks. Maximum 900 mg/day Coal Tar 1- 6 % in D05AA00946G5003 B Dandruff, seborrhoeic Apply to the affected areas381 Betamethasone 17 - XX dermatitis, atopic dermatitis, sparingly 1-2 times daily eczema and psoriasis Valerate 0.01 % Ointment Dandruff, seborrhoeic dermatitis, atopic dermatitis, eczema and psoriasis. Used Apply sparingly to the D05AA00000G5001 as a mild astringent for the affected area 1-3 times daily382 Coal Tar 1-9% Ointment XX B skin, as a soothing and starting with low strength protective application in preparations eczema and as a protective to slight excoriation383 Coal Tar 20% Solution D05AA00000L5201X B Dandruff, seborrhoeic Use 100 ml in a bath X dermatitis, atopic dermatitis, eczema and psoriasis Coal Tar and Salicylic Acid D05AA00946G5002 B Dandruff, seborrhoeic Apply to the affected areas384 (various concentrations) XX dermatitis, atopic dermatitis, eczema and psoriasis Ointment385 Coal Tar with Salicylic Acid D05AA00000L5202X B Dandruff, seborrhoeic Apply to the affected areas or (various concentrations) X dermatitis, atopic dermatitis, as in product leaflet Solution eczema and psoriasis386 Cocaine 10% Solution N01BC01110L5001X B To produce local anaesthesia Maximum total dose X or vasoconstriction during recommended for application endoscopic nasal surgery, to the nasal mucosa in turbinectomy septoplasty, healthy adult is 1.5 to 2 polypectomy etc mg/kg of a 10% cocaine solution387 Cocois Co. Ointment D05AA00946G5001 B Scalp psoriasis and severe Rub a small amount into the XX seborrhoeic dermatitis scalp gently i) Initial dose, 0.5-1.2 mg, and then 0.5-0.6 mg every hour until relief of pain is388 Colchicine 0.5 mg Tablet M04AC01000T1001 B i) Acute gout and prophylaxis obtained or vomiting or XX of recurrent gout. diarrhoea occurs (Maximum: ii) Leucocytoclastic Vasculitis 8 mg). The course should not either cutaneous or systemic be repeated within 3 days. involvement, Behcet's Prevention of attacks during syndrome, Urticarial initial treatment with vasculitis, Systemic sclerosis, allopurinol or uricosuric Sweet's syndrome and drugs: 0.5 mg 1-3 times daily. severe recalcitrant aphthous ii) 0.5 mg 1-3 times daily stomatitis depends on disease and severity, up to a maximum of 3 mg/dayUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 64 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY A minimum of 5 days treatment is generally recommended. For the treatment of respiratory exacerbations in cystic fibrosis patients, treatment should be continued up to 12 days. Children and adults (including elderly): Up to 60kg: 50,000 units/kg/day to a maximum of 75,000 units/kg/day. The total daily dose should be divided into Colistimethate Sodium 1 J01XB01520P4001X A* Intravenous administration three doses given at389 million IU per vial X for the treatment of serious approximately 8-hour infections caused by Gram intervals. Over 60kg: 1-2 (Polymyxin E) negative bacteria, when more million units three times a commonly used systemic day. The maximum dose is 6 antibacterial agents may be million units in 24 hours. contraindicated or may be Renal impairment: In ineffective because of moderate to severe renal bacterial resistance. impairment, excretion of colistimethate sodium is delayed. Therefore, the dose and dose interval should be adjusted in order to prevent accumulation. Suggested Dosage Adjustment in Renal Impairment (for over 60 kg body weight): - Mild (CrCl 20- 50 ml/min): 1-2 million units every 8 hr. - Moderate (CrCl 10-20 ml/min): 1 million units every 12-18 hr. - Severe (CrCl <10 ml/min): 1 million units every 18-24 hr. Eradication therapy for390 Colloidal Bismuth Subcitrate A02BX05136T1001X A Helicobacter Pylori in 240 mg twice daily for 1-2 120 mg Tablet X combination with antibiotics weeks and antisecretory drugs391 Compound Sodium Lactate B05XA30125P6001X C Replacement of extracellular 100-1000 ml by IV or (Hartmanns Solution) X losses of fluid and according to the needs of the electrolytes, as an alkaliniser patient agent i) Osteoporosis associated with oestrogen deficiency ii) Female hypoestrogenism i) 0.3 - 0.625 mg daily Conjugated estrogens 0.3 G03CA57000T1003 iii) Vasomotor symptoms ii) 0.3- 1.25mg daily for392 mg Tablet XX A associated with oestrogen 3weeks, then off for 1 week deficiency iii) & iv) 0.3mg-1.25mg daily iv)atrophic vaginitis and urethritis Conjugated Estrogens G03FA12295T1002X Management of moderate to 0.625 mg & X severe vasomotor symptoms393 Medroxyprogesterone A associated with menopause, 1 tablet daily prevention and management Acetate 2.5 mg Tablet of postmenopausalUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 65 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY osteoporosis, atropic vaginitis and atropic urethritis in post menopausal woman with intact uterus394 Conjugated Oestrogens G03CA57000T1001 A i) Osteoporosis associated i) 0.3 - 0.625 mg daily 0.625 mg Tablet XX with oestrogen deficiency ii) 0.3- 1.25mg daily for ii) Female hypoestrogenism 3weeks, then off for 1 week395 Conjugated Oestrogens G03CA57000G1001 A iii) Vasomotor symptoms iii) & iv) 0.3mg-1.25mg daily 0.625 mg/g Cream XX associated with oestrogen deficiency Intravaginally or topically 0.5- Continuous Ambulatory iv)atrophic vaginitis and 2g daily depending on Peritoneal Dialysis (CAPD) urethritis severity of condition. Administration should be396 Solution containing 2.3% B05DB00908H2504 B Atrophic vaginitis and post cyclic, with 3 weeks on glucose (Calcium XX B menopausal atrophic conjugated estrogens and B urethritis one week off. Estrogens 1.75mmol/L) & (Calcium B should be used for the For chronic renal diseases shortest duration possible 1.25mmol/L) requiring dialysis and acute when treating atrophic therapy-resistance renal vaginitis. Every 3 to 6 months397 Continuous Ambulatory B05DB00908H2501 failure eg. prior to transfer to attempts should be made to Peritoneal Dialysis Solution XX a dialysis centre taper or discontinue therapy containing 1.5% Dextrose For chronic renal diseases and conjugated estrogens requiring dialysis and acute should be titrated to give the398 Continuous Ambulatory B05DB00908H2502 therapy-resistance renal lowest possible dosage to Peritoneal Dialysis Solution XX failure eg. prior to transfer to control symptoms containing 2.5% Dextrose a dialysis centre For chronic renal diseases Dose depending on clinical399 Continuous Ambulatory B05DB00908H2503 requiring dialysis and acute cases Peritoneal Dialysis Solution XX therapy-resistance renal containing 4.25% Dextrose failure eg. prior to transfer to Dose depending on clinical a dialysis centre cases400 Copper 250 mm2 G02BA02000M9001 B For chronic renal diseases Intrauterine Device XX requiring dialysis and acute Dose depending on clinical therapy-resistance renal cases failure eg. prior to transfer to a dialysis centre Dose depending on clinical cases Intrauterine contraception One unit intrauterine deviceUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) to be inserted into the uterine cavity on the last day of the menstrual flow or in the first days afterwards. It is advised that the Multiload Cu 250 66 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY devices are replaced every 3 years401 Copper 375 mm2 G02BA02000M9002 B Contraception One unit intrauterine device Intrauterine Device XX to be inserted into the uterine Wounds cavity on the last day of the402 Copper Sulphate Crystal D08A000183F9901X C menstrual flow or in the first X Controlled Ovarian days afterwards. It is advised Stimulation (COS) in that the Multiload Cu 375 Corifollitropin Alfa G03GA09000P5001 A* combination with a GnRH devices are replaced every 5403 100mcg/0.5ml solution for XX antagonist for the years development of multiple The tip of the crystal should injection follicles in woman be moistened by dipping in participating in an Assisted water and applied carefully to Corifollitropin Alfa G03GA09000P5002 A* Reproductive Technology the lesion404 150mcg/0.5ml solution for XX (ART) program Restriction: As second line treatment Women with Body Weight injection alternative to other ≤60 kg: A single dose of 100 recombinant FSH mcg should be administered.405 Cortisone Acetate 5 mg H02AB10122T1002X B Controlled Ovarian Women with Body Weight Tablet X Stimulation (COS) in >60 kg: A single dose of 150 combination with a GnRH mcg should be administered.406 Crotamiton 10 % Cream P03A000000G1001X A/KK antagonist for the Details : Refer to Product X development of multiple Information follicles in woman participating in an Assisted Women with Body Weight Reproductive Technology ≤60 kg: A single dose of 100 (ART) program Restriction: mcg should be administered. As second line treatment Women with Body Weight alternative to other >60 kg: A single dose of 150 recombinant FSH mcg should be administered. Details : Refer to Product For salt losing congenital Information adrenal hyperplasia in newborn and paediatric 20-30 mg/m2 daily. Doses patients may be divided with two- thirds in the morning and i) Pruritus one-third late in the afternoon ii) Scabies i) and iii) Massage into iii) Insect bite reactions affected area until the medication is completelyUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) absorbed. Repeat as needed. Apply 2 or 3 times daily ii) Apply to the whole body from below the chin. 2nd application is applied 24 hr later. May need to use once daily for up to 5 days. 67 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) Prophylaxis of anaemia: i) Prophylaxis of anaemia 250-1000 mcg IM every month407 Cyanocobalamin 0.1 mg B03BA01000P3001X B ii) Uncomplicated pernicious ii) Uncomplicated pernicious Injection X anaemia or Vitamin B12 anaemia or Vitamin B12 malabsorption: Initial 100 malabsorption mcg daily for 5-10 days followed by 100-200 mcg i) Prophylaxis of anaemia monthly until complete associated with Vitamin B12 remission is achieved. Maintenance: up to 1000408 Cyanocobalamin 1 mg B03BA01000P3002X B deficiency mcg monthly. CHILD 30-50 Injection X ii) Uncomplicated pernicious mcg daily for 2 or more weeks (to a total dose of 1- anaemia or Vitamin B12 5mg). Maintenance: 100 mcg monthly to sustain remission malabsorption OR AS PRESCRIBED.409 Cyanocobalamin 50 mcg B03BA01000T1002X B Vitamin B12 deficiency of i) Prophylaxis of anaemia: Tablet X dietary origin 250-1000 mcg IM every month Cyclopentolate 0.2% with S01GA55990D2001 A Dilating agent for premature ii) Uncomplicated pernicious410 Phenylephrine 1% Eye XX babies anaemia or Vitamin B12 malabsorption: Initial 100 Drops mcg daily for 5-10 days followed by 100-200 mcg411 Cyclopentolate 0.5% Eye S01FA04000D2001X A Mydriasis and cycloplegia monthly until complete Drops X remission is achieved. Maintenance: up to 1000 mcg monthly. CHILD 30-50 mcg daily for 2 or more weeks (to a total dose of 1- 5mg). OR AS PRESCRIBED. ADULT 50-150 mcg daily. CHILD 50-105 mcg daily in 1- 3 divided doses 1 drop every 5 - 10 minutes; not exceeding three times to produce rapid mydriasis. Observe infants closely for at least 30 minutes 1 drop of solution in eye(s); may repeat after 5 to 10 minutes if needed. INFANT : Single instillation of 1 drop of 0.5% solution in the eye; apply pressure to nasolacrimal sac for 2 to 3 minutes; observe infant closely for at least 30 minutes for signs or symptoms of systemic absorptionUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 68 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE S01FA04000D2002X CATEGORY412 Cyclopentolate 1% Eye Mydriasis and cycloplegia ADULT: 1 drop of solution in Drops X A eye(s); may repeat after 5-10 i) Solid tumours (adult and minutes if needed. CHILD: 1413 Cyclophosphamide 1 g L01AA01000P4002X A paediatric), leukaemia, non- drop of solution in eye(s); Injection X Hodgkin's lymphoma, may repeat after 5-10 multiple myeloma minutes if needed. Pre- ii) Severe lupus nephritis treatment on the day prior to (Class III and IV) examination is usually not iii) Other systemic vasculitis necessary. If desirable, 1 or 2 iv) Systemic lupus drops may be instilled the erythematosus, rheumatoid evening prior to examination. arthritis, polyarteritis nodosa, wegener granulomatosis i) ADULT: 600 - 750 mg/m2 v) Pemphigus vulgaris IV once every 3 weeks as part of combination regime. CHILD: Dose variable depending on disease and protocol. Range 600 mg/m2 to 2 g/m2 infusion over 1 hour to 6 hours (lower doses can be given as bolus). Care with pre and post-hydration. Mesna to be given with doses more than 1 g/m2. Higher doses are used in haematopoetic stem cell transplant-refer to specific protocols ii) 750 mg/m2 BSA monthly for 18 months iii) 750 mg/m2 BSA monthly for 6 months. Dose can be adjusted up to 1,000 mg/m2 BSA to achieve adequate leucocyte suppression iv) 500 - 1000 mg intravenously (Regime varies according to indication). Starting dose may be given fortnightly then at monthly intervals followed by 3 monthly intervals v) 500 mg infusion on the 2nd day of the dexamethasone- cyclophosphamide pulsed regime, the cycle is repeated every 4 weeks up to 6 cycles or till remission followed by oral cyclophosphamideUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 69 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) ADULT: 600 - 750 mg/m2 IV once every 3 weeks as part of combination regime. CHILD: Dose variable depending on disease and protocol. Range 600 mg/m2 to 2 g/m2 infusion over 1 hour to 6 hours (lower doses can be given as bolus). Care with pre and post-hydration. Mesna to be given with doses more than 1 g/m2. Higher doses are used in i) Solid tumours (adult and haematopoetic stem cell paediatric), leukaemia, non- transplant-refer to specific Hodgkin's lymphoma, protocols multiple myeloma ii) 750 mg/m2 BSA monthly ii) Severe lupus nephritis for 18 months iii) 750 mg/m2414 Cyclophosphamide 200 mg L01AA01000P4001X A (Class III and IV) BSA monthly for 6 months. Injection X iii) Other systemic vasculitis Dose can be adjusted up to iv) Systemic lupus 1,000 mg/m2 BSA to achieve erythematosus, rheumatoid adequate leucocyte arthritis, polyarteritis nodosa, suppression wegener granulomatosis iv) 500 - 1000 mg v) Pemphigus vulgaris intravenously (Regime varies according to indication). Starting dose may be given fortnightly then at monthly intervals followed by 3 monthly intervals v) 500 mg infusion on the 2nd day of the dexamethasone- cyclophosphamide pulsed regime, the cycle is repeated every 4 weeks up to 6 cycles or till remission followed by oral cyclophosphamide i) Solid tumours, leukaemia, lymphoma, autoimmune disorders, autoimmune i) ADULT: 50 - 100 mg/day. bullous diseases, connective Monitor full blood count tissue disease, pyoderma (FBC), liver function, urine gangrenosum microscopy and renal ii) For severe lupus nephritis function. CHILD, up to 1415 Cyclophosphamide 50 mg L01AA01000T1001X A (Class III & IV), systemic year: 10 - 20 mg daily, 1 - 5 Tablet X vasculitis and steroid years: 30 - 50 mg daily, 6 - resistant/dependent 12 years: 50 - 100 mg daily nephrotic syndrome ii) 2 mg/kg/day for 3 - 4 iii) Systemic lupus months erythematosus (SLE), iii) 1 - 1.5 mg/kg/day orally in rheumatoid arthritis, divided doses polyarteritis nodosa, wegener granulomatosis416 Cycloserine 250 mg J04AB01000C1001X A* Multi-Drug Resistance ADULT: Initial: 250 mg every Capsule X Tuberculosis treatment 12 hours for 14 days, then administer 0.5 - 1 g daily in 2Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 70 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY failure. (For respiratory divided doses for 18 - 24 physicians) months (maximum daily dose: 1 g). CHILD: 2-12 yr: 5 mg/kg bid; 12-18 yr: 250 mg bid for 2 wk then adjusted to a max dose of 1 g daily To increase tear production in patients whose tear production is presumed to be suppressed due to ocular417 Cyclosporine Ophthalmic S01XA18000D2001X A* inflammation associated with 1 drop twice a day in each Emulsion 0.05% X keratoconjunctivitis sicca. eye approximately 12 hours Increased tear production apart. was not seen in patients currently taking anti inflammatory drugs or using punctal plugs. 1 tablet daily for 21 days on the first day of the cycle, followed by 7 tab free days. Cyproterone Acetate 2 mg G03HB01954T1001 A* Androgen dependent Starting on day 2 to 5 is418 & Ethinyloestradiol 0.035 XX diseases in women allowed, but during the first cycle a barrier method is mg Tablet recommended for the first 7days of tablet taking. i) After orchidectomy, 100 mg once daily or twice daily ii) If used together with LHRH agonists, the initial dose is419 Cyproterone Acetate 50 mg G03HA01122T1001 A* Carcinoma of prostate 100 mg twice daily for 5 to 7 Tablet XX days before the start of LHRH agonist, then 100 mg twice daily for 3 to 4 weeks together with the LHRH agonist Standard doses 100 - 200 mg/m2 daily over 5 - 10 days.420 Cytarabine 1 g Injection L01BC01000P4004X A i) Central nervous system Higher doses for X lymphoma intensification/consolidation: ii) Meningeal leukemia 1000 - 3000 mg/m2 daily iii) Non Hodgkin's Lymphoma over 3 - 5 days depending on iv) High dose cytarabine as specific protocols. CHILD: conditioning to cytoreduce Dose variable depending on the disease before stem cell disease and protocol. Range transplant for relapsed or from 100 mg/m2 to 3 g/m2 refractory leukemia twice daily. May be given as v) As salvage for acute SC, IV bolus or infusion. lymphocytic leukemia Intrathecal dose: Less than 1 vi) As salvage for acute year: 15 mg, 1 - 2 years: 20 myeloid leukemia mg, 2 - 3 years: 25 mg, more vii) As palliative than 3 years: 30 mg. chemotherapy in elderly (ENSURE THAT acute myeloid leukemia/ PREPARATION IS myelodysplastic syndrome SUITABLE FOR INTRATHECAL USE)Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 71 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Standard doses 100 - 200 mg/m2 daily over 5 - 10 days.421 Cytarabine 100 mg Injection L01BC01000P4002X A i) Central nervous system Higher doses for X lymphoma intensification/consolidation: ii) Meningeal leukemia 1000 - 3000 mg/m2 daily iii) Non Hodgkin's Lymphoma over 3 - 5 days depending on iv) High dose cytarabine as specific protocols. CHILD: conditioning to cytoreduce Dose variable depending on the disease before stem cell disease and protocol. Range transplant for relapsed or from 100 mg/m2 to 3 g/m2 refractory leukemia twice daily. May be given as v) As salvage for acute SC, IV bolus or infusion. lymphocytic leukemia Intrathecal dose: Less than 1 vi) As salvage for acute myeloid leukemia year: 15 mg, 1 - 2 years: 20 vii) As palliative mg, 2 - 3 years: 25 mg, more chemotherapy in elderly than 3 years: 30 mg. acute myeloid leukemia/ (ENSURE THAT myelodysplastic syndrome PREPARATION IS SUITABLE FOR INTRATHECAL USE) Standard doses 100 - 200422 Cytarabine 500 mg Injection L01BC01000P4003X A i) Central nervous system mg/m2 daily over 5 - 10 days. X lymphoma Higher doses for ii) Meningeal leukemia intensification/consolidation: iii) Non Hodgkin's Lymphoma 1000 - 3000 mg/m2 daily iv) High dose cytarabine as over 3 - 5 days depending on conditioning to cytoreduce specific protocols. CHILD: the disease before stem cell Dose variable depending on transplant for relapsed or disease and protocol. Range refractory leukemia from 100 mg/m2 to 3 g/m2 v) As salvage for acute twice daily. May be given as lymphocytic leukemia SC, IV bolus or infusion. vi) As salvage for acute Intrathecal dose: Less than 1 myeloid leukemia year: 15 mg, 1 - 2 years: 20 vii) As palliative mg, 2 - 3 years: 25 mg, more chemotherapy in elderly than 3 years: 30 mg. acute myeloid leukemia/ (ENSURE THAT myelodysplastic syndrome PREPARATION IS SUITABLE FOR INTRATHECAL USE)Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 72 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) Following total knee replacement: Initially ADULT 110mg (ELDERLY, 75 mg) within 1- 4 hours after surgery, then 220 mg (ELDERLY, 150 mg) once daily thereafter for 6-10 days Following total hip replacement: Initially ADULT 110 mg (ELDERLY, 75 mg) within 1- 4 hours after surgery, then 220 mg (ELDERLY, 150 mg) once daily thereafter for 28-35 days423 Dabigatran Etexilate 110 B01AE07999C1002X A* i) Prevention of venous ii) Recommended daily dose mg Capsule X thromboembolic events in is 300mg taken orally as patients who have undergone 150mg hard capsule twice total knee replacement or daily. Therapy should be total hip replacement continued lifelong. surgery. iii) Recommended daily dose ii) Reduction of the risk of is 300mg taken as one stroke and systemic 150mg capsule BD following embolism in patients with treatment with a parenteral non-valvular atrial fibrillation anticoagulant for at least 5 (AF). days. The duration of therapy iii) Treatment of deep vein should be individualized after thrombosis (DVT) and careful assessment of the pulmonary embolism (PE) treatment benefit against the and prevention of recurrent risk for bleeding. ii) & iii) For DVT and PE in adults. the following groups, the recommended daily dose is 220 mg taken as one 110mg capsule twice daily: - Patients aged 80 years or above - Patients who receive concomitant verapamil Special patient population for renal impairment: Renal function should be assessed by calculating the creatinine clearance (CrCl) prior to initiation of treatment with Dabigatran to exclude patients for treatment with severe renal impairment (i.e. CrCl < 30 ml/min). Following total knee replacement: Initially ADULT 110 mg (ELDERLY, 75 mg) Prevention of venous within 1- 4 hours after thromboembolic events in surgery, then 220 mg Dabigatran Etexilate 75 mg B01AE07999C1001X424 Capsule X A* patients who have undergone (ELDERLY, 150 mg) once total knee replacement or daily thereafter for 6-10 days total hip replacement surgery Following total hip replacement: Initially ADULT 110 mg (ELDERLY, 75 mg) within 1- 4 hours afterUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 73 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY surgery, then 220 mg i) Reduction of the risk of (ELDERLY, 150 mg) once daily thereafter for 28-35 stroke and systemic days embolism in patients with i) Recommended daily dose non-valvular atrial fibrillation is 300mg taken orally as 150mg hard capsule twice425 Dabigatran Etexilate150 mg B01AE07999C1003X A* (AF). daily. Therapy should be Capsule X ii) Treatment of deep vein continued lifelong. ii) Recommended daily dose thrombosis (DVT) and is 300mg taken as one 150mg capsule BD following pulmonary embolism (PE) treatment with a parenteral and prevention of recurrent anticoagulant for at least 5 days. The duration of therapy DVT and PE in adults. should be individualized after careful assessment of the i) Malignant melanoma, treatment benefit against the risk for bleeding. For the426 Dacarbazine 100 mg L01AX04000P4001X A* sarcomas, neuroblastomas following groups, the Injection X and other childhood solid recommended daily dose is tumours 220 mg taken as one 110mg capsule twice daily: - Patients ii) Hodgkin's Disease aged 80 years or above - Patients who receive427 Danazol 100 mg Capsule G03XA01000C1001 i)Endometriosis and concomitant verapamil XX gynaecomastia Special patient population for renal impairment: Renal A/KK ii)Menorrhagia function should be assessed iii)Prophylaxis of hereditary by calculating the creatinine clearance (CrCl) prior to angioedema initiation of treatment with Dabigatran to exclude428 Danazol 200 mg Capsule G03XA01000C1002 i) Endometriosis and patients for treatment with XX gynaecomastia severe renal impairment (i.e. A/KK ii) Menorrhagia CrCl < 30 ml/min). iii) Prophylaxis of hereditary angioedema i) 250 mg/m2 for 5 days, may be repeated every 3 weeks429 Dapsone 100 mg Tablet J04BA02000T1001X B i)Leprosy ii) 375 mg/m2 IV every 2 X ii) Dermatitis herpetiformis weeks i)200 - 800 mg daily for max of 9 months ii)200 mg daily for 12 weeks ii)400 mg daily. Reduce to 200 mg daily after 2 months attack free period i) 200 - 800 mg daily for max of 9 months ii) 200 mg daily for 12 weeks ii) 400 mg daily. Reduce to 200 mg daily after 2 months attack free period i) ADULT: 6 - 10 mg/kg weekly/ 1.4mg/kg daily (around 50 - 100 mg daily). CHILD: 1 - 2 mg/kg/day.Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 74 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Maximum: 100 mg/day ii) ADULT: 50 - 300 mg daily i) 45 - 60 mg/m2 IV daily for 3 - 5 days ii) 25 - 45 mg/m2 once a week for first 4 weeks during induction phase. Caution: Total cumulative dose of i) Acute myeloblastic daunorubicin and doxorubicin must not exceed 500 mg/m2430 Daunorubicin HCl 20 mg L01DB02110P4001X A* leukaemia (AML) due to risk of cardiotoxicity. Injection X ii) Acute lymphoblastic CHILD: 30-45 mg/m2/dose leukemia (ALL) infusion over 6 hours. Schedule depends on protocol. Need to check cardiac function closely by echocardiography every cumulative dose of 100mg/m2 to max. 360 mg/m2 Myelodysplastic syndromes (MDS) including: Previously treated and untreated de novo and secondary MDS of431 Decitabine 50 mg Injection L01BC08000P3001X A* all French-American-British 15 mg/m2 by continuous IV X subtypes (refractory anemia, infusion over 3 hours refractory anemia with ringed repeated every 8 hours for 3 sideroblasts, refractory days. Repeat this treatment anemia with excess blasts, cycle every 6 weeks for a refractory anemia with minimum of 4 cycles. excess blasts in However, complete or partial transformation, and chronic response may take longer myelomonocytic leukemia) than 4 cycles. Treatment may and Intermediate-1, be continued as long as there Intermediate-2, and High- is continued Risk International Prognostic Scoring System (IPSS) groups432 Deferasirox 125 mg V03AC03000T4001X A* Treatment of chronic iron Initial 20 mg/kg/day. Starting Dispersible Tablet X overload due to blood dose can also be based on transfusions (transfusional transfusion rate and existing haemosiderosis) in adult and iron burden. Max is 30 pediatric patients aged 2 mg/kg/day years and above433 Deferasirox 500 mg V03AC03000T4002X A* Treatment of chronic iron Initial 20 mg/kg/day. Starting Dispersible Tablet X overload due to blood dose can also be based on transfusions (transfusional transfusion rate and existing haemosiderosis) in adult and iron burden. Max is 30 pediatric patients aged 2 mg/kg/day years and above Treatment of iron overload in434 Deferiprone 500 mg Tablet V03AC02000T1001X A* patients with thalassemia 25 mg/kg 3 times a day for X major for whom total daily dose of 75 mg/kg. desferrioxamine therapy is Doses greater 100 mg/kg are contraindicated or not recommended inadequate. Add on therapy to desferrioxamine forUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 75 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY thalassemia patients with cardiac complication A single subcutaneous Denosumab in 1.0 mL Post-Menopausal injection of 60 mg Osteoporosis. (To be used by administered once every 6 solution (60 mg/mL) Pre‐ M05BX04000P4001435 filled syringe (subcutaneous XX A* Orthopaedic Specialist, months. Patients should Rheumatologist and receive calcium and vitamin injection) Endocrinologist) D supplements whilst undergoing treatment. i) 2 g by IM immediately and 5 g by mouth after gastric i) Acute iron poisoning in lavage children ii) 0.5 - 1.5 g by IM injection ii) Investigation and treatment daily Desferrioxamine B V03AC01196P3001X A of haemochromatosis iii) Diagnosis: 5 mg per kg by436 Methanesulphonate 0.5 g X iii) Diagnosis and treatment slow intravenous infusion of aluminium toxicity in during the last hour of Injection patients with renal failure and haemodialysis. Treatment: 5 dialysis mg per kg once a week by iv) Chronic iron toxicity or slow intravenous infusion overload during the last hour of dialysis iv) 30 - 50 mg/kg ADULT: Induction, initially 3% in oxygen or nitrous oxide/oxygen and increased by 0.5%-1% every 2-3 i) Induction and maintenance breaths or as tolerated (up to437 Desflurane Liquid N01AB07000L5001X A of anaesthesia in adult 11%), until loss of X ii) Maintenance of consciousness. Maintenance: anaesthesia in infants & 2.5%-8.5% with or without children concomitant nitrous oxide CHILD: maintenance, inhaled in concentrations of 5.2%- 10% with or without concomitant nitrous oxide R06AX27000T1001X Allergic rhinitis and chronic Adults and Adolescents (12 X idiopathic urticaria years of age and older): 5mg438 Desloratadine 5 mg Tablet A* once a day regardless of mealtime. i)ADULT and CHILD : 0.1- 0.2mg 3 times daily, up to i) Central diabetes insipidus 0.1-1.2mg daily Desmopressin 0.1 mg H01BA02122T1001X ii) Primary nocturnal enuresis ii) ADULT & Child≥5 yr 0.2- Tablet X439 A iii) Treatment of nocturia 0.4mg at night associated with nocturnal iii)Initially 0.1 mg at night. polyuria in adult May be increased to 0.2 mg and then to 0.4 mg by means of weekly increase440 Desmopressin 0.2 mg H01BA02122T1002X A i) Central diabetes insipidus i) ADULT and CHILD : 0.1- Tablet X ii) Primary nocturnal 0.2mg 3 times daily, up to enuresis 0.1-1.2mg daily ii) Treatment of nocturia ii) ADULT & Child≥5 yr 0.2- associated with nocturnal 0.4mg at night polyuria in adult iii) Initially 0.1 mg at night. May be increased to 0.2 mgUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 76 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY and then to 0.4 mg by means of weekly increase441 Desmopressin 100 mcg/ml H01BA02122A4101X A i) Diabetes Insipidus i) ADULT: 10 - 20 mcg 1-2 Nasal Spray X A ii) Primary nocturnal enuresis times daily. CHILD: 5 - 10mcg 1-2 times daily442 Desmopressin Acetate 4 H01BA02122P3001X Diabetes insipidus ii) 10-40 mcg nocte mcg/ml Injection X ADULT: 1 - 4 mcg IV daily. Contraception. Only for CHILD :0.4 mcg daily443 Desogestrel 0.075 mg G03AC09000T1001 A* women who should not take Tablets must be taken in the Tablet XX combined oral contraceptives order directed on the (COCs) eg Obese, smoker, package every day at about Desogestrel 150 mcg & G03AA09954T1002X A/KK migraine, breast feeding the same time with some444 Ethinylestradiol 20 mcg X C+ liquid as needed. One tablet A* Oral contraception is to be taken daily for 28 Tablet consecutive days. Each Contraception subsequent pack is started Desogestrel 150 mcg & G03AB05954T1001X immediately after finishing445 Ethinylestradiol 30 mcg X Major depression the previous pack. One tablet daily for 21 days Tablet N06AX23999T5002X i) Prophylaxis and starting on 1st day of menses X management of nausea and followed by 7 tablet-free Desvenlafaxine Succinate vomiting in cancer days.446 50 mg Extended Release chemotherapy, post- 1 tablet daily for 21 days, operation and palliative care, subsequent courses Tablet ii) Treatment of repeated after 7 day interval adrenocortical function (during which withdrawal447 Dexamethasone 0.5 mg H02AB02000T1001X A abnormalities, bleeding occurs) Tablet X iii) Any other treatment Recommended dose is 50mg requiring corticosteroid once daily, with or without448 Dexamethasone 4mg H02AB02000T1003X A therapy. food. Tablet X i) Prophylaxis and management of nausea and 0.5mg to 10mg daily is given vomiting in cancer for oral administration, chemotherapy, post- depending upon the disease operation and palliative care, being treated. Up to 15 mg ii) Treatment of daily in severe disease. adrenocortical function abnormalities, 0.5mg to 10mg daily is given iii) Any other treatment for oral administration, requiring corticosteroid depending upon the disease therapy. being treated.Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 77 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Dexamethasone and S01CA01990G5101 A Treatment of ocular Apply 1 - 1.5 cm 3 - 4 times449 Neomycin Sulphate and XX inflammation when daily, may be used concurrent use of an adjunctively with drops at Polymyxin B Eye Ointment antimicrobial is judged bedtime necessary Dexamethasone and S01CA01990D2001 Treatment of ocular 1 - 2 drops hourly for severe Neomycin Sulphate and XX inflammation when cases and 4 - 6 hourly for450 Polymyxin B Sulphate A concurrent use of an mild infection antimicrobial is judged Ophthalmic Suspension necessary451 Dexamethasone Sodium S01BA01162D2001X A Acute steroid responsive 1 - 2 drops 4 - 6 times a day Phosphate 0.1% Eye Drops X inflammatory and allergic conditions i) Prophylaxis and management of nausea and vomiting in cancer Dexamethasone Sodium H02AB02162P3001X B chemotherapy, post- Initially 0.5 - 9 mg IM, IV or452 Phosphate 4 mg/ml X operation and palliative care, infusion daily, depending ii) Treatment of upon the disease being Injection adrenocortical function treated abnormalities, iii) Any other treatment requiring corticosteroid therapy.453 Dexchlorpheniramine R06AB02253T1001X B Symptomatic treatment of ADULT: 2 mg 3 times daily. Maleate 2 mg Tablet X allergic rhinitis and allergic CHILD : 2 - 12 years : 2 mg 3 dermatoses times daily CHILD 2 - 5 years : 0.5 mg454 Dexchlorpheniramine R06AB02253L9001X B Symptomatic treatment of every 4 - 6 hours; 6 - 11 Maleate 2 mg/5 ml Syrup X allergic rhinitis years : 1 mg every 4 - 6 hours i) Not to be infused for more i) Sedation of intubated and than 24 hours, 1 mcg/kg over mechanically ventilated ICU 10 minutes as loading dose. N05CM18110P4001 patients. For use only by Maintenance dose: 0.2 - 0.7 Dexmedetomidine HCl 100 XX specialist anaesthetist mcg/kg/hr455 mcg/ml Injection A* ii) For sedation of non- ii) Not to be infused for more intubated patients prior to than 24 hours, 1 mcg/kg over and/or during surgical and 10 minutes as loading dose. other procedures Maintenance dose: 0.2 - 0.7 mcg/kg/hr456 Dextran 40 Injection B05AA05000P6001X A* Condition associated with Initially 500-1000 ml by X peripheral local slowing of infusion, further doses are the blood flow, prophylaxis of given according to the post surgical thromboembolic patient's condition disease For parenteral replenishment457 Dextrose 10% Injection B05BA03000P6002X B of fluid and minimal According to the needs of the X carbohydrate calories as patient required by the clinical condition of the patient For parenteral replenishment of fluid and minimal458 Dextrose 20% Injection B05BA03000P6003X B carbohydrate calories as According to the needs of the X required by the clinical patient condition of the patientUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 78 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE459 Dextrose 30% Injection B05BA03000P3004X CATEGORY For parenteral replenishment of fluid and minimal According to the needs of the460 Dextrose 5% Injection X B carbohydrate calories as patient B05BA03000P6001X B required by the clinical461 Dextrose 50% Injection B condition of the patient According to the needs of the462 Dextrose Powder X B For parenteral replenishment patient B05BA03000P3005X of fluid and minimal Diatrizoate Meglumine and A carbohydrate calories as According to the needs of the463 Sodium Amidotrizoate X required by the clinical patient V04CA02000F2101X B condition of the patient Solution For parenteral replenishment 75 g stat X C of fluid and minimal464 Diazepam 2 mg Tablet carbohydrate calories as i) ADULT and CHILD more V08AA01254L9901X required by the clinical than 10 year, ORALLY: 60 -465 Diazepam 5 mg Rectal X condition of the patient 100 ml RECTALLY, contrast Solution Use as a diagnostic agent for medium should be diluted N05BA01000T1001X diabetes with 3-4 times its volume of X water. ORALLY: CHILD less i) Contrast medium for the than 10 years,: 15- 30 ml N05BA01000G2001 radiological examination of NEWBORN, INFANT XX the gastrointestinal tract contrast medium should be (primarily in cases in which diluted with 3 times its barium sulphate is volume of water. RECTALLY: contraindicated) CHILD more than 5 years, ii) Computerised tomography contrast medium should be in abdominal region diluted with 4-5 times its iii) Treatment of Mecolinium volume of water. Younger ileus patients a dilution with 5 times its volume is i) Muscle spasm of varied recommended aetiology, including tetanus ii) Adult, orally, 25-77 mL in ii) Anxiety disorders 1000 mL tap water 15-30 minutes prior to imaging Status epilepticus, skeletal i) ADULT: 2-10 mg 3-4 times muscle spasm daily. CHILD 6 months and older: 0.12 - 0.8 mg/kg daily in divided doses, every 6-8 hours ii) ADULT: 2 mg 3 times daily, increased in severe anxiety to 15 - 30 mg daily in divided doses. ELDERLY (or delibitated) half adult dose. CHILD (night terrors), 1 - 5 mg at bedtime Status epilepticus - ADULT: 0.5 mg/kg repeated after 12 hours if necessary. CHILD (febrile convulsions, prolonged or recurrent): 0.5 mg/kg (maximum 10 mg), repeated if necessary. NotUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 79 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY recommended for children below 2 years i) ADULT: 2-10 mg 3-4 times daily. CHILD 6 months and older: 0.12 - 0.8 mg/kg daily in divided doses, every 6-8466 Diazepam 5 mg Tablet N05BA01000T1002X B i) Muscle spasm of varied hours X aetiology, including tetanus ii) ADULT: 2 mg 3 times ii) Anxiety disorders daily, increased in severe anxiety to 15 - 30 mg daily in divided doses. ELDERLY (or delibitated) half adult dose. CHILD (night terrors), 1 - 5 mg at bedtime i) Status epilepticus, by slow IV: 5-10 every 10-15 minute (rate not more than 5 mg/min), to a total dose of 30 mg, may repeat in 2 hour if needed. Infants 30 days to 5 years, 0.05-0.3 mg/kg/dose given over 2-3 minutes, every 15-30 minutes to a total dose of 5 mg, repeat in 2-4 hours if necessary. CHILD more than 5 years, 1 mg by slow IV,467 Diazepam 5 mg/ml Injection N05BA01000P3001X B i) Status epilepticus every 2-5 minutes, maximum X ii) Skeletal muscle spasm 10 mg, repeat in 2-4 hours if iii) Anxiety disorders necessary ii) Skeletal muscle spasm, by slow IV or IM, 5-10 mg repeated if necessary in 3-4 hours. CHILD (tetanus): 30 days - 5 years, 1-2 mg IM or IV slowly every 3-4 hours as needed. 5 years and above, 5-10 mg IM or IV slowly every 3-4 hours if needed iii) Anxiety disorders, 2-10 mg by slow IV (not more than 5 mg/min). Repeat if necessary every 3-4 hours Post-traumatic inflammation of the tendons, ligaments &468 Diclofenac 1% Gel M02AA15520G3001 A joints. Localised forms of soft Apply 3 - 4 times daily and XX tissue rheumatism and gently rubbed in degenerative rheumatism Diclofenac Suppositories are469 Diclofenac 100mg M01AB05520S2004 A Pain and inflammation in normally inserted one, two or Suppository XX rheumatic disease and three times a day up to a juvenile arthritis maximum total daily dose of 150 mg.470 Diclofenac 12.5 mg M01AB05520S2001 A Pain and inflammation in ADULT: 75 - 150 mg daily in Suppository XX rheumatic disease and divided doses. CHILD 1-12 juvenile arthritis years, 12.5- 25 mg dailyUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 80 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY471 Diclofenac 25 mg M01AB05520S2002 A Pain and inflammation in ADULT: 75 - 150 mg daily in Suppository XX rheumatic disease and divided doses. CHILD 1-12 juvenile arthritis years, 12.5- 25 mg daily ADULTS: Initial dose of 150 mg daily. Mild or long term: 75 - 150 mg daily in 2 to 3 divided doses after food.472 Diclofenac 50 mg Tablet M01AB05520T1001 B Pain and inflammation in Maximum 200mg/day. XX rheumatic disease PAEDS more than 6 months: 1 - 3 mg/kg body weight daily in divided doses. Maximum 3mg/kg/day (Max 150mg/day). ADULTS: 75 - 150 mg daily in divided doses. Maximum Pain and inflammation in 150mg/day. PAEDS more473 Diclofenac Sodium 50 mg M01AB05520S2003 A rheumatic disease and than 6 months: 1 - 3 mg/kg Suppository XX juvenile arthritis body weight daily in divided doses. Maximum 3mg/kg/day (Max 150mg/day). IM 75 mg once daily (2 times474 Diclofenac Sodium 75 mg/3 M01AB05520P3001 A/KK Pain and inflammation in daily in severe cases) for not ml Injection XX rheumatic disease more than 2 days. Max 150mg/day. Not suitable for children. ADULT less than 60 kg: 125 mg twice daily or 250 mg once daily; more than 60 kg:475 Didanosine 100 mg Tablet J05AF02000T1002X A* HIV infection, in combination 400 mg once daily or 200 mg (ddI) X with other antiretrovirals twice daily. CHILD: 2 weeks to less than 3 months: 50mg/m2 twice daily; 3-8 months: 100mg/m2 twice daily ADULT less than 60 kg: 125 mg twice daily or 250 mg once daily; more than 60 kg: 400 mg once daily or 200 mg476 Didanosine 2 g Oral J05AF02000F2101X A* HIV infection, in combination twice daily. CHILD: 2 weeks Solution (ddI) X with other antiretrovirals to less than 3 months: 50mg/m2 twice daily; 3-8 months: 100mg/m2 twice daily ADULT less than 60 kg: 125 mg twice daily or 250 mg once daily; more than 60 kg:477 Didanosine 25 mg Tablet J05AF02000T1001X A* HIV infection, in combination 400 mg once daily or 200 mg (ddI) X with other antiretrovirals twice daily. CHILD: 2 weeks to less than 3 months: 50mg/m2 twice daily; 3-8 months: 100mg/m2 twice daily ADULT less than 60 kg: 250478 Didanosine 250 mg Enteric J05AF02000C1001X A* HIV infection, in combination mg once daily; 60 kg or Coated Capsule X with other antiretrovirals greater: 400 mg once daily. Dose may varies if taken in combination with tenofovirUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 81 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY ADULT less than 60 kg: 250 mg once daily; 60 kg or479 Didanosine 400 mg Enteric J05AF02000C1002X A* HIV infection, in combination greater: 400 mg once daily. Coated Capsule X with other antiretrovirals Dose may varies if taken in combination with tenofovir One tablet daily. Treatment can be started on any day of480 Dienogest 2mg tablet G03DB08000T1001 A/KK Treatment of endometriosis menstrual cycle. Tablets XX must be taken continously without regard to vaginal bleeding. i) 1 mg/kg on the first day and increased gradually over481 Diethylcarbamazine Citrate P02CB02136T1001X B i) Bancrofti filariasis, 3 days to 6 mg/kg daily in 50 mg Tablet X onchocerciasis, loasis, divided doses. This dosage is creeping eruption maintained for 21 days. ii) Ascariasis ii) 13 mg/kg once daily for 7 iii) Tropical eosinophilia days. CHILD : 6 - 10 mg/kg 3 times daily for 7 days iii) 6 mg/kg/day in 3 divided doses for 21 days Rapid digitalisation: 0.75 -1.5 mg in divided doses over 24 hours; less urgent digitalisation, 250 mcg-500 mcg daily (higher dose may Heart failure , with atrial be divided). Maintenance :482 Digoxin 0.25 mg Tablet C01AA05000T1001X B fibrillation, supraventricular 62.5mg -500 mcg daily X arrhythmias (particularly, (higher dose may be divided) atrial fibrillation) according to renal function and in atrial fibrillation,on heart rate response; usual range, 125-250 mcg daily (lower dose may be appropriate in elderly)483 Digoxin 250 mcg/ml C01AA05000P3001X A Heart failure with atrial Rapid digitilisation: ADULT & Injection X fibrillation, supraventricular CHILD over 10 years, initially arrhythmias (particularly atrial 0.75 - 1.5 mg, followed by fibrillation) 250 mcg 6 hourly until digitilisation is complete Rapid digitalization, give in divided doses; PREMATURE: 20-30 mcg/kg; FULLTERM: 25-35 mcg/kg; CHILD 1-2 years : 35 to 60 mcg/kg; CHILD 2-5 years: 30-40 mcg/kg; CHILD C01AA05000L1001X Heart failure, supraventricular 5-10 years: 20- 35 mcg/kg;484 Digoxin 50 mcg/ml Elixir X B arrhythmias (particularly atrial CHILD over 10 years: 10-15 fibrillation) mcg/kg. For daily maintenance doses or for gradual digitalization, give 20% to 30% of oral digitalizing dose for premature infants or 25% to 35% of oral digitalizing dose for all other pediatric patientsUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 82 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Rapid digitalisation: 1-1.5 mg in divided doses over 24 hours; less urgent digitalisation, 250 mcg-500 mcg daily (higher dose may Heart failure, with atrial be divided). Maintenance: C01AA05000T1002X fibrillation, supraventricular 62.5 - 500 mcg dailly (higher485 Digoxin 62.5 mcg Tablet X B arrhythmias (particularly, dose may be divided) atrial fibrillation) according to renal fuction, and in atrial fibrillation, on heart-response; usual range :125 - 250 mcg daily (lower doses may be appropriate in the elderly) ADULT: 30 - 60 mg every 4 -486 Dihydrocodeine Tartrate 30 N02AA08123T1001X B For the control of moderate 6 hours. PAED, over 4 yrs: mg Tablet X to severe chronic pain 0.5 - 1 mg/kg body weight every 4-6 hours Dihydroergocristine or Co- C04AE01196T1001X A/KK Adjunct in elderly with mild to 3-6 mg daily in divided doses487 dergocrine Mesilate 1 mg X moderate dementia, prevention of migraine and Tablet vascular headache Treatment of angina pectoris in the following cases: i) inadequate response or Initially 30mg tds, may488 Diltiazem HCl 30 mg Tablet C08DB01110T1001X B intolerance to beta-blockers increase to 60mg tds (elderly X and Isosorbide Dinitrate initially twice daily; increased ii) contraindication to beta- if necessary to 360 mg daily. blockers iii) coronary artery spasm Usual Adult & Adolescent Dose: Antiemetic; or Antivertigo agent: Intramuscular, 50 mg repeated every four hours as needed. Intravenous, 50 mg in 10 mL of 0.9% sodium chloride injection, administered slowly over a period of at least two489 Dimenhydrinate Injection N07CA00000P2001 B Prevention and relief of minutes, repeated every four 10ml/vial (50mg/ml) XX motion sickness, treatment of hours as needed. Usual vertigo, nausea or vomiting Pediatric Dose: Antiemetic; associated with electroshock or Antivertigo agent: therapy, anaesthesia and Intramuscular, 1.25 mg per surgery; labyrinthine kg of body weight or 37.5 mg disturbances and radiation per square meter of body sickness. surface, every six hours as needed, not to exceed 300 mg per day. Intravenous, 1.25 mg per kg of body weight or 37.5 mg per square meter of body surface, in 10 ml of 0.9% sodium chloride injection, administered slowly over a period of at least two minutes, every six hours asUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 83 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY needed, not to exceed 300 mg per day. For prevention and treatment ADULT: 50-100 mg every 4 of motion sickness. Also hours as needed. For motion used as anti-emetic agent in sickness, take medicine at irradiation sickness, least 30 minutes, and490 Dimenhydrinate Syrup N07CA00000L9003X B postoperative vomiting, drug preferably 1-2 hours before 15mg/5ml X induced nausea and travelling. Usual adult vomiting, and for prescribing limit: Up to 400 symptomatic treatment of mg daily. CHILD: Children 6- nausea and vertigo due to 12 years: 25-50 mg every 6-8 Meniere`s disease and other hours as needed (maximum labyrinthine disturbances. of 150 mg daily). ADULT: 50-100 mg every 4491 Dimenhydrinate Tablet N07CA00000T1001X B Prevention and treatment of hours as needed. For motion 50mg X the nausea, vomiting and sickness, take medicine at dizziness associated with least 30 minutes, and motion sickness. preferably 1-2 hours before Symptomatic treatment of travelling. Usual adult nausea and vertigo caused prescribing limit: Up to 400 by Meniere's disease and mg daily. CHILD: 6-12 years: other vestibular disturbances. 25-50 mg every 6-8 hours as needed (maximum of 150 mg daily). By IM: 2.5 - 3 mg/kg every 4492 Dimercaprol 50 mg/ml V03AB09000P3001X B Poisoning by antimony, hours for 2 days, 2 - 4 times Injection X arsenic, bismuth, gold, on the third day, then 1 - 2 mercury, possibly thallium; times daily for 10 days or adjunct (with calcium until recovery. For ophthalmic disodium edetate) in lead use : instillation of 50 mg/ml poisoning oily solution in conjunctival sac, within 5 minutes of contamination 3 mg vaginal tablet to be Dinoprostone (Prostagladin inserted high into the E2) 3 mg Vaginal Tablet G02AD02000S1001 posterior formix. A second 3493 XX A Induction of labour mg tablet may be inserted after 6-8 hours if labour is not established. Max 6 mg i) Acute attack: 6 tablets daily i) Haemorrhoids for the first 4 days, then 4 ii) Chronic venous tablets daily in 2 divided494 Diosmin 450 mg and C05CA53931T1001X A/KK insufficiency doses for 3 days and 2 Hesperidin 50 mg Tablet X tablets thereafter. Chronic: 2 tablets daily ii) 2 tab daily with mealsUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 84 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Diphenhydramine R06AA02110L1001X Cough and allergic rhinitis Allergic rhinitis495 Hydrochloride 10 mg/5 ml X C 1) Adults & Children over 12 Cough years of age: 25 to 50 mg 3 Oral solution R06AA52110L2101X C to 4 times a day X C Cough 2) Children 6 to 12 years of Diphenhydramine B Acute diarrhoea age: 10 mg 3 to 4 times a496 Hydrochloride 14 mg/5 ml R06AA52110L9003X C+ Immunisation against day X B diphtheria and tetanus 3) Children 1 to 6 years of Expectorant C age: 5 mg 3 to 4 times a day. A07DA01922T1001X C+ Diphtheria Maximum daily dosage <300 Diphenhydramine X Immunisation of children mg (adults and children)497 Hydrochloride 7 mg/5 ml against Haemophilus Type B Cough and cold J07AM51963P3001X infections, diphtheria, tetanus 1) Adults: 25 mg every 4 hrs. Expectorant X and pertussis Not to exceed 150 mg in 24 Active immunisation against hours Diphenoxylate HCl 2.5mg J07AF01000P3001X diphtheria, tetanus, pertussis 2) Children (6 to 12years):498 with Atropine Sulphate X and hepatitis B in infants 12.5 mg every 4 hours. Not from 6 weeks onwards to exceed 75 mg in 24 hours 0.025mg Tablet J07AG52000P3001X 3) Children (2 to 6 years): X 6.25 mg every 4 hours. Not499 Diphtheria and Tetanus to exceed 25 mg in 24 hours Vaccine Injection J07CA05963P3001X ADULT: 5 - 10 ml 2 - 3 times X daily. CHILD : 2.5 - 5 ml 2 - 3500 Diphtheria Antitoxin times daily (not to be used in Injection children less than 2 years of age) Diphtheria, Pertussis, ADULT: 5 - 10 ml 2 - 3 times Tetanus and Conjugated daily. CHILD : 2.5 - 5 ml 2 - 3501 Haemophilus Type B 10 times daily (not to be used in children less than 2 years of mcg Vaccine age) ADULT initially 4 tablet Diphtheria, Pertussis, followed by 2 tablet 4 times502 Tetanus and Hepatitis B daily until diarrhoea is controlled Vaccine Prophylactic: 2 or 3 doses by deep SC or IM injection, 0.5 or 1 ml. Each second dose at 4 - 6 weeks then 4 - 6 months. Booster at 4 - 6 years Therapeutic: 10,000 - 30,000 units by IM or IV. Increase to 40,000 - 100,000 units in severe cases. Doses up to 30,000 units may be given IM 0.5 ml given by IM Primary vaccination: 3 doses of 0.5 ml each within the first 6 months of life. Administer each dose at intervals of at least 4 weeks. A booster dose can be administered in the second year of lifeUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 85 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY By deep SC or IM injection: 3 doses each of 0.5 or 1 ml503 Diphtheria, Pertussis, J07AJ52963P3001X C Prophylactic immunisation with intervals of 6 - 8 weeks Tetanus Vaccine Injection X against diphtheria, pertussis and 4 - 6 months respectively and tetanus between the doses. Booster 1 and 5 years after primary immunisation Diphtheria, Tetanus, Acellular Pertussis, Immunisation of children Inactivated Polio Virus, against Diphtheria, Tetanus, Primary : 0.5 ml by IM at 1 - 2504 Haemophilus Influenza J07CA06963P3001X C+ Acellular Pertussis, Polio and months intervals Booster : X Haemophilus Influenza Type Second year of life Type B (DTaP-IPV-HiB) Vaccine Injection (Single B infection Dose) B01AC07000T1001X As an adjunct to oral X anticoagulation/ antiplatelet 75-150 mg 3 times daily to be505 Dipyridamole 75 mg Tablet B therapy in the prophylaxis of taken 1 hour before meals cerebrovascular events i) ADULT: 5 mg daily 30 minutes before breakfast. Increase at intervals of 3 - 4 days if necessary to506 Distigmine Bromide 5 mg N07AA03320T1001X A i) Myasthenia gravis maximum of 20 mg daily. Tablet X ii) Prevention and treatment CHILD: Up to 10 mg daily of post-operative intestinal according to age atony, urinary retention and ii) Urinary retention: 5 mg neurogenic bladder daily 30 minutes before breakfast. Neurogenic bladder : 5 mg daily or on alternate days 30 minutes before breakfast507 Dithranol 0.1 - 5% in D05AC01000G5001 A Short contact treatment for For application to skin or Vaseline/ Ointment XX plaque psoriasis and scalp. 0.1-0.5% suitable for alopecia areata overnight treatment. 1-2% for max 1 hour.508 Dithranol 1 % in Lassars D05AC01000G6001 A Treatment of quiescent or Apply liberally and carefully Paste XX chronic psoriasis of the skin, to the lesions with a suitable scalp and alopecia areata applicator. A dressing may be applied Initial 0.5-1 mcg/kg/min by IV, maintenance 2.5- 10mcg/kg/min. Frequently, Dobutamine 12.5 mg/ml C01CA07110P3001 doses up to 20mcg/kg/min509 Injection XX A Hypotension and heart failure are required for adequate hemodynamic improvement. On rare occasions,infusion rates up to 40mcg/kg/minUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 86 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) 75 mg/m2 IV over 1 hour after doxorubicin 50 mg/m2 and cyclophosphamide 500 i) Adjuvant treatment of mg/m2 every 3 weeks for 6 patients with high risk node- cycles positive breast cancer in ii) 75 mg/m2 IV over 1 hour combination with doxorubicin every 3 week in combination and cyclophosphamide with doxorubicin 50 mg/m2 ii) Breast cancer, locally iii) Administer IV over 1 hour advanced or metastatic, not every 3 weeks. previously on cytotoxic Chemotherapy-naive patients therapy, in combination with 75 mg/m2 immediately doxorubicin followed by 75 mg/m2 Docetaxel 40mg/ml L01CD02000P3002X iii) First line therapy in non cisplatin over 30-60 mins or Injection X small cell lung cancer in carboplatin (AUC 6510 A* stage 3- 4 and performance mg/mL/min) over 30-60 status 0-1, in combination minutes. Monotherapy of non with cisplatin small cell lung cancer iv) Inoperable locally (NSCLC) after failure of prior advanced squamous cell platinum-based carcinoma of head and neck, chemotherapy 75 mg/m2 in combination with cisplatin iv) 75 mg/m2 as a 1 hour and 5-FU for induction infusion followed by cisplatin treatment 75 mg/m2 over 1 hour, on v) Prostate cancer, in day one, followed by 5- combination with fluorouracil as a continuous prednisolone infusion at 750 mg/m2 per day for five days. This regimen is administered every 3 weeks for 4 cycles. Chronic dyspepsia: CHILD 2.5 mL/10 kg body weight 3 times daily and once more in the evening if necessary. Domperidone 1 mg/ml A03FA03000L8001X Dosage may be doubled in Suspension X Nausea, vomiting, dyspepsia, adults & childs over 1 year.511 B gastro-esophageal reflux Acute and subacute conditions (particularly nausea and vomiting). CHILD: 5 mL/10 kg bodyweight. All to be taken 3- 4 times daily Chronic dyspepsia ADULT A03FA03253T1001X 10 mg 3 times daily. Acute X Nausea, vomiting, dyspepsia, and subacute conditions512 Domperidone 10 mg Tablet B gastro-esophageal reflux (particularly nausea and vomiting):ADULT 20 mg 3-4 times daily Treatment of mild to moderate dementia in513 Donepezil HCl 10 mg Tablet N06DA02110T1002X A Alzheimer's disease, as well 5 - 10 mg once daily at X as in patients with severe bedtime. Maximum 10 mg Alzheimer's disease. daily [psychiatrists and neurologists only]Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 87 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY Treatment of mild to moderate dementia in 5 - 10 mg once daily at514 Donepezil HCl 5 mg Tablet N06DA02110T1001X A Alzheimer's disease, as well bedtime. Maximum 10 mg X as in patients with severe daily Alzheimer's disease. Treatment of mild to Initiated at 5mg/day (one a day dosing), should be moderate dementia in maintained for at least 1515 Donepezil Hydrochloride N06DA02110T4002X A* Alzheimer's disease, as well month in order to allow the as in patients with severe earliest clinical responses 10mg Orodispersible Tablet X Alzheimer's disease. and to allow steady state [psychiatrists and concentration to be achieved. neurologists only] The maximum recommended daily dose is 10 mg. Treatment of mild to Initiated at 5mg/day (one a day dosing), should be moderate dementia in maintained for at least 1 Alzheimer's disease, as well month in order to allow the516 Donepezil Hydrochloride N06DA02110T4001X A* as in patients with severe earliest clinical responses 5mg Orodispersible Tablet X Alzheimer's disease. and to allow steady state [psychiatrists and concentration to be achieved. neurologists only] The maximum recommended daily dose is 10 mg. Initial dose 2-5 mcg/kg/min with incremental changes of 5-10 mcg/kg/min at 10-15 minutes intervals until517 Dopamine HCl 40 mg/ml C01CA04110P3001 B Non-hypovolemic adequate response is noted. Injection XX hypotension Most patients are maintained at less than 20 mcg/kg/min. If dosage exceeds 50 mcg/kg/min, assess renal function frequently518 Doripenem Monohydrate J01DH04000P4001X A* Ventilator-associated 500mg every 8 hours as a 500 mg Injection X pneumonia (VAP) patients at one hour infusion for 5 to 14 risk or involving multidrug days according to severity, resistant pathogens site of infection and the especially Pseudomonas patient's clinical response. aeruginosa infections Monotherapy: 1 drop 3 times daily. Adjunctive therapy with an ophthalmic beta-blocker: 1 drop 2 times daily. When substituting for another All glaucoma patients where ophthalmic antiglaucoma519 Dorzolamide HCl 2% S01EC03110D2001 A* beta-blockers are agent with this product, Ophthalmic Solution XX contraindicated and when discontinue the other agent intraocular pressure is not after proper dosing on one well controlled by other drugs day and start Trusopt on the next day. If more than 1 topical ophthalmic drug is used, the drugs should be administered at least 10 mins apart520 Dothiepin HCl 25 mg N06AA16110C1001 Initially 75 mg (ELDERLY 50- Capsule XX A Depression of any aetiology 75 mg) daily in divided doses or single dose at bedtime,Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 88 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY increased gradually as necessary to 150 mg daily (ELDERLY 75 mg may be sufficient), up to 225 mg daily in some circumstances. CHILD is not recommended Initially 75 mg (ELDERLY 50- 75 mg) daily in divided doses or single dose at bedtime, increased gradually as521 Dothiepin HCl 75 mg Tablet N06AA16110T1001X A Depression of any aetiology necessary to 150 mg daily X (ELDERLY 75 mg may be sufficient), up to 225 mg daily in some circumstances. CHILD is not recommended522 Doxazosin Mesilate 4 mg C02CA04196T5001X A* Benign Prostatic Hyperplasia 4 mg once daily to maximum CR Tablet X 8mg/day i) 30 - 75 mg/m2 IV as a single dose at 21 day intervals ii) 25 - 45 mg/m2 once a week for the first 4 weeks during induction or re- induction phase (refer to specific protocol. Caution: Total cumulative dose of i) Solid tumours, leukaemia, doxorubicin must not exceed523 Doxorubicin HCl 10 mg L01DB01110P4001X A non-Hodgkin's lymphoma 550 mg/m2 due to risk of Injection X ii) Leukaemia (ALL induction) cardiotoxicity. CHILD: 30 iii) Multiple myeloma mg/m2/dose over 6 - 24 hours for 1 - 2 days. Need to check cardiac function closely by echocardiography every cumulative dose of 100 mg/m2 to maximum 360 mg/m2 iii) 9 mg/m2 over 24 hours infusion for 4 days at monthly intervals i) 30 - 75 mg/m2 IV as a single dose at 21 day intervals ii) 25 - 45 mg/m2 once a week for the first 4 weeks during induction or re- induction phase (refer to i) Solid tumours, leukaemia, specific protocol. Caution: Doxorubicin HCl 50 mg L01DB01110P4002X non-Hodgkin's lymphoma Total cumulative dose of524 Injection X A ii) Leukaemia (ALL induction) doxorubicin must not exceed iii) Multiple myeloma 550 mg/m2 due to risk of cardiotoxicity. CHILD: 30 mg/m2/dose over 6 - 24 hours for 1 - 2 days. Need to check cardiac function closely by echocardiography every cumulative dose of 100 mg/m2 to maximum 360Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 89 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY mg/m2 iii) 9 mg/m2 over 24 hours infusion for 4 days at monthly intervals ADULT: 200 mg on the first525 Doxycycline 100 mg J01AA02000C1001X B Infections due to susceptible day followed by 100 mg daily. Capsule X organisms Severe infections: 200 mg daily ADULT: 200 mg on the first J01AA02000T1001X Infections due to susceptible day followed by 100 mg daily.526 Doxycycline 100 mg Tablet X B organisms Severe infections: 200 mg daily527 D-Penicillamine 0.25 g M01CC01000C1001 A i) Treatment of severe lead i) Heavy metal poisoning: Capsule XX poisoning, it is used as 900mg-1800mg daily. adjunctive treatment Duration of treatment is following initial treatment with dictated by the urinary heavy another chelating agent. May metal excretion. also be used as sole therapy Simultaneous oral vitamin B6 in the treatment of replacement with at least asymptomatic patients with 40mg daily is essential moderately elevated blood ii) Wilson's disease: 0.25g - concentrations 1.5g daily on an incremental ii) Wilson's Disease: to aid in basis. Maximal daily dose: elimination of copper ions 2g. Maintenance dose: 0.75g - 1g daily ADULT: 60 mg once daily up to a maximum dose of528 Duloxetine 30 mg Capsule N06AX21110C1001 A* Major depressive disorder, 120mg/day (in divided doses) XX diabetic peripheral CHILD and ADOLESCENT neuropathic pain under 18 years not recommended ADULT: 60 mg once daily up to a maximum dose of529 Duloxetine 60 mg Capsule N06AX21110C1002 A* Major depression, diabetic 120mg/day (in divided doses) XX peripheral neuropathic pain CHILD and ADOLESCENT under 18 years not recommended530 Dutasteride 0.5 mg Capsule G04CB02000C1001 Benign prostatic hyperplasia 0.5 mg daily XX A* in men with an enlarged prostate gland Combination therapy for the treatment of moderate to severe symptoms of BPH with: Dutasteride 0.5mg and G04CA52953C1001531 Tamsulosin 0.4mg Capsule XX A* i) Large prostate (>30g) One capsule daily ii) Poor risk or not fit for surgery iii)Those who are awaiting their turn for surgery i) Dysmenorrhoea i) 10 mg bd from day 5 - 25 of ii) Endometriosis cycle iii) Dysfunctional uterine ii) 10 mg bd - tds from day 5 - Dydrogesterone 10 mg G03DB01110T1001 bleeding (to arrest and to 25 of the cycle or532 Tablet XX A/KK prevent bleeding) continuously iv) Threatened abortion iii) To arrest bleeding :10 mg v) Habitual abortion bd with an oestrogen once vi) Post menopausal daily for 5 - 7 days, ToUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 90 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY prevent bleeding : 10 mg bd complaints (hormone with an oestrogen once daily replacement therapy in from day 11 - 25 of the cycle combination with oestrogen) iv) 40 mg at once, then 10mg 8hrly until symptoms remit i) For reversal of v) 10 mg bd until 20th week of pregnancy533 Edrophonium Chloride 10 N07AA00100P3001X B neuromuscular block vi) 10-20 mg daily during last mg/ml Injection X ii) Diagnosis of myasthenia 12-14 days of each cycle gravis i) Intravenous injection on over several minutes, 500 - Combination therapy for HIV 700 mcg/kg (after or with infections with a protease atropine sulphate 600 mcg)534 Efavirenz 100 mg Capsule J05AG03000C1002X A* inhibitor and or Nucleoside ii) Intravenous injection 2 mg X Reverse Transcriptase followed by 8 mg if no response occurs within 30 Inhibitors (NRTIs) seconds. CHILD: 20 mcg followed by 80 mcg/kg after Combination therapy for HIV 30 seconds535 Efavirenz 200 mg Capsule J05AG03000C1003X A* infections with a protease ADULT: 600 mg once daily. X inhibitor and or Nucleoside ADOLESCENT & CHILD less Reverse Transcriptase than 17 years, more than 40 kg: 600 mg once daily, 32.5 - Inhibitors (NRTIs) less than 40 kg: 400 mg once daily, 25 - less than 32.5 kg: 350 mg once daily, 20 - less than 25 kg: 300 mg once daily, 15 - less than 20 kg: 250 mg once daily, 13 - less than 15 kg: 200 mg once daily. No studies in children less than 3 years or less than 13 kg. Formulation unsuitable for children less than 40 kg ADULT: 600 mg once daily. ADOLESCENT & CHILD less than 17 years, more than 40 kg: 600 mg once daily, 32.5 - less than 40 kg: 400 mg once daily, 25 - less than 32.5 kg: 350 mg once daily, 20 - less than 25 kg: 300 mg once daily, 15 - less than 20 kg: 250 mg once daily, 13 - less than 15 kg: 200 mg once daily. No studies in children less than 3 years or less than 13 kg. Formulation unsuitable for children less than 40 kg ADULT: 600 mg once daily. Combination therapy for HIV ADOLESCENT & CHILD less infections with a protease than 17 years, more than 40536 Efavirenz 50 mg Capsule J05AG03000C1001X A* inhibitor and or Nucleoside kg: 600 mg once daily, 32.5 - X Reverse Transcriptase less than 40 kg: 400 mg once Inhibitors (NRTIs) daily, 25 - less than 32.5 kg: 350 mg once daily, 20 - lessUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 91 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY than 25 kg: 300 mg once Combination therapy for HIV daily, 15 - less than 20 kg: infections with a protease 250 mg once daily, 13 - less537 Efavirenz 600 mg Tablet J05AG03000T1001X A/KK inhibitor and or Nucleoside than 15 kg: 200 mg once X Reverse Transcriptase daily. No studies in children less than 3 years or less than Inhibitors (NRTIs) 13 kg. Formulation unsuitable for children less than 40 kg Short term use in idiopathic ADULT: 600 mg once daily. thrombocytopenic purpura ADOLESCENT & CHILD less than 17 years, more than 40538 Eltrombopag Olamine 25 B02BX05999T1001X A* patients as bridging therapy kg: 600 mg once daily, 32.5 - mg Film-coated Tablet X for splenectomy or surgery less than 40 kg: 400 mg once daily, 25 - less than 32.5 kg: and in cases of severe 350 mg once daily, 20 - less than 25 kg: 300 mg once bleeding. daily, 15 - less than 20 kg: 250 mg once daily, 13 - less539 Emulsificants Ointment D02AC00952G5001 C Xerosis and ichthyosis than 15 kg: 200 mg once XX daily. No studies in children less than 3 years or less than540 Enalapril 10 mg Tablet C09AA02253T1002X B i) Hypertension 13 kg. Formulation unsuitable X ii) Congestive heart failure for children less than 40 kg Individualised dosage based541 Enalapril 20 mg Tablet C09AA02253T1003X B i) Hypertension on the patient's platelet542 Enalapril 5 mg Tablet X ii) Congestive heart failure count. Adult Initially 50 mg once daily. East Asian patient C09AA02253T1001X B i) Hypertension 25 mg once daily. Then, X ii) Congestive heart failure adjust dose to maintain platelet count ≥50,000/microliter. Max: 75 mg daily. Use as a soap and emollient i) Initially 5 mg daily, (ELDERLY 2.5 mg once daily), usual maintenance dose 10 - 20 mg daily. Maximum: 40 mg/day in 1 - 2 divided doses ii) Initially 2.5 mg daily, usual maintenance dose 20 mg daily in 1 - 2 divided doses; maximum: 40 mg/day i) Initially 5 mg daily, (ELDERLY 2.5 mg once daily), usual maintenance dose 10 - 20 mg daily. Maximum: 40 mg/day in 1 - 2 divided doses ii) Initially 2.5 mg daily, usual maintenance dose 20 mg daily in 1 - 2 divided doses; maximum: 40 mg/day i) Initially 5 mg daily, (ELDERLY 2.5 mg once daily), usual maintenanceUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 92 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY543 Enoxaparin Sodium 20 mg B01AB05520P5001X i) Prevention of Deep Vein dose 10 - 20 mg daily. Injection X A* Thrombosis(DVT) especially Maximum: 40 mg/day in 1 - 2 in perioperative and high risk divided doses544 Enoxaparin Sodium 40 mg B01AB05520P5002X A* surgical cases ii) Initially 2.5 mg daily, usual Injection X ii) Treatment of DVT maintenance dose 20 mg iii) Unstable angina and non daily in 1 - 2 divided doses; Q wave Myocardial Infarction maximum: 40 mg/day i) Prevention of Deep Vein i) Prophylaxis fo DVT Thrombosis(DVT) especially especially in surgical in perioperative and high risk patients: moderate risk, 20 surgical cases mg SC approximately 2 ii) Treatment of DVT hours before surgery then 20 iii) Unstable angina and non mg every 24 hours for Q wave Myocardial Infarction minimum 7 - 10 days, high risk (eg orthopaedic surgery, medical patients, 40mg every 24 hours for at least 6 days until patient ambulant, max 14 days. ii) Treatment of DVT or pulmonary embolism, 1.5 mg/kg every 24 hours, usually for 5 days and until adequate oral anticoagulation established. iii) Unstable angina and non- ST-segment-elevation myocardial infarction 1 mg/kg every 12 hours, usually for 2 - 8 days i) Prophylaxis for DVT especially in surgical patients: moderate risk, 20 mg SC approximately 2 hours before surgery then 20 mg every 24 hours for minimum 7 - 10 days, high risk (eg orthopaedic surgery, medical patients, 40mg every 24 hours for at least 6 days until patient ambulant, max 14 days. ii) Treatment of DVT or pulmonary embolism, 1.5 mg/kg every 24 hours, usually for 5 days and until adequate oral anticoagulation established. iii) Unstable angina and non- ST-segment-elevation myocardial infarction 1 mg/kg every 12 hours, usually for 2 - 8 daysUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 93 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) Prophylaxis fo DVT especially in surgical patients: moderate risk, 20 mg SC approximately 2 hours before surgery then 20 mg every 24 hours for minimum 7 - 10 days, high risk (eg orthopaedic surgery, i) Prevention of Deep Vein medical patients, 40mg every Thrombosis(DVT) especially 24 hours for at least 6 days545 Enoxaparin Sodium 60 mg B01AB05520P5003X A* in perioperative and high risk until patient ambulant, max Injection X surgical cases 14 days. ii) Treatment of DVT ii) Treatment of DVT or iii) Unstable angina and non pulmonary embolism, 1.5 Q wave Myocardial Infarction mg/kg every 24 hours, usually for 5 days and until adequate oral anticoagulation established. iii) Unstable angina and non- ST-segment-elevation myocardial infarction 1 mg/kg every 12 hours, usually for 2 - 8 days Parkinson's Disease. An adjunct to standard levodopa/benserazide or 200 mg to be taken with each546 Entacapone 200 mg Tablet N04BX02000T1001X A levodopa/carbidopa for use in daily dose of levodopa/dopa- X patients with parkinson's decarboxylase inhibitor. Max disease and end of dose 2g daily. May be taken with motor fluctuations, who or without food cannot be stabilised on those combinations547 Entecavir 0.5 mg Tablet J05AF10000T1001X A* First line treatment of Chronic 0.5-1mg once daily. Renal X Hepatitis B in patients who Dose Adjustment: 0.5-1mg satisfy the criteria for every 48hours (30-49ml/min); treatment and require long- 0.5-1mg every 72hours (10- term therapy or have a very 29ml/min); 0.5mg-1mg every high baseline viral load 5-7 days (<10ml/min; HD or CAPD). Myotonic symptoms Eperisone HCl 50 mg M03BX09110T1001 associated with cervical548 Tablet XX A syndrome, periarthritis of 50 mg 3 times daily shoulder and lumbago spastic paralysis549 Ephedrine 0.5% w/v Nasal R01AA03110D6001 A/KK Decongestion of the upper 2 drops 3 times daily. Drops XX respiratory tract Maximum use for 1 week By IM, SC or IV. Severe, acute bronchospasm: 12.5- 25 mg. Further dosage550 Ephedrine HCl 30 mg/ml R03CA02110P3001 B Treatment of bronchial should be determine by Injection XX spasm in asthma, adjunct to patient response. When used correct haemodynamic as a pressor agent: ADULT imbalances and treat 25 - 50 mg SC/IM. If hypotension in epidural and necessary, a second IM dose spinal anaesthesia of 50 mg or an IV dose of 25 mg may be given. Direct IV injection, 10 - 25 mg may beUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 94 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE551 Epirubicin 10 mg Injection CATEGORY552 Epirubicin 50 mg Injection L01DB03110P4001X Breast cancer, Non- given slowly. Maximum553 Erlotinib 100 mg Tablet X A* Hodgkin's lymphoma, parenteral ADULT dose: 150554 Erlotinib 150 mg Tablet A* Leukaemia (ALL induction), mg in 24 hours. CHILD : 3 L01DB03110P4002X gastric cancer, ovarian mg/kg or 100 mg/m2 SC or X A* cancer IV daily, in 4 - 6 divided doses L01XE03110T1003X A* Breast cancer, Non- 75 - 90mg/m2 body area X Hodgkin's lymphoma, injected IV in 3 - 5 min, Leukaemia (ALL induction), repeated at 21 day L01XE03110T1002X gastric cancer, ovarian intervals.Higher doses up to X cancer 135mg/m2 as single agent and 120mg/m2 as i) As monotherapy for combination (effective in maintenance treatment in treatment of breast cancer) patients with locally CHILD: 50 mg/m2 over 6 advanced or metastatic non- hours. Schedule depends on small cell lung cancer protocol. (NSCLC) with stable disease 75 - 90mg/m2 body area after 4 cycles of standard injected IV in 3 - 5 min, platinum-based first-line repeated at 21 day chemotherapy. intervals.Higher doses up to ii) For the treatment of 135mg/m2 as single agent patients with locally and 120mg/m2 as advanced or metastatic combination (effective in NSCLC after failure of at treatment of breast cancer) least one prior chemotherapy CHILD: 50 mg/m2 over 6 regimen. Restricted to non- hours. Schedule depends on smoker, female, epidermal protocol. growth factor receptor (EGFR) positive and Asian 150 mg taken at least one patients only hour before or two hours i) As monotherapy for after the ingestion of food maintenance treatment in once daily. Reduce in steps patients with locally of 50 mg when necessary. advanced or metastatic non- Continue treatment until small cell lung cancer disease progression or (NSCLC) with stable disease unacceptable toxicity occurs. after 4 cycles of standard May require dose platinum-based first-line modifications when chemotherapy. coadministered with strong ii) For the treatment of CYP3A4 inhibitors or inducers; or in cigarette smoking patients. 150 mg taken at least one hour before or two hours after the ingestion of food once daily. Reduce in steps of 50 mg when necessary. Continue treatment until disease progression or unacceptable toxicity occurs. May require dose modifications whenUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 95 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY patients with locally coadministered with strong advanced or metastatic CYP3A4 inhibitors or NSCLC after failure of at inducers; or in cigarette least one prior chemotherapy smoking patients. regimen. Restricted to non- smoker, female, epidermal growth factor receptor (EGFR) positive and Asian patients only. i) Patient with confirm ESBL producing gram-negative555 Ertapenem 1 g Injection J01DH03520P4001X A* infection. ADULT: 1 g once daily. X ii) Empiric treatment for CHILD 3 month to 12 years: severe community acquired 15 mg/kg twice daily. Not to pneumonia or other exceed 1 g/ day infections when Pseudomonas aeruginosa is not suspected. Child: 30-50 mg/kg daily,556 Erythromycin J01FA01238F2101X B Treatment of susceptible increased to twice the usual Ethylsuccinate 200 mg/5 ml X bacterial infections dose in severe cases. 2-8 yr: Suspension 1 g daily in divided doses; <2 yr: 500 mg daily in divided doses. Adult 400 mg 6 hrly or 800 mg 12 hrly. Max: 4 g/day. Childn 30-50 mg/kg in Erythromycin J01FA01238T1001X B Treatment of susceptible557 Ethylsuccinate 400 mg X bacterial infections divided doses. Childn 2-8 yr 1 g/day in divided doses in Tablet severe cases. Infant & childn ≤2 yr 500 mg/day in divided doses. Child: 30-50 mg/kg daily,558 Erythromycin J01FA01238F2102X B Treatment of susceptible increased to twice the usual Ethylsuccinate 400 mg/5 ml X bacterial infections dose in severe cases. 2-8 yr: Suspension 1 g daily in divided doses; <2 yr: 500 mg daily in divided doses. Only for treatment of i) certain forms of meningitis ii) septicaemia not responding to usual antibiotics559 Erythromycin Lactobionate J01FA01129P3001X A* iii) mycoplasma pneumonia Adult & Child: 25 - 50mg/kg 500 mg Injection X iv) infection with gram- /day infusion every 6 hours. positive organisms (e.g. Maximum: 4 g/day. tetanus, streptococcal infection) associated with Penicillin allergy, only when oral erythromycin cannot be given Child: 30-50 mg/kg daily, increased to twice the usual Erythromycin Stearate 250 J01FA01258T1001X Infections due to susceptible dose in severe cases. 2-8 yr:560 mg Tablet X B organism 1 g daily in divided doses; <2 yr: 500 mg daily in divided doses.Updated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 96 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) ADULT by IV injection over 1-5 minutes, initially 50 units/kg 3 times weekly adjusted according to response in step of 25 units/kg 3 times weekly at interval of at least 4 weeks. Erythropoietin Human B03XA01000P5005X A* i) Treatment of anaemia CHILD initially as for adult. X associated with chronic renal Maintenance, bodyweight561 Recombinant 10,000 IU/ml failure. Dialysis patients who under 10 kg usually 75-150 Injection are haemoglobin less than 8 units/kg 3 times weekly, g or exhibiting symptoms of bodyweight 10-30 kg usually anaemia although 60-150 units/kg 3 times haemoglobin more than 8 g and pre-transplant cases weekly, bodyweight over 30 ii) Anaemia in cancer (non- kg usually 30-100 units/kg 3 myeloid malignancies) with times weekly concomitant chemotherapy ii) ADULT by SC injection (max. 1 ml per injection site), initially 150 units/kg 3 times weekly, increased if appropriate rise in haemoglobin not achieved after 4 weeks to 300 units/kg 3 times weekly. Discontinue if inadequate response after 4 weeks at higher dose i) ADULT by IV injection over 1-5 minutes, initially 50 units/kg 3 times weekly adjusted according to response in step of 25 units/kg 3 times weekly at interval of at least 4 weeks. CHILD initially as for adult.562 Erythropoietin Human B03XA01000P5001X A* i) Treatment of anaemia Maintenance, bodyweight Recombinant 1000 IU/0.5ml X associated with chronic renal under 10 kg usually 75-150 Injection failure. Dialysis patients who units/kg 3 times weekly, are haemoglobin less than 8 bodyweight 10-30 kg usually g or exhibiting symptoms of 60-150 units/kg 3 times anaemia although weekly, bodyweight over 30 haemoglobin more than 8 g kg usually 30-100 units/kg 3 and pre-transplant cases times weekly ii) Anaemia in cancer (non- ii) ADULT by SC injection (max. 1 ml per injection site), myeloid malignancies) with initially 150 units/kg 3 times concomitant chemotherapy weekly, increased if appropriate rise in haemoglobin not achieved after 4 weeks to 300 units/kg 3 times weekly. Discontinue if inadequate response after 4 weeks at higher doseUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 97 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) ADULT by IV injection over 1-5 minutes, initially 50 units/kg 3 times weekly adjusted according to response in step of 25 units/kg 3 times weekly at interval of at least 4 weeks.563 Erythropoietin Human B03XA01000P5002X A i) Treatment of anaemia CHILD initially as for adult. X associated with chronic renal Maintenance, bodyweight Recombinant 2000 IU/0.5ml failure. Dialysis patients who under 10 kg usually 75-150 Injection are haemoglobin less than 8 units/kg 3 times weekly, g or exhibiting symptoms of bodyweight 10-30 kg usually anaemia although 60-150 units/kg 3 times haemoglobin more than 8 g and pre-transplant cases weekly, bodyweight over 30 ii) Anaemia in cancer (non- kg usually 30-100 units/kg 3 myeloid malignancies) with times weekly concomitant chemotherapy ii) ADULT by SC injection (max. 1 ml per injection site), initially 150 units/kg 3 times weekly, increased if appropriate rise in haemoglobin not achieved after 4 weeks to 300 units/kg 3 times weekly. Discontinue if inadequate response after 4 weeks at higher dose i) ADULT by IV injection over 1-5 minutes, initially 50 units/kg 3 times weekly adjusted according to response in step of 25 units/kg 3 times weekly at interval of at least 4 weeks. CHILD initially as for adult.564 Erythropoietin Human B03XA01000P5003X A* i) Treatment of anaemia Maintenance, bodyweight Recombinant 3000 IU/0.3ml X associated with chronic renal under 10 kg usually 75-150 Injection failure. Dialysis patients who units/kg 3 times weekly, are haemoglobin less than 8 bodyweight 10-30 kg usually g or exhibiting symptoms of 60-150 units/kg 3 times anaemia although weekly, bodyweight over 30 haemoglobin more than 8 g kg usually 30-100 units/kg 3 and pre-transplant cases times weekly ii) Anaemia in cancer (non- ii) ADULT by SC injection (max. 1 ml per injection site), myeloid malignancies) with initially 150 units/kg 3 times concomitant chemotherapy weekly, increased if appropriate rise in haemoglobin not achieved after 4 weeks to 300 units/kg 3 times weekly. Discontinue if inadequate response after 4 weeks at higher doseUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 98 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY i) ADULT by IV injection over 1-5 minutes, initially 50 units/kg 3 times weekly adjusted according to response in step of 25 units/kg 3 times weekly at interval of at least 4 weeks.565 Erythropoietin Human B03XA01000P5004X A i) Treatment of anaemia CHILD initially as for adult. X associated with chronic renal Maintenance, bodyweight Recombinant 4000 IU/0.4ml failure. Dialysis patients who under 10 kg usually 75-150 Injection are haemoglobin less than 8 units/kg 3 times weekly, g or exhibiting symptoms of bodyweight 10-30 kg usually anaemia although 60-150 units/kg 3 times haemoglobin more than 8 g and pre-transplant cases weekly, bodyweight over 30 ii) Anaemia in cancer (non- kg usually 30-100 units/kg 3 myeloid malignancies) with times weekly concomitant chemotherapy ii) ADULT by SC injection (max. 1 ml per injection site), initially 150 units/kg 3 times weekly, increased if appropriate rise in haemoglobin not achieved after 4 weeks to 300 units/kg 3 times weekly. Discontinue if inadequate response after 4 weeks at higher dose i) 10 mg once daily; may be increased to max 20 mg daily. ii) Panic disorder with or without agoraphobia: Initially i) Major depression 5 mg for the first week,566 Escitalopram 10 mg Tablet N06AB10124T1001X A* ii) Treatment of panic thereafter increased to 10 mg X disorder with or without daily. Max 20 mg daily, agoraphobia ELDERLY initially half the adult dose, lower maintenance dose may be sufficient. CHILD and ADOLESCENT under 18 years not recommended567 Esmolol HCl 10 mg/ml C07AB09110P3001X A* Tachycardia and By IV infusion usually within Injection X hypertension in perioperative range of 50 - 200 mcg/kg/min period i) 20mg daily for 4-8 weeks ii) 40mg daily for 10 days in568 Esomeprazole 20 mg Tablet A02BC05000T1002X A* i) Gastro-oesophageal reflux combination with amoxicillin X disease 1g twice daily or ii) H. pylori eradication clarithromycin 500mg twice daily i) Acute erosive/ ulcerative i) 20- 40 mg once daily for 2- Esomeprazole 40 mg A02BC05000P3001X oesophagitis 5 days ii) 80 mg by IV bolus569 Injection X A* ii) Non -variceal upper followed by 8mg/hour gastrointestinal bleed infusion for 72 hours570 Esomeprazole 40 mg Tablet A02BC05000T1001X A* i) Gastro-oesophageal reflux i) 20mg daily for 4-8 weeks X disease ii) 40mg daily for 10 days in ii) H. pylori eradication combination with amoxicillin 1g twice daily orUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 99 / 314

MINISTRY OF HEALTH MEDICINES FORMULARY (MARCH 2016)NO. GENERIC NAME MDC PRESCRIBER INDICATION(S) DOSAGE CATEGORY clarithromycin 500mg twice daily Essential Phospholipids, nicotinamide,571 cyanocobalamine, A05BA00924C1001X A/KK Nutritional supplement in liver Please refer to product leaflet tocopheryl, pyridoxine, X A* disorders thiamine, riboflavine capsule572 Estradiol 1 mg & Estradiol 1 G03FB08954T1001X Hormone Replacement One tablet daily without pill- mg with Dydrogesterone 10 X Therapy for women with free interval, starting with 1 disorders due to natural or mg of Estradiol for first 14 mg surgically induced days, followed by 1mg menopause with intact Estradiol with 10 mg573 Estradiol 1 mg & G03FA01122T1001X A* uterus. Dydrogestrone daily for the Norethisterone Acetate 0.5 X next 14 days mg Tablet Hormone replacement therapy for oestrogen 1 tablet per day without Estradiol 1 mg with G03FB08954T1002X A* deficiency symptoms in interruption574 Dydrogesterone 5 mg X women more than 1 year after menopause and One tablet daily, taken Tablet prevention of osteoporosis in continuously without post menopausal women interruption. Should be used575 Estradiol Valerate 1 mg G03CA03256T1002 A* only in postmenopausal Tablet XX B i) Hormone replacement women more than 12 month therapy for the relief of after menopause Estradiol Valerate 2 mg and symptoms due to oestrogen Norgestrel 500 mcg with G03FB01953T1001X deficiency 1 mg daily continuously or 21576 Estradiol Valerate 2 mg X ii) Prevention of day regimen with 1 week of postmenopausal tablet free interval Tablet osteoporosis in women with a uterus Start on the 5th day of577 Etanercept 25 mg Injection L04AA11000P4001X A* menstrual cycle - 1 tab daily X Oestrogen replacement for 21 days then stop for 7 therapy - only those who days. If patient forgets dose cannot tolerate Premarin at usual time, it should be taken within following 12 Pre and post menopausal hours syndrome, primary and secondary amenorrhea, Adult & geriatric dose: menstrual irregularities. Rheumatoid arthritis, Deficiency symptoms after psoriatic arthritis, ankylosing oophorectomy or radiological spondylitis; 50 mg SC once- castration for weekly for once-weekly noncarcinomatous disease dosing or 25 mg SC twice weekly (individual doses i) Moderately to severe should be separated by 72 to rheumatoid arthritis as 96 hours) for twice-weekly monotherapy or in dosing. Plaque psoriasis; combination with Initial: 50 mg SC twice methotrexate in patients with weekly, 72 to 96 hours apart; inadequate response to maintain initial dose for 3 methotrexate alone. ii) Active months (starting doses of 25 polyarticular-course juvenile idiopathic arthritis in children 2-17 years with inadequate response to, or who have proved intolerant of methotrexate. iii) Psoriatic arthritis asUpdated until MOH Medicines Formulary Review Panel Meeting 1/2016 (March 2016) 100 / 314