WHO Model List of Essential Medicines for Children

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WHO Model List of Essential Medicines for Children

Explanatory Notes

This Model List is intended for use for children up to 12years of age.

The core list presentsa list of minimum medicine needs for a basic health‐caresystem, listing themost efficacious, safe andcost‐effectivemedicines for priority conditions. Priority conditions are selectedon the basis of current and estimated futurepublic health relevance,and potential for safe and cost‐ effective treatment.

The complementary listpresents essential medicines for prioritydiseases, for which specializeddiagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed.In case of doubt medicines may also be listed as complementary on the basisof consistent higher costsor less attractivecost‐effectiveness in a variety of settings.

The square box symbol () is primarily intendedtoindicate similar clinical performance within a pharmacological class. The listed medicine should be the example of theclass for which there is the best evidence for effectiveness andsafety. In somecases, this may be the firstmedicine that is licensedfor marketing; in other instances,subsequently licensed compounds may be saferor more effective. Where there is no difference in terms of efficacy and safety data, thelisted medicine should be the one that is generally available at the lowest price, based oninternationaldrug price information sources.

Therapeutic equivalence is only indicatedon the basis of reviews of efficacy and safety and when consistent with WHO clinical guidelines.Nationallists shouldnot use a similar symboland should be specific in theirfinalselection, which would depend on localavailability and price.

The format and numbering of the 17th WHO Model List of Essential Medicineshave been retained but, as indicated inthe text, some sections have beendeleted because they containmedicines thatarenot relevant for children.

a indicates that thereis an age or weight restriction on use of the medicines; the details for each medicine are in Table 1.

In the List of Essential Medicines for Children,anadditional symbol is used:

R indicates that the Committee has endorsed the medicine as essential but has requested a review ofthe efficacy andsafety toconfirm this decision, or to expanduse to additional age groups.

The presence of anentry on the Essential MedicinesList carries no assurance as to pharmaceutical quality. It is theresponsibility of therelevantnational or regional drug regulatory authority to ensurethateach product is of appropriatepharmaceutical quality (including stability) and that when relevant, different products are interchangeable.

For recommendations and adviceconcerning allaspects of the quality assurance of medicinessee the

WHO Medicinesweb site http://www.who.int/medicines/areas/quality_assurance/en/index.html

Medicines and dosageforms are listed in alphabetical orderwithin each sectionand there is no

implicationofpreference for one form overanother. Standard treatment guidelines should be consulted for informationon appropriate dosageforms.

The mainterms used for dosage forms inthe Essential Medicines Listcanbe found in Annex 1. Definitionsof many of these terms and pharmaceutical quality requirementsapplicable tothe different categories are published in the currentedition of The International Pharmacopoeiahttp://www.who.int/medicines/publications/pharmacopoeia/en/index.html.

1. ANAESTHETICS
1.1 General anaesthetics and oxygen
1.1.1 Inhalational medicines
halothane	Inhalation.
isoflurane	Inhalation.
nitrous oxide	Inhalation.
oxygen	Inhalation (medicinal gas).
1.1.2 Injectable medicines
ketamine	Injection: 50 mg (as hydrochloride)/ml in 10‐ml vial.
propofol*	Injection: 10 mg/ml; 20 mg/ml. * Thiopental may be used as an alternative depending on local availability and cost.
1.2 Local anaesthetics
bupivacaine	Injection: 0.25%; 0.5% (hydrochloride) in vial. Injection for spinal anaesthesia: 0.5% (hydrochloride) in 4‐ml ampoule to be mixed with 7.5% glucose solution.
lidocaine	Injection: 1%; 2% (hydrochloride) in vial. Injection for spinal anaesthesia: 5% (hydrochloride) in 2‐ml ampoule to be mixed with 7.5% glucose solution. Topical forms: 2% to 4% (hydrochloride).
lidocaine + epinephrine (adrenaline)	Dental cartridge: 2% (hydrochloride) + epinephrine 1:80 000. Injection: 1%; 2% (hydrochloride or sulfate) + epinephrine 1:200 000 in vial.
1.3 Preoperative medication and sedation for short-term procedures
atropine	Injection: 1 mg (sulfate) in 1‐ml ampoule.
midazolam	Injection: 1 mg/ml. Oral liquid: 2 mg/ml. Tablet: 7.5 mg; 15 mg.
morphine	Injection: 10 mg (sulfate or hydrochloride) in 1‐ml ampoule.
2. ANALGESICS, ANTIPYRETICS, NON-STEROIDAL ANTI- INFLAMMATORY MEDICINES (NSAIMs), MEDICINES USED TO TREAT GOUT AND DISEASE MODIFYING AGENTS IN RHEUMATOID DISORDERS (DMARDs)
2.1 Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)
ibuprofen a	Oral liquid: 200 mg/5 ml. Tablet: 200 mg; 400 mg. a >3 months.

paracetamol*		Oral liquid: 125 mg/5 ml. Suppository: 100 mg. Tablet: 100 mg to 500 mg. * Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
*Complementary List*
acetylsalicylic acid*		*Suppository:* 50 mg to 150 mg. *Tablet:* 100 mg to 500 mg. * For use for rheumatic fever, juvenile arthritis, Kawasaki disease.
2.2 Opioid analgesics
morphine		Injection: 10 mg (morphine hydrochloride or morphine sulfate) in 1‐ml ampoule. Oral liquid: 10 mg (morphine hydrochloride or morphine sulfate)/5 ml. Tablet: 10 mg (morphine sulfate). Tablet (prolonged release): 10 mg; 30 mg; 60 mg (morphine sulfate).
~~2.3 Medicines used to treat gout~~
2.4 Disease modifying agents used in rheumatoid disorders (DMARDs)
*Complementary List*
hydroxychloroquine	*Solid oral dosage form:* 200 mg (as sulfate).
methotrexate	*Tablet:* 2.5 mg (as sodium salt).
3. ANTIALLERGICS AND MEDICINES USED IN ANAPHYLAXIS
† chlorphenamine a R		Injection: 10 mg (hydrogen maleate) in 1‐ml ampoule. Oral liquid: 2 mg/5 ml (hydrogen maleate). Tablet: 4 mg (hydrogen maleate). a >1 year. R Review of diphenhydramine to assess comparative efficacy and safety with chlorphenamine as a possible preferable alternative.
dexamethasone		Injection: 4 mg/ml in 1‐ml ampoule (as disodium phosphate salt).
epinephrine (adrenaline)		Injection: 1 mg (as hydrochloride or hydrogen tartrate) in 1‐ml ampoule.
hydrocortisone		Powder for injection: 100 mg (as sodium succinate) in vial.
prednisolone		Oral liquid: 5 mg/ml. Tablet: 5 mg; 25 mg.

4. ANTIDOTES AND OTHER SUBSTANCES USED IN POISONINGS
4.1 Non-specific
charcoal, activated	Powder.
4.2 Specific
acetylcysteine	Injection: 200 mg/ml in 10‐ml ampoule. Oral liquid: 10%; 20%.
atropine	Injection: 1 mg (sulfate) in 1‐ml ampoule.
calcium gluconate	Injection: 100 mg/ml in 10‐ml ampoule.
naloxone	Injection: 400 micrograms (hydrochloride) in 1‐ml ampoule.
*Complementary List*
deferoxamine	*Powder for injection:* 500 mg (mesilate) in vial.
dimercaprol	*Injection in oil:* 50 mg/ml in 2‐ml ampoule.
sodium calcium edetate	*Injection:* 200 mg/ml in 5‐ml ampoule.
succimer	*Solid oral dosage form:* 100 mg.
5. ANTICONVULSANTS/ANTIEPILEPTICS
carbamazepine	Oral liquid: 100 mg/5 ml. Tablet (chewable): 100 mg; 200 mg. Tablet (scored): 100 mg; 200 mg.
diazepam	Gel or rectal solution: 5 mg/ml in 0.5 ml; 2‐ml; 4‐ml tubes.
lorazepam	Parenteral formulation: 2 mg/ml in 1‐ml ampoule; 4 mg/ml in 1‐ml ampoule.
phenobarbital	Injection: 200 mg/ml (sodium). Oral liquid: 15 mg/5 ml. Tablet: 15 mg to 100 mg.
phenytoin	Injection: 50 mg/ml in 5‐ml vial (sodium salt). Oral liquid: 25 mg to 30 mg/5 ml.* Solid oral dosage form: 25 mg; 50 mg; 100 mg (sodium salt). Tablet (chewable): 50 mg. * The presence of both 25 mg/5 ml and 30 mg/5 ml strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
valproic acid (sodium valproate)	Oral liquid: 200 mg/5 ml. Tablet (crushable): 100 mg. Tablet (enteric‐coated): 200 mg; 500 mg (sodium valproate).
*Complementary List*
ethosuximide	*Capsule:* 250 mg. *Oral liquid:* 250 mg/5 ml.

6. ANTI-INFECTIVE MEDICINES
6.1 Anthelminthics
*6.1.1 Intestinal anthelminthics*
albendazole	Tablet (chewable): 400 mg.
levamisole*	Tablet: 50 mg; 150 mg (as hydrochloride). * The Committee recommended that this medicine be reviewed for deletion at its next meeting. Should only be used in combination with other anthelminthics.
mebendazole	Tablet (chewable): 100 mg; 500 mg.
niclosamide*	Tablet (chewable): 500 mg. * Niclosamide is listed for use when praziquantel treatment fails. The Committee recommended that this medicine be reviewed for deletion at its next meeting.
praziquantel	Tablet: 150 mg; 600 mg.
pyrantel	Oral liquid: 50 mg (as embonate or pamoate)/ml. Tablet (chewable): 250 mg (as embonate or pamoate).
*6.1.2 Antifilarials*
albendazole	Tablet (chewable): 400 mg.
diethylcarbamazine	Tablet: 50 mg; 100 mg (dihydrogen citrate).
ivermectin	Tablet (scored): 3 mg; 6 mg.
*6.1.3 Antischistosomals and other antitrematode medicines*
praziquantel	Tablet: 600 mg.
triclabendazole	Tablet: 250 mg.
*Complementary List*
oxamniquine*	*Capsule:* 250 mg. *Oral liquid:* 250 mg/5 ml. * Oxamniquine is listed for use when praziquantel treatment fails.
6.2 Antibacterials
*6.2.1 Beta Lactam medicines*
amoxicillin	Powder for oral liquid: 125 mg (as trihydrate)/5 ml; 250 mg (as trihydrate)/5 ml. Solid oral dosage form: 250 mg; 500 mg (as trihydrate).
amoxicillin + clavulanic acid	Oral liquid: 125 mg amoxicillin + 31.25 mg clavulanic acid/5 ml AND 250 mg amoxicillin + 62.5 mg clavulanic acid/5 ml. Tablet: 500 mg (as trihydrate) + 125 mg (as potassium salt).
ampicillin	Powder for injection: 500 mg; 1 g (as sodium salt) in vial.
benzathine benzylpenicillin	Powder for injection: 900 mg benzylpenicillin (= 1.2 million IU) in 5‐ml vial; 1.44 g benzylpenicillin (= 2.4 million IU) in 5‐ml vial.

benzylpenicillin

Powder for injection: 600 mg (= 1 million IU); 3 g (= 5 million IU)

(sodium or potassium salt) in vial.

cefalexin

Powder for reconstitution with water: 125 mg/5 ml; 250 mg/5 ml

(anhydrous).

Solid oral dosage form: 250 mg (as monohydrate).

† cefazolin* a

Powder for injection: 1 g (as sodium salt) in vial.

* For surgical prophylaxis.

a >1 month.

ceftriaxone* a

Powder for injection: 250 mg; 1 g (as sodium salt) in vial.

* Do not administer with calcium and avoid in infants with hyperbilirubinemia.

a >41 weeks corrected gestational age.

† cloxacillin

Capsule: 500 mg; 1 g (as sodium salt).

Powder for injection: 500 mg (as sodium salt) in vial.

Powder for oral liquid: 125 mg (as sodium salt)/5 ml.

phenoxymethylpenicillin

Powder for oral liquid: 250 mg (as potassium salt)/5 ml.

Tablet: 250 mg (as potassium salt).

procaine benzylpenicillin*

Powder for injection: 1 g (=1 million IU); 3 g (=3 million IU) in

vial.

* Procaine benzylpenicillin is not recommended as first‐line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.

Complementary List

cefotaxime*

Powder for injection: 250 mg per vial (as sodium salt).

* 3rd generation cephalosporin of choice for use in hospitalized neonates.

ceftazidime

Powder for injection: 250 mg or 1 g (as pentahydrate) in vial.

imipenem* + cilastatin*

Powder for injection: 250 mg (as monohydrate) + 250 mg (as sodium

salt); 500 mg (as monohydrate) + 500 mg (as sodium salt) in vial.

* Only listed for the treatment of life‐threatening hospital‐based infection due to suspected or proven multidrug‐resistant infection. Meropenem is indicated for the treatment of meningitis and is licensed for use in children over the age of 3 months.

6.2.2 Other antibacterials

azithromycin*

Capsule: 250 mg; 500 mg (anhydrous).

Oral liquid: 200 mg/5 ml.

* Only listed for trachoma.

chloramphenicol

Capsule: 250 mg.

Oily suspension for injection*: 0.5 g (as sodium succinate)/ml in

2‐ml ampoule.

* Only for the presumptive treatment of epidemic meningitis in children older than 2 years.

Oral liquid: 150 mg (as palmitate)/5 ml.

Powder for injection: 1 g (sodium succinate) in vial.

ciprofloxacin

Oral liquid: 250 mg/5 ml (anhydrous). Solution for IV infusion: 2 mg/ml (as hyclate). Tablet: 250 mg (as hydrochloride).

doxycycline a

Oral liquid: 25 mg/5 ml; 50 mg/5 ml (anhydrous).

Solid oral dosage form: 50 mg; 100 mg (as hyclate).

a Use in children <8 years only for life-threatening infections when no alternative exists.

erythromycin

Powder for oral liquid: 125 mg/5 ml (as stearate or estolate or

ethyl succinate).

Solid oral dosage form: 250 mg (as stearate or estolate or ethyl succinate).

† gentamicin

Injection: 10 mg; 40 mg (as sulfate)/ml in 2‐ml vial.

metronidazole

Injection: 500 mg in 100‐ml vial.

Oral liquid: 200 mg (as benzoate)/5 ml.

Tablet: 200 mg to 500 mg.

nitrofurantoin

Oral liquid: 25 mg/5 ml.

Tablet: 100 mg.

sulfamethoxazole +

trimethoprim

Injection:

80 mg + 16 mg/ml in 5‐ml ampoule;

80 mg + 16 mg/ml in 10‐ml ampoule. Oral liquid: 200 mg + 40 mg/5 ml. Tablet: 100 mg + 20 mg; 400 mg + 80 mg.

trimethoprim a

Oral liquid: 50 mg/5 ml.

Tablet: 100 mg; 200 mg.

a >6 months.

Complementary List

clindamycin

Capsule: 150 mg (as hydrochloride).

Injection: 150 mg (as phosphate)/ml.

Oral liquid: 75 mg/5 ml (as palmitate).

vancomycin

Powder for injection: 250 mg (as hydrochloride) in vial.

*6.2.3 Antileprosy medicines*
Medicines used in the treatment of leprosy should never be used except in combination. Combination therapy is essential to prevent the emergence of drug resistance. Colour coded blister packs (MDT blister packs) containing standard two medicine (paucibacillary leprosy) or three medicine (multibacillary leprosy) combinations for adult and childhood leprosy should be used. MDT blister packs can be supplied free of charge through WHO.
clofazimine	Capsule: 50 mg; 100 mg.
dapsone	Tablet: 25 mg; 50 mg; 100 mg.
rifampicin	Solid oral dosage form: 150 mg; 300 mg.
*6.2.4 Antituberculosis medicines*
The Committee recommends and endorses the use of fixed‐dose combinations and the development of appropriate new fixed‐dose combinations, including modified dosage forms, non‐refrigerated products and paediatric dosage forms of assured pharmaceutical quality.
ethambutol	Oral liquid: 25 mg/ml. Tablet: 100 mg; 400 mg (hydrochloride).
isoniazid	Oral liquid: 50 mg/5 ml. Tablet: 100 mg to 300 mg. Tablet (scored): 50 mg.
pyrazinamide	Oral liquid: 30 mg/ml. Tablet: 400 mg. Tablet (dispersible): 150 mg. Tablet (scored): 150 mg.
rifampicin	Oral liquid: 20 mg/ml. Solid oral dosage form: 150 mg; 300 mg.
streptomycin R	Powder for injection: 1 g (as sulfate) in vial. R Review of safety and efficacy of streptomycin in childhood TB.
*Complementary List*
*Reserve second‐line drugs for the treatment of multidrug‐resistant tuberculosis (MDR‐TB)* *should be used in specialized centres adhering to WHO standards for TB control.* R R The Committee requests a review of the medicines for MDR-TB in children.
amikacin	*Powder for injection:* 100 mg; 500 mg; 1 g (as sulfate) in vial.
capreomycin	*Powder for injection:* 1 g (as sulfate) in vial.
cycloserine	*Solid oral dosage form:* 250 mg.
ethionamide	*Tablet:* 125 mg; 250 mg.
kanamycin	*Powder for injection:* 1 g (as sulfate) in vial.
ofloxacin*	*Tablet:* 200 mg; 400 mg. * Levofloxacin may be an alternative based on availability and programme considerations.

p‐aminosalicylic acid

Granules: 4 g in sachet.

Tablet: 500 mg.

6.3 Antifungal medicines

fluconazole

Capsule: 50 mg.

Injection: 2 mg/ml in vial.

Oral liquid: 50 mg/5 ml.

griseofulvin

Oral liquid: 125 mg/5 ml.

Solid oral dosage form: 125 mg; 250 mg.

nystatin

Lozenge: 100 000 IU.

Oral liquid: 50 mg/5 ml; 100 000 IU/ml.

Tablet: 100 000 IU; 500 000 IU.

Complementary List

amphotericin B

Powder for injection: 50 mg in vial.

As sodium deoxycholate or liposomal complex.

flucytosine

Capsule: 250 mg.

Infusion: 2.5 g in 250 ml.

potassium iodide

Saturated solution.

6.4 Antiviral medicines

6.4.1 Antiherpes medicines

aciclovir

Oral liquid: 200 mg/5 ml.

Powder for injection: 250 mg (as sodium salt) in vial.

Tablet: 200 mg.

6.4.2 Antiretrovirals

Based on current evidence and experience of use, medicines in the following three classes of

antiretrovirals are included as essential medicines for treatment and prevention of HIV (prevention of mother‐to‐child transmission and post‐exposure prophylaxis). The Committee emphasizes the importance of using these products in accordance with global and national guidelines. The Committee recommends and endorses the use of fixed‐dose combinations and the development of appropriate new fixed‐dose combinations, including modified dosage forms, non‐refrigerated products and paediatric dosage forms of assured pharmaceutical quality.

Scored tablets can be used in children and therefore can be considered for inclusion in the listing of tablets, provided adequate quality products are available.

6.4.2.1 Nucleoside/Nucleotide reverse transcriptase inhibitors

abacavir (ABC)

Oral liquid: 100 mg (as sulfate)/5 ml.

Tablet: 300 mg (as sulfate).

didanosine (ddI)

Buffered powder for oral liquid: 100 mg; 167 mg; 250 mg packets.

Capsule (unbuffered enteric‐coated): 125 mg; 200 mg; 250 mg;

400 mg.

Tablet (buffered chewable, dispersible): 25 mg; 50 mg; 100 mg;

150 mg; 200 mg.

emtricitabine (FTC)* a

Capsule: 200 mg.

Oral liquid: 10 mg/ml.

* FTC is an acceptable alternative to 3TC, based on knowledge of the pharmacology, the resistance patterns and clinical trials of antiretrovirals.

a >3 months.

lamivudine (3TC)

Oral liquid: 50 mg/5 ml.

Tablet: 150 mg.

stavudine (d4T)

Capsule: 15 mg; 20 mg; 30 mg.

Powder for oral liquid: 5 mg/5 ml.

zidovudine (ZDV or AZT)

Capsule: 100 mg; 250 mg.

Oral liquid: 50 mg/5 ml.

Solution for IV infusion injection: 10 mg/ml in 20‐ml vial.

Tablet: 300 mg.

6.4.2.2 Non-nucleoside reverse transcriptase inhibitors

efavirenz (EFV or EFZ) a

Capsule: 50 mg; 100 mg; 200 mg.

Oral liquid: 150 mg/5 ml.

Tablet: 600 mg.

a >3 years or >10 kg.

nevirapine (NVP)

Oral liquid: 50 mg/5 ml.

Tablet: 200 mg.

6.4.2.3 Protease inhibitors

Selection of protease inhibitor(s) from the Model List will need to be determined by each country after

consideration of international and national treatment guidelines and experience. Ritonavir is recommended for use in combination as a pharmacological booster, and not as an antiretroviral in its own right. All other protease inhibitors should be used in boosted forms (e.g. with ritonavir).

atazanavir a

Solid oral dosage form: 100 mg; 150 mg; 300 mg (as sulfate).

a >25 kg.

lopinavir + ritonavir (LPV/r)

Capsule: 133.3 mg + 33.3 mg.

Oral liquid: 400 mg + 100 mg/5 ml.

Tablet (heat stable): 100 mg + 25 mg; 200 mg + 50 mg.

ritonavir

Oral liquid: 400 mg/5 ml.

Solid oral dosage form: 100 mg.

Tablet (heat stable): 25 mg; 100 mg.

3rd WHO Model List of Essential Medicines for Children (March 2011) page 11

saquinavir (SQV) a

Solid oral dosage form: 200 mg (as mesilate).

a >25 kg.

FIXED-DOSE COMBINATIONS

lamivudine + nevirapine +

stavudine

Tablet: 150 mg + 200 mg + 30 mg.

Tablet (dispersible):

30 mg + 50 mg + 6 mg; 60 mg + 100 mg + 12 mg.

lamivudine + nevirapine +

zidovudine

Tablet: 30 mg + 50 mg + 60 mg; 150 mg + 200 mg + 300 mg.

lamivudine + zidovudine

Tablet: 30 mg + 60 mg; 150 mg + 300 mg.

6.4.3 Other antivirals

oseltamivir*

Capsule: 30 mg; 45 mg; 75 mg (as phosphate).

Oral powder: 12 mg/ml.

* Oseltamivir should be used only in compliance with the WHO treatment guidelines, i.e. (1) for treatment of patients with severe or progressive clinical illness with confirmed or suspected influenza pandemic (H1N1) 2009, (2) for the treatment of patients with confirmed or suspected but uncomplicated illness due to pandemic influenza virus infection who were in higher risk groups, most notably for pregnant women and children under 2 years of age.

ribavirin*

Injection for intravenous administration: 800 mg and 1 g in

10‐ml phosphate buffer solution.

Solid oral dosage form: 200 mg; 400 mg; 600 mg.

* For the treatment of viral haemorrhagic fevers only.

6.5 Antiprotozoal medicines

6.5.1 Antiamoebic and antigiardiasis medicines

diloxanide a

Tablet: 500 mg (furoate).

a >25 kg.

metronidazole

Injection: 500 mg in 100‐ml vial.

Oral liquid: 200 mg (as benzoate)/5 ml.

Tablet: 200 mg to 500 mg.

6.5.2 Antileishmaniasis medicines

amphotericin B

Powder for injection: 50 mg in vial.

As sodium deoxycholate or liposomal complex.

miltefosine

Solid oral dosage form: 10 mg; 50 mg.

paromomycin

Solution for intramuscular injection: 750 mg of paromomycin base

(as the sulfate).

sodium stibogluconate or

meglumine antimoniate R

Injection: 100 mg/ml, 1 vial = 30 ml or 30%, equivalent to

approximately 8.1% antimony (pentavalent) in 5‐ml ampoule.

R Review of comparative effectiveness and safety of antimonials for leishmaniasis, and whether they should be kept on the core list or moved to the complementary list.

6.5.3 Antimalarial medicines

6.5.3.1 For curative treatment

Medicines for the treatment of P. falciparum malaria cases should be used in combination. The list

currently recommends combinations according to treatment guidelines. The Committee recognizes that not all of these FDCs exist and encourages their development and rigorous testing. The Committee also encourages development and testing of rectal dosage formulations.

amodiaquine*

Tablet: 153 mg or 200 mg (as hydrochloride).

* To be used in combination with artesunate 50 mg.

artemether*

Oily injection: 80 mg/ml in 1‐ml ampoule.

* For use in the management of severe malaria.

artemether + lumefantrine*

Tablet: 20 mg + 120 mg.

Tablet (dispersible): 20 mg + 120 mg.

* Not recommended in the first trimester of pregnancy or in children below 5 kg.

artesunate*

Injection: ampoules, containing 60 mg anhydrous artesunic acid

with a separate ampoule of 5% sodium bicarbonate solution. For use in the management of severe malaria.

Rectal dosage form: 50 mg; 200 mg capsules (for pre‐referral

treatment of severe malaria only; patients should be taken to an appropriate health facility for follow‐up care).

Tablet: 50 mg.

* To be used in combination with either amodiaquine, mefloquine

or sulfadoxine + pyrimethamine.

artesunate + amodiaquine *

Tablet: 25 mg + 67.5 mg; 50 mg + 135 mg; 100 mg + 270 mg.

* Other combinations that deliver the target doses required such as

153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be

alternatives.

chloroquine*

Oral liquid: 50 mg (as phosphate or sulfate)/5 ml.

Tablet: 100 mg; 150 mg (as phosphate or sulfate).

* For use only for the treatment of P.vivax infection.

doxycycline*

Capsule: 100 mg (as hydrochloride or hyclate).

Tablet (dispersible): 100 mg (as monohydrate).

* For use only in combination with quinine.

mefloquine*

Tablet: 250 mg (as hydrochloride).

* To be used in combination with artesunate 50 mg.

primaquine*

Tablet: 7.5 mg; 15 mg (as diphosphate).

* Only for use to achieve radical cure of P.vivax and P.ovale

infections, given for 14 days.

quinine*

Injection: 300 mg quinine hydrochloride/ml in 2‐ml ampoule.

Tablet: 300 mg (quinine sulfate) or 300 mg (quinine bisulfate).

* For use only in the management of severe malaria, and should be used in combination with doxycycline.

sulfadoxine + pyrimethamine*

Tablet: 500 mg + 25 mg.

* Only in combination with artesunate 50 mg.

6.5.3.2 For prophylaxis

chloroquine*

Oral liquid: 50 mg (as phosphate or sulfate)/5 ml.

Tablet: 150 mg (as phosphate or sulfate).

* For use only for the treatment of P.vivax infection.

doxycycline a

Solid oral dosage form: 100 mg (as hydrochloride or hyclate).

a >8 years.

mefloquine a

Tablet: 250 mg (as hydrochloride).

a >5 kg or >3 months.

proguanil*

Tablet: 100 mg (as hydrochloride).

* For use only in combination with chloroquine.

6.5.4 Antipneumocystosis and antitoxoplasmosis medicines

pyrimethamine

Tablet: 25 mg.

sulfadiazine

Tablet: 500 mg.

sulfamethoxazole +

trimethoprim

Injection:

80 mg + 16 mg/ml in 5‐ml ampoule;

80 mg + 16 mg/ml in 10‐ml ampoule. Oral liquid: 200 mg + 40 mg/5 ml. Tablet: 100 mg + 20 mg; 400 mg + 80 mg.

6.5.5 Antitrypanosomal medicines

6.5.5.1 African trypanosomiasis

Medicines for the treatment of 1st stage African trypanosomiasis.

pentamidine*

Powder for injection: 200 mg (as isetionate) in vial.

* To be used for the treatment of Trypanosoma brucei gambiense

infection.

suramin sodium*

Powder for injection: 1 g in vial.

* To be used for the treatment of the initial phase of

Trypanosoma brucei rhodesiense infection.

Medicines for the treatment of 2nd stage African trypanosomiasis
eflornithine*	Injection: 200 mg (hydrochloride)/ml in 100‐ml bottle. * To be used for the treatment of Trypanosoma brucei gambiense infection.
*Complementary List*
melarsoprol	*Injection:* 3.6% solution in 5‐ml ampoule (180 mg of active compound).
*6.5.5.2 American trypanosomiasis* R
benznidazole	Tablet: 100 mg.
nifurtimox	Tablet: 30 mg; 120 mg; 250 mg.
7. ANTIMIGRAINE MEDICINES
7.1 For treatment of acute attack
ibuprofen	Tablet: 200 mg; 400 mg.
paracetamol	Oral liquid: 125 mg/5 ml. Tablet: 300 mg to 500 mg.
7.2 For prophylaxis
propranolol	Tablet: 20 mg; 40 mg (hydrochloride).
8. ANTINEOPLASTIC, IMMUNOSUPPRESSIVES AND MEDICINES USED IN PALLIATIVE CARE
8.1 Immunosuppressive medicines
*Complementary List*
azathioprine	*Powder for injection:* 100 mg (as sodium salt) in vial. *Tablet (scored):* 50 mg.
ciclosporin	*Capsule:* 25 mg. *Concentrate for injection:* 50 mg/ml in 1‐ml ampoule for organ transplantation.
8.2 Cytotoxic and adjuvant medicines Medicines listed below should be used according to protocols for treatment of the diseases.
*Complementary List*
ACUTE LYMPHOBLASTIC LEUKAEMIA
STEP 1
asparaginase	*Powder for injection:* 10 000 IU in vial.
dexamethasone	*Oral liquid:* 2 mg/5 ml.
mercaptopurine	*Tablet:* 50 mg.
methotrexate	*Powder for injection:* 50 mg (as sodium salt) in vial. *Tablet:* 2.5 mg (as sodium salt).

methylprednisolone	*Injection:* 40 mg/ml (as sodium succinate) in 1‐ml single dose vial and 5‐ml multidose vials; 80 mg/ml (as sodium succinate) in 1‐ml single dose vial.
prednisolone	*Oral liquid:* 5 mg/ml.
vincristine	*Powder for injection:* 1 mg; 5 mg (sulfate) in vial.
STEP 2
cyclophosphamide	*Powder for injection:* 500 mg in vial.
cytarabine	*Powder for injection:* 100 mg in vial.
daunorubicin	*Powder for injection:* 50 mg (hydrochloride) in vial.
doxorubicin	*Powder for injection:* 10 mg; 50 mg (hydrochloride) in vial.
hydrocortisone	*Powder for injection:* 100 mg (as sodium succinate) in vial.
methotrexate	*Powder for injection:* 50 mg (as sodium salt) in vial.
thioguanine	*Solid oral dosage form:* 40 mg.
WILMSʹ TUMOUR (NEPHROBLASTOMA)
STEP 1 & STEP 2
dactinomycin	*Powder for injection:* 500 micrograms in vial.
daunorubicin	*Powder for injection:* 50 mg (hydrochloride) in vial.
vincristine	*Powder for injection:* 1 mg; 5 mg (sulfate) in vial.
BURKITTʹS LYMPHOMA
STEP 1 & STEP 2
cyclophosphamide	*Powder for injection:* 500 mg in vial.
cytarabine	*Powder for injection:* 100 mg in vial.
doxorubicin	*Powder for injection:* 10 mg; 50 mg (hydrochloride) in vial.
prednisolone	*Oral liquid:* 5 mg/ml.
vincristine	*Powder for injection:* 1 mg; 5 mg (sulfate) in vial.
ADJUVANT MEDICINES
allopurinol	*Tablet:* 100 mg; 300 mg.
mesna	*Injection:* 100 mg/ml in 4‐ml and 10‐ml ampoules. *Tablet:* 400 mg; 600 mg.
~~8.3 Hormones and antihormones~~
8.4 Medicines used in palliative care
amitriptyline	Tablet: 10 mg; 25 mg.
cyclizine	Injection: 50 mg/ml. Tablet: 50 mg.
dexamethasone	Injection: 4 mg/ml in 1‐ml ampoule (as disodium phosphate salt). Tablet: 2 mg.

3rd WHO Model List of Essential Medicines for Children (March 2011) page 16

diazepam

Injection: 5 mg/ml.

Oral liquid: 2 mg/5 ml.

Rectal solution: 2.5 mg; 5 mg; 10 mg.

Tablet: 5 mg; 10 mg.

docusate sodium

Capsule: 100 mg.

Oral liquid: 50 mg/5 ml.

fluoxetine a

Solid oral dosage form: 20 mg (as hydrochloride).

a >8 years.

hyoscine hydrobromide

Injection: 400 micrograms/ml; 600 micrograms/ml.

Transdermal patches: 1 mg/72 h<