HARGA OBAT UNTUK PENGADAAN PEMERINTAH TAHUN 2012

NO NAMA OBAT KEMASANHARGA PER SATUAN KEMASAN

REGIONAL-IV1 2 3 4

1ACT (Artesunate tablet 50 mg + Amodiaquine anhydrida tablet 200 mg)

2 blister @12 tablet / kotak 39.600

4 Albendazol tablet/tablet kunyah 400 mg ktk 5 x 6 tablet14.640

5 Alopurinol tablet 100 mg ktk 10 x 10 tablet15.840

9 Alprazolam tablet 1 mg ktk 10 x 10 tablet108.000

10 Ambroxol sirup 15 mg/ml btl 60 ml3.960

11 Ambroxol tablet 30 mg ktk 10 x 10 tablet15.008

15 Aminofilin tablet 200 mg btl 100 tablet13.596

24 Amoksisilin kaplet 500 mg ktk 10 x 10 kaplet44.400

31 Ampisilin sirup kering 125 mg/5 ml btl 60 ml5.280

32Antasida DOEN I tablet kunyah,kombinasi :Aluminium Hidroksida 200 mg

ktk 10 x 10 tablet kunyah19.440

36Antihemoroid DOEN kombinasi :Bismut subgalat 150 mgHeksaklorofen 2,5 mg

ktk 10 supp24.000

38Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg

btl 100 tablet14.796

42 Artesunate injeksi, vial 60 mg ktk 8 vial240.600

43Asam Asetilsalisilat tablet 100 mg(Asetosal)

ktk 10 x 10 tablet11.520

45Asam Askorbat (Vitamin C) tablet250 mg

btl 250 tablet38.400

48 Asam Folat tablet 1 mg btl 100 tablet8.160

49 Asam Folat tablet 5 mg btl 1000 tablet56.400

51 Asam Mefenamat kaplet 500 mg ktk 10 x 10 kaplet21.120

52 Asetazolamid tablet 250 mg btl 100 tablet21.314

53 Asiklovir krim 5% tube 5 gram3.780

54 Asiklovir krim 5%ktk 25 tube @ 5 gram

90.000

59 Asiklovir tablet 400 mg ktk 5 x 10 tablet37.830

61 Atenolol tablet 100 mg ktk 5 x 10 tablet30.595

70Benzatin Benzil Penisilin 2,4 jutaIU/vial

ktk 10 vial @ 20 ml136.800

76 Betametason tablet 0,5 mg ktk 10 x 10 tablet8.396

77 Bisoprolol tablet 5 mg ktk 3 x 10 tablet83.580

78 Bromheksin tablet 8 mg ktk 10 x 10 tablet4.622

79 Cetirizin sirup 5 mg/5 ml btl 60 ml12.540

80 Cetirizine tablet 10 mg ktk 3 x 10 tablet11.880

82 Cisapride tablet 10 mg ktk 10 x 10 tablet163.020

84 Clobazam tablet 10 mgktk 10 x 10 tablet

114.000

86 Dapson tablet 100 mg btl 1000 tablet37.800

87 Deksametason injeksi i.v. 5 mg/ml ktk 100 ampul @ 1 ml240.240

88 Deksametason tablet 0,5 mg ktk 10 x 10 tablet10.440

89 Dekstran 70 - larutan infus 6% steril btl 500 ml42.631

90Dekstrometorfan sirup 10 mg/5 ml(HBr)

btl 60 ml3.438

91 Dekstrometorfan tablet 15 mg (HBr) ktk 10 x 10 tablet13.200

92 Diazepam injeksi 5 mg/ml ktk 30 ampul @ 2 ml85.252

97 Diazepam tablet 5 mg ktk 10 x 10 tablet7.920

98 Dietilkarbamazin Sitrat tablet 100 mg ktk 10 x 10 tablet11.700

99Difenhidramin injeksi i.m. 10 mg/ml(HCl)

ktk 30 ampul @ 1 ml34.560

100 Digoksin tablet 0,25 mg ktk 10 x 10 tablet17.160

102 Dikloksasilin kapsul 125 mg ktk 100 kapsul27.340

104 Dikloksasilin kapsul 500 mgktk 25 x 4 kapsul

50.514

105 Diltiazem HCl tablet 30 mg ktk 10 x 10 tablet18.196

106 Dimenhidrinat tablet 50 mg btl 100 tablet11.520

108 Doksisiklin kapsul 100 mg ktk 10 x 10 kapsul30.360

109 Domperidon suspensi 5 mg/5 ml btl 60 ml15.180

110 Domperidon tablet 10 mg ktk 10 x 10 tablet48.434

111 Efedrin tablet 25 mg (HCl) btl 250 tablet15.378

113Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl)

ktk 30 ampul @ 1 ml44.640

114 Eritromisin kapsul 250 mgktk 10 x 10 kapsul

60.480

116 Eritromisin kaplet 500 mg ktk 10 x 10 kaplet111.600

121 Etambutol tablet salut 500 mg (HCl) ktk 10 x 10 tablet salut68.832

124 Famotidine tablet 20 mgktk 5 x 10 tablet

6.786

125 Fenilbutason tablet 200 mg btl 1000 tablet97.200

126 Fenitoin kapsul 100 mg btl 250 kapsul23.861

135 Fenol Gliserol tetes telinga 10% ktk 24 btl @ 5 ml29.040

143 Furosemid injeksi i.v./i.m. 10 mg/ml ktk 25 ampul @ 2 ml61.802

144 Furosemid tablet 40 mgktk 20 x 10 tablet

24.240

153 Gentamisin injeksi 80 mg/ml ktk 1 vial @ 2 ml4.538

157 Gentamisin salep kulit 0.1% tube 5 gram2.220

159 Gentamisin Sulfat tetes mata 0,3 % ktk 10 btl @ 5 ml39.600

160 Gentian Violet larutan 1 % btl 10 ml540

169 Glimepiride tablet 4 mg ktk 3 x 10 tablet93.817

172 Gliseril guaiakolat tablet 100 mgbtl 1000 tablet

33.480

173 Gliserin btl 100 ml5.676

174 Glukosa larutan infus 10 % steril btl 500 ml6.872

175 Glukosa larutan infus 40 % steril ktk 10 ampul @ 25 ml17.429

177 Griseofulvin tablet 250 mg ktk 10 x 10 tablet54.000

180 Haloperidol tablet 5 mg ktk 10 x 10 tablet14.675

184 Hidrokortison krim 1% tube 5 gram2.760

188 Ibuprofen suspensi 100 mg/5 ml btl 60 ml4.200

190 Ibuprofen tablet 200 mg btl 100 tablet13.860

191 Ibuprofen tablet 400 mg ktk 10 x 10 tablet24.605

195 Isoniazid tablet 300 mg btl 1000 tablet116.400

196 Isosorbid Dinitrat tablet sublingual 5 mgktk 10 x 10 tablet sublingual

11.682

197 Itrakonazol kapsul 100 mg ktk 3 x 10 kapsul51.984

198 Kalium Diklofenak tablet 25 mg ktk 5 x 10 tablet23.450

199 Kalium Diklofenak tablet 50 mg ktk 5 x 10 tablet42.481

206 Kaptopril tablet 25 mg ktk 6 x 10 tablet10.322

209 Karbamazepin tablet 200 mg ktk 10 x 10 tablet29.574

210 Ketokonazol krim 2% tube 15 gram8.400

211 Ketokonazol tablet 200 mg ktk 5 x 10 tablet24.600

212 Ketoprofen injeksi 100 mgktk 6 amp @ 1 ml

40.680

213 Ketoprofen tablet 100 mg ktk 10 x 10 tablet162.000

214 Ketorolac injeksi 10 mg ktk 6 ampul @ 1 ml54.000

221 Klindamisin kapsul 300 mg ktk 5 x 10 kapsul45.166

222 Klindamisin kapsul 300 mgktk 10 x 10 kapsul

90.330

223 Klofazimin kapsul 100 mg micronize btl 100 kapsul249.480

224 Klomifen tablet 50 mg btl 10 tablet20.119

225 Klonidin tablet 0,15 mg ktk 10 x 10 tablet24.600

226 Kloramfenikol kapsul 250 mg ktk 12 X 10 kapsul38.400

227 Kloramfenikol kapsul 250 mg ktk 10 X 10 kapsul31.980

228 Kloramfenikol kapsul 250 mg btl 250 kapsul69.300

229 Kloramfenikol salep mata 1 % tube 5 gram1.876

232 Kloramfenikol tetes telinga 3 %btl 5 ml

1.920

235 Klorokuin tablet 250 mg btl 1000 tablet126.000

240 Kodein tablet 10 mg btl 250 tablet128.185

245Kotrimoksazol DOEN I (dewasa)kombinasi :Sulfametoksazol 400 mg

ktk 10 x 10 tablet 19.800

246Kotrimoksazol DOEN II (pediatrik)kombinasi :Sulfametoksazol 100 mg

ktk 10 x 10 tablet9.108

255 Lanzoprazol kapsul 30 mg ktk 2 x 10 kapsul32.432

258 Levofloksasin tablet 500 mg ktk 5 x 10 tablet69.221

260 Lidokain injeksi 2%ktk 100 ampul @ 2 ml

121.200

270 Loratadin tablet 10 mgktk 5 x 10 tablet

19.985

275 Mebendazol tablet 100 mg ktk 5 x 6 tablet7.800

276 Mebendazol tablet 500 mg ktk 10 x 10 tablet28.200

277 Meloksikam suppositoria ktk 10 supp79.200

278 Meloksikam tablet 15 mg ktk 5 x 10 tablet71.940

283 Metampiron injeksi 250 mg ktk 30 ampul @ 2 ml48.000

284 Metampiron tablet 500 mg ktk 10 x 10 tablet17.880

285 Metformin HCl tablet 500 mg ktk 10 x 10 tablet21.780

286 Metformin HCl tablet 850 mg ktk 10 x 10 tablet39.600

288Metilergometrin Maleat (Metilergometrin)tablet salut 0,125 mg

ktk 10 x 10 tablet salut14.520

290 Metilprednisolon injeksi 500 mgktk 1 vial

99.630

291 Metilprednisolon tablet 16 mg ktk 3 x 10 tablet42.120

292 Metilprednisolon tablet 16 mg ktk 10 x 10 tablet124.200

299 Metronidazol infus 500 mg/100 ml btl 100 ml35.400

300 Metronidazol tablet 250 mgktk 10 x 10 tablet

17.160

301 Metronidazol tablet 500 mg ktk 10 x 10 tablet26.400

302 Mikonazol krim/salep 2 % (Nitrat) tube 10 gram3.600

308 Natrium Bikarbonat tablet 500 mgbtl 1000 tablet

17.160

311 Natrium Fluoresein tetes mata 2% ktk 24 btl @ 5 ml113.059

316 Nifedipin tablet 10 mg ktk 10 x 10 tablet15.480

318 Nistatin vaginal tablet 100.000 IU/ gktk 10 x 10 tablet vaginal

44.400

322 Obat Batuk Hitam ( O.B.H. ) cairan btl 100 ml1.716

323 Obat Batuk Hitam ( O.B.H. ) cairan btl 200 ml3.419

336 Omeprazol kapsul 20 mg btl 7 kapsul6.463

337 Omeprazol kapsul 20 mg ktk 3 x 10 kapsul14.700

339 Papaverin injeksi 40 mg/ml ktk 100 ampul @ 1 ml63.600

340 Papaverin tablet 40 mg btl 1000 tablet119.400

341 Parasetamol drops btl 15 ml6.336

342 Parasetamol sirup 120 mg / 5 ml btl 60 ml2.760

344 Parasetamol tablet 500 mg ktk 10 x 10 tablet12.600

352 Piracetam injeksi 1 g/5 ml ktk 10 ampul66.000

357 Piracetam tablet 800 mg ktk 10 x 10 tablet96.360

358 Pirantel sirup 125 mg/5 mlbtl 60 ml

4.200

359 Pirantel tablet score (base) 125 mg ktk 25 x 4 tablet38.400

362Piridoksin (Vitamin B6) tablet 10 mg(HCl)

btl 1000 tablet20.880

363Piridoksin (Vitamin B6) tablet 25 mg(HCl)

btl 1000 tablet36.000

364 Piroksikam tablet 10 mg ktk 10 x 10 tablet10.080

367 Piroksikam kapsul 20 mg ktk 12 x 10 kapsul15.120

377 Prednison tablet 5 mg btl 1000 tablet75.000

378 Primakuin tablet 15 mgbtl 1000 tablet

130.800

384 Propiltiourasil tablet 50 mg btl 1000 tablet253.440

387 Ranitidin injeksi 25 mg/2 ml ktk 25 ampul77.100

388 Ranitidin tablet 150 mgktk 3 x 10 tablet

7.920

395 Rifampisin kaplet 600 mg ktk 10 x 10 kaplet110.700

404 Risperidon tablet 3 mg ktk 5 x 10 tablet171.000

408 Salisil Bedak 2 %ktk 50 gram

1.716

410 Sefadroksil kapsul 250 mg ktk 3 x 10 kapsul16.022

412 Sefadroksil kapsul 500 mg ktk 5 x 10 kapsul50.400

419 Sefiksim kapsul 100 mg ktk 5 x 10 kapsul143.676

422 Sefiksim sirup kering 100 mg/ 5 ml btl 30 ml36.300

423 Sefiksim 400 mg + Azitromisin 1000 mg paket39.600

424 Sefotaksim injeksi 0,5 gram ktk 2 vial10.415

425 Sefotaksim injeksi 1 gram ktk 2 vial16.632

428 Seftazidim injeksi 1 gktk 2 vial

81.259

436 Simetidin tablet 200 mg ktk 10 x 10 tablet13.788

437 Simvastatin tablet 5 mg ktk 3 x 10 tablet9.234

441 Simvastatin tablet 20 mg ktk 5 x 10 tablet61.560

442 Siprofloksasin tetes mata 0,3 % btl 10 ml4.647

447Siprofloksasin tablet 500 mg(sebagai HCl)

ktk 5 x 10 tablet15.600

452 Spironolakton tablet 25 mg ktk 10 x 10 tablet41.564

460 Teofilin tablet 150 mg ktk 10 x 10 tablet6.523

468Tiamin (Vitamin B1) tablet 50 mg(HCl/ Nitrat)

btl 1000 tablet45.360

471 Tramadol injeksi 50 mg/ml ktk 5 ampul38.412

481 Vitamin B Kompleks tablet btl 1000 tablet26.640

484 Zinc tablet 20 mg ktk 10 x 10 tablet57.000