Ministry of Health & Population (MOHP) NNEEDDLLGG National Essential Drug List &Guidelines 2006 EGYPT Technical Research and Training Department (TRTD) Central Administration of Pharmaceutical Affairs (CAPA) Foreword: The first Essential Drug List and Guidelines was issued in the year 1998. The Essential Drug concept was adopted in developing the Essential Drug List and Guidelines as one of the ways and means to ensure that the pharmaceutical products included in the list are available when and where they are needed. Furthermore, the list helps to reduce the number of drugs and to lower the cost. Essential Drugs are crucial to the success of health programs; the drugs are part of the final link between health services. For all the above reasons, it was very important to update the Essential Drug List to comply with the strategy of the Ministry of Health and Population (MOHP) . "Health for all " is the ultimate goal of all endeavors of MOHP. For the sake of patients we do our best to ensure safety, efficacy, quality, and affordability of drugs. I would like to express my deep thanks and appreciation to all experts who participated in updating the list, revising the text, and made the final editing. My sincere thanks are also extended to the experts who prepared the first edition. Minister Of Health & Population Prof. Dr. Hatem El Gabaly INTRODUCTION For the optimal use of the limited financial resources for health in developing countries the availability of drugs must be restricted to those proven to be therapeutically effective, to have acceptable safety and to satisfy the health needs of the population. These selected drugs are labeled "Essential" indicating they are the basic and necessary group of agents that are needed to meet the health needs of the population. The primary concept behind the use of the list of essential drugs is to reduce the number of drugs available. This will assist in the monitoring of the quality and availability of drugs in order to avoid waste and to concentrate on the pharmaceutical agents within Egypt. The advantages of an essential drug list are: 1. Reduced number of pharmaceutical products. 2. Reduced cost. 3. Improved procurement, storage and distribution and local availability. 4. Fewer drugs for quality control. 5. Training is easier with fewer drugs. 6. Improvement in the quality of drug utilization, management, information and monitoring. 7. Providing a stimulus to the local pharmaceutical industries to supply essential, generically labeled drugs, which will reduce expenditures and minimize drug importation. The aim of the "Essential Drug Committee" is to establish an up-to-date, essential drug list for different levels of health care in Egypt. Every drug is identified using a coding system that assigns that drug to a specific health care level. For each generic name, the health care level is placed on the right side of the page framed within a black box. The levels are: 1: for use by all medical professionals. 2: for use only by medical specialist and consultant physicians. 3: for use only by consultant physicians. The drugs selected for this list are described both using generic and brand names to facilitate the selection of the most appropriate drug product. In selection these factors were considered: • Source of raw material. • Innovator or generic. • Organoleptic properties. • Stability (Accelerated, real time, climatic zone). • Bioavilability and bioequivalence. • Drug history (benefit/risk ratio). • Cost. This multi-level essential drug list has these characteristics : • Consistent with the pattern of prevalent diseases. • Simple drugs are always selected. Combinations of drugs are limited. • Contains a common core with universal relevance and application. • Indicates priorities in drug needs. • Contains drugs, which are available at all times in adequate amounts and in the proper dosage forms at a suitable price. • Flexible enough to meet the changing priorities in health care. The chosen drugs are Written in generic and taken into consideration in selecting a brand are illustrated. •The different levels were assigned on the bases of the requirements of working physicians in various care settings. The Arrangement of the updated Essential Drug List: Part 1 (page 1-18) contains the National Essential Drug List (EDL) under its Nonproprietary names (Generics). Part 2 (page 1 - 137) contains monographs on non-proprietary drugs of the list arranged under therapeutic categories. Each monograph includes basic information such as indications, side effects, contraindications, interactions, precautions and doses. Part 3 (page 1 - 31) contains proprietary names of generics that are included in the essen- tial drug list. For the proprietary preparations, the information provided includes the trade name, the manufacturer, units in one pack, dosage form, and the retail price. Index : A general index to make fullest use of the contents of this book. Members of High Expert Committee for Updating of the Essential Drug List (2006) (Alphabet order): Prof. Adel Foad Ramzy Prof. Adel Sadek . Prof. Aly Ahmed El Garem. Prof. Amal El Beshlawy. Prof. Ashraf Hatem. Prof. Enas Shaltot Prof. Esmat Sheba. Prof. Ez El Deen El Denshary Prof. Gaafer Ragab. Prof. Gamela Moussa. Prof. Hady Goiran . Prof. Hany Hafez. Prof. Hasen Hosny. Prof. Hedar Galeb. Prof. Hossen Kaled. Prof. Izes Gally. Prof. Khaery Abd El Dayem. Prof. Kaled Abd El Whab El Brolosy . Prof. Magdy Arafa. Prof. Magdy Amen. Prof. Mahmod Alam . Prof. Mohamed El Tawy. Prof. Mohamed Sharaf . Prof. Mohamed Nada. Prof. Omyma El Henawy. Prof. Rashad Barsom . Prof. Reda Hamza. Prof. Roshdy El Badrawy. Prof. Sheriff El Topgy. Prof. Shokry Hanter. Prof. Taha El Shewy. Prof. Yehea Abd El Whab. Prof. Zenab Ebied. Prof. Zoher Halag. • Revision Committee : Prof. Hedar Galeb. Prof. Mamdoh Zaky. Prof. Esmat Sheba . Prof. Ez El Deen El Denshary. Prof. Zenab Ebied. • Coordinators: Prof. Zenab Ebied. • Editors& Designers Dr. Heba Moustafa. Mr. Hany Kamal. • Cover Designer : Mr. Hany Kamal. • Under Secratory of State: Dr. Zenab Ebied.. Members of High Expert Committee for Previous Essential Drug List (Alphabet Order) Prof. Abdalla M. Molokhia. Prof. Abdel K. Hammad. Prof. Abde] M. Hussein. Prof. Ahmed Abd El-bary. Prof. Ahmed S. Geneidy. Prof. Ahmed S. Khalifa. Prof. Essam M. Khedr. Prof. Ezz Eidin El-Denshary. Prof. Foad A. Ismail. Dr. Gamila M- Moussa. Dr. Hassan Abdel Fatah. Prof. Heider Ghalib. Dr. Hosny Tammam. Prof. Hussein Sabry. Prof. Laila Abo-basha. Prof. Mohamed A. Sallam. Prof. Mohamed I- Abdalla. Prof. Mohamed M. Ragheb. Prof. Mohamed N. El-Makhzangi. Prof. Mohamed R. Awadin. Dr. M. Tayseer El-Sawi. Dr. Morad Abdel Salam. Prof. Nabil M. Omar. Prof. Nadia M. Morsi. Prof. Nazly Gad El-Mawla. Prof. Rafeek Zaher. Prof. Ramzy H. El-Mawardy. Prof. Sadek A.Abd Alla. Prof. Soher Hashem. Dr. Samiha S. Faltas. Dr. Taha El-khoby. *********************************************************** ***************************************** Abbreviations : ACE : Angiotensin Converting Enzyme Amp. : Ampoule AV :.Atrioventricular Cap. : Capsule Cap. Soft : Soft Gelatin Capsule Carp. :Carpoule CNS : Central Nervous System CVs : Cardiovascular System DVT : Deep venous Thrombosis Ernul. : Emulsion E.d. : Eye Drops E.O. : Eye Ointment ECG : Electrocardiograph Er.drops : Ear Drops Elix. : Elixir Gmlm2 : Gram per Square meter GlT : Gastrointestinal Tract Gm. : Gram Inj. : Injection Inhal. : Inhaler IV : Intravenous 1M : Intramuscular I.Soi. : Inhaler solution I.aeros. : Inhaler aerosol Kg : Kilogram L : Liter Lot. : Lotion M.W. : Mouth wash Mg : Milligram MAol : Monoamine Oxidase Inhibitor Mmol : Millimol mg/m2 : Milligram per square meter M.wash : Mouth wash NSAIDS : Nonsteroidal anti-inflammatory drugs Oint. : Ointment P.inf. : Parentral infusion Powd. Sach. : Powder sachet P.disp. syg : Parentral disposable syringe Powd. : Powder Syrp. : Syrup Supp. : Suppository SC : Subcutaneous Syp. : Syrup Susp. : Suspension Soap Liq. : Soap liquid Tab. : Tablet Tab. chew. : Tablet chewable Tab. Subling : Tablet sublingual Tab. eff. : Tablet effervescent T.gel : Topical gel T.sol. : Topical solution T.saginata : Tinea Saginata TB : Tuberculosis T. spray : Topical Spray UG : Microgram UT : Urinary tract W IW : Weight per weight V N : Volume per volume ****PART 1**** (National Essential Drug List) Non-Proprietary Names (Generics) Part 1 Table of Contents 1-(G.I.T.) - Gastro-intestinal Tract Drugs--- -------------------- A1 2-(C.V.S.) - Cardiovascular System Drugs --------------------- A2 3- (R.S.) - Respiratory System Drugs----------------------------- A4 4- (A.) - Antiallergics Drugs------------------------------------------ A5 5- (C.N.S.) - Central Nervous System Drugs------------------- A6 6- (Anti.I.D) - Anti-Infectious Disease Drugs------------------- A6 7- (E.) - Endocrine System Drugs --------------------------------- A9 8- (Gyn.) - Obstetric & Gynecology Drugs --------------------- A10 9-(M.)- Malignancy & Immunosuppressive Drugs------------ A11 10- (N.&B.R.) Nutrition & Blood Restorative Drugs---------- A11 11- (S.M.D.) - Skeletomuscular Drugs --------------------------- A12 12- (OPH.) Ophthalmic Preparations ----------------------------- A13 13- (E.N.T.) - Ear, Nose & Oropharynx Drugs ---------------- A14 14- (D.) - Dermatological Drugs ----------------------------------- A16 15 - (Vac.) - Vaccins & Sera ---------------------------------------- A17 16 - (Anesth.) – Anesthetics ---------------------------------------- A17 17- (Diag.) - Diagnostic & Contrast Media Drugs -----------