Exported on: 09/07/2025

Essential drugs
Practical guide intended for physicians, pharmacists, nurses and medical
auxiliaries

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© Médecins Sans Frontières
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 All rights reserved for all countries. No reproduction, translation and adaptation may be done without
the prior permission of the Copyright owner.

Médecins Sans Frontières. Essential drugs - practical guidelines.

December 2024
ISBN 978-2-37585-280-4

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 Table of contents
Authors/Contributors

Preface

Foreword

Use of the guide

Abbreviations and acronyms

Oral drugs

Injectable drugs

Infusion fluids

Vaccines, immunoglobulins and antisera

Drugs for external use, antiseptics and disinfectants

Drugs potentially dangerous or obsolete or ineffective

Part two

Main references

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 Authors/Contributors
Essential drugs has been developed by Médecins Sans Frontières.

MSF would like to express its sincere gratitude to everyone who has contributed to developing these
guidelines.

Co-authors: Roberta Caboclo, Aurélien Sigwalt

Contributors:
Gabriel Alcoba, Jessica Burry, Helen Bygrave, Cristina Carreno, Vinciane Cruyt, Ana Paula Dresch,
Grace Dubois, Sylvie Fagard-Sultan, Caroline Gelosi, Melissa Hozjan, Nathalie Isouard, John Johnson,
Stephanie Johnston, Louise Keane, Nadia Lafferty, Amin Lamrous, James Lee, Isabel Lucas Manzano,
Miguel Palma, Barbara Pawulska, Roberta Petrucci, Nicolas Peyraud, Jean Rigal, Blandine Vasseur-
Binachon, Cedric Yoshimoto.

Specific support has been given by the International Guidelines Publication team:
Editor: Véronique Grouzard (until December 2024), Clara van Gulik (from May 2025)
Language editors: Mohamed Elsonbaty Ramadan, Carolina López, Anna Romero
Layout designer: Evelyne Laissu (until September 2024), Mike Smith (from September 2024)

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 Preface
The 1978 Alma Ata Conference on primary health care recognized that essential drugs are vital for
preventing and treating illnesses which affect millions of people throughout the world. Essential drugs
save lives and improve health.
In 1981, the World Health Organization established the Action Programme on Essential Drugs to
support countries to implementing national drug policies and to work towards rational use of drugs.
This work was broadened in 1998 when WHO created the department of Essential Drugs and Other
Medicines (EDM), combining the responsibilities of the former DAP with WHO's global efforts to
promote quality, safety, efficacy, and accurate information for all medicines.
EDM works with countries, international agencies, NGOs like Médecins Sans Frontières, and other
organizations to ensure that people everywhere have access to the essential drugs they need at a
price which is affordable; that the drugs are safe, effective, and of good quality; and that they are
prescribed and used rationally.
Appropriate tools are critical to the effective implementation of essential drugs policies. This practical
handbook, based on Médecins Sans Frontières' field experience, is one of the tools which we strongly
recommend.
Designed to give practical, concise information to physicians, pharmacists and nurses, this “Essential
drugs - practical guidelines” is an important contribution from Médecins Sans Frontières to improve
the rational use of drugs, which will be a continuing challenge in the coming years.

Dr Jonathan D. Quick
Director,
Essential Drugs and Other medicines
World Health Organization

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 Foreword
T his guide is not a dictionary of pharmacological agents. It is a practical manual intended for health
professionals, physicians, pharmacists, nurses and health auxiliaries involved in curative care and drug
management.

We have tried to provide simple, practical solutions to the questions and problems faced by medical
staff, using the accumulated field experience of Médecins Sans Frontières, the recommendations of
reference organizations such as the World Health Organization (WHO) and specialized documentation
in each field.

T his manual is not only used by Médecins Sans Frontières, but also in a wide range of other
programmes and contexts.

T he list of drugs in this edition has been revised: in accordance to the most recent WHO list of
essential medicines (https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2023.02), certain
drugs have been added, others have been removed.

Among the entries in this guide, some are not listed in the WHO list of essential medicines. However
these drugs are in the same pharmaceutical class for which the WHO has named only one "example of
a therapeutic group" preceded by a square symbol to indicate that various drugs can be used as
alternatives.

Certain medicines, which are not on the WHO list, are still frequently administered although their use is
not recommended. T hese medicines have been included in this guide by entries marked by a grey
diagonal line.

T he entries are classified according to the route of administration and in alphabetical order. T his
classification reflects the drug management system proposed in this manual (see Organization and
management of a pharmacy).

Only the main contra-indications, adverse effects, precautions and drug interactions of each drug have
been indicated in this manual. For further detailed information refer to specialised literature. Concerning
Weantiretrovirals,
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Despite all efforts, it is possible that certain errors may have been overlooked in this manual. Please
inform the authors of any errors detected. It is important to remember, that if in doubt, it is the
responsibility of the prescribing medical professional to ensure that the doses indicated
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 To ensure that this guide continues to evolve while remaining adapted to field realities, please send
any comments or suggestions.

As treatment protocols are regularly revised, please check the monthly updates.

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 Use of the guide
Last updated: April 2024

Nomenclature of drugs
T he International Non-proprietary Names (INN) of drugs is used in this guide.

Dosage
Prescription tables showing average dosage in drug units (tablets, ampoules etc.) according to weight
or age of patients are included for the most commonly used drugs.

Dilution and administration of injectable drugs

Refer to the manufacturer’s instructions as the primary source of information. Manufacturer’s
instructions are tailored to the specific formulation and concentration of a drug to ensure its
effectiveness and safe use.
T he dilution and administration instructions in this guide are provided as a guidance, to be used only if
the manufacturer’s instructions are not available.

Symbols

Prescription under medical supervision

T his box indicates potentially toxic drugs, administered under medical prescription only in many
countries.

T his symbol is used to draw attention to drugs whose toxicity is significant and whose use
requires specific precautions and/or closer patient monitoring.

Recommendations for drug storage

Protect from light

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 Abbreviations and acronyms
Last update: March 2024

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 ACE angiotensin converting enzyme

ACT artemisinin-based combination therapy

ALT alanine aminotransferase

amp. ampoule

ARV antiretroviral

AST aspartate aminotransferase

BCG bacillus Calmette-Guérin

BP blood pressure

°C degree Celsius

cap capsule

CNS central nervous sytem

co-amoxiclav amoxicillin + clavulanic acid

co-trimoxazole sulfamethoxazole + trimethoprim

CSF cerebrospinal fluid

D1 (D2, D3, etc.) Day 1 or first day (Day 2 or 2nd day, Day 3 or 3rd day, etc.)

e.g. for example

dl decilitre

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 HIV human immunodeficiency virus

i.e. that is

Ig immunoglobulin

IM intramuscular

IO intraosseous

IU international unit

IV intravenous

kcal kilocalorie

KCl potassium chloride

kg kilogram

mEq milliequivalent

mg milligram

MIU million international units

ml millilitre

mmHg millimetre of mercury

mmol millimole

MSF Médecins Sans Frontières

WeNaCl
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NSAID nonsteroidal anti-inflammatory drug
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PO per os – oral administration

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 SC subcutaneous

SMX sulfamethoxazole

SMX + T MP sulfamethoxazole + trimethoprim = co-trimoxazole

sol. solution

SpO2 arterial blood oxygen saturation measured by pulse oximetry

SSRI selective serotonin reuptake inhibitor

susp. suspension

tab tablet

T MP trimethoprim

v/v volume in volume

WHO World Health Organization

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 Oral drugs
ABACAVIR = ABC oral

ACETAMINOPHEN oral

ACET YLSALICYLIC acid = ASPIRIN = ASA oral

ACICLOVIR oral

ALBENDAZOLE oral

ALBUT EROL aerosol

ALBUT EROL nebuliser solution

ALUMINIUM HYDROXIDE/MAGNESIUM HYDROXIDE oral

AMIT RIPT YLINE oral

AMLODIPINE oral

AMOXICILLIN oral

AMOXICILLIN/CLAVULANIC acid = CO-AMOXICLAV oral

ART EMET HER/LUMEFANT RINE = AL oral

ART ESUNAT E/AMODIAQUINE = AS/AQ oral

ASCORBIC acid = VITAMIN C oral

ASPIRIN oral

ATAZANAVIR = AT V oral

AZIT HROMYCIN oral

BECLOMETASONE metered dose inhaler

BECLOMETASONE/FORMOT EROL metered dose inhaler

BIPERIDEN oral
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BUT YLSCOPOLAMINE oral

CABERGOLINE oral
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 CALCIUM FOLINAT E = FOLINIC acid oral

CARBAMAZEPINE = CBZ oral

CEFALEXIN oral

CEFIXIME oral

Activated CHARCOAL oral

CHLOROQUINE sulfate or phosphate oral

CHLORPROMAZINE oral

CIMET IDINE oral

CIPROFLOXACIN oral

CLARIT HROMYCIN oral

CLINDAMYCIN oral

CLOXACILLIN oral

CO-AMOXICLAV oral

CO-ART EMET HER oral

CODEINE oral

COLECALCIFEROL = VITAMIN D3 oral

CO-T RIMOXAZOLE = SULFAMET HOXAZOLE (SMX)/T RIMET HOPRIM (T MP) oral

DAPSONE oral

DARUNAVIR = DRV oral

DESOGEST REL oral

DEXAMET HASONE oral

DIAZEPAM oral

DIET HYLCARBAMAZINE = DEC oral

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DOLUT EGRAVIR = DT G oral
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DOXYCYCLINE

EFAVIRENZ = EFV = EFZ oral

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ENALAPRIL oral
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 ERGOCALCIFEROL = VITAMIN D2 oral

ERYT HROMYCIN oral

ET HAMBUT OL = E oral

ET HINYLEST RADIOL/LEVONORGEST REL oral

FERROUS salts oral

FERROUS salts/FOLIC acid oral

FLUCONAZOLE oral

FLUCYT OSINE oral

FLUOXET INE oral

FOLIC acid = VITAMIN B9 oral

FOSFOMYCIN T ROMETAMOL oral

FUROSEMIDE oral

GLIBENCLAMIDE oral

GLICLAZIDE oral

GLYCERYL T RINIT RAT E = NIT ROGLYCERIN = T RINIT RIN oral

GRISEOFULVIN oral

HALOPERIDOL oral

HYDROCHLOROT HIAZIDE oral

HYDROXYZINE oral

HYOSCINE BUT YLBROMIDE = BUT YLSCOPOLAMINE oral

IBUPROFEN oral

IODIZED OIL oral

IPRAT ROPIUM bromide metered dose inhaler

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ISOSORBIDE DINIT RAT E oral
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IT RACONAZOLE

IVERMECT IN oral
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LABETALOL oral
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 LACT ULOSE oral

LAMIVUDINE = 3T C oral

LEVET IRACETAM = LEV oral

LEVODOPA/CARBIDOPA oral

LEVONORGEST REL oral

LEVONORGEST REL for emergency contraception

LOPERAMIDE oral

LOPINAVIR/RIT ONAVIR = LPV/r oral

LORATADINE oral

MEBENDAZOLE oral

MEDROXYPROGEST ERONE acetate oral

MET FORMIN oral

MET HYLDOPA oral

MET OCLOPRAMIDE oral

MET RONIDAZOLE oral

MICONAZOLE oral gel

MIFEPRIST ONE oral

MISOPROST OL oral

MORPHINE immediate-release (MIR) oral

MORPHINE sustained-release (MSR) oral

MULT IVITAMINS - VITAMIN B COMPLEX oral

NEVIRAPINE = NVP oral

NICLOSAMIDE oral

WeNICOT
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NIFEDIPINE
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NIT ROFURANT OIN oral
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NITat "Settings". oral
ROGLYCERIN

NYSTAT IN oral
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OLANZAPINE oral
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 OMEPRAZOLE oral

ORAL REHYDRAT ION SALT S = ORS

PARACETAMOL = ACETAMINOPHEN oral

PAROXET INE oral

PHENOBARBITAL = PB oral

PHENOXYMET HYLPENICILLIN = PENICILLIN V oral

PHENYT OIN = PHT oral

POTASSIUM CHLORIDE immediate-release oral

POTASSIUM CHLORIDE sustained-release oral

PRAZIQUANT EL oral

PREDNISOLONE and PREDNISONE oral

PROMET HAZINE oral

PYRAZINAMIDE = Z oral

PYRIDOXINE = VITAMIN B6 oral

PYRIMET HAMINE oral

QUININE oral

ReSoMal (REhydration SOlution for MALnutrition) oral

RET INOL = VITAMIN A oral

RIFAMPICIN = R oral

RIFAPENT INE = P oral

RISPERIDONE oral

RIT ONAVIR = RT V oral

SALBUTAMOL metered dose inhaler

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SERT RALINE oral
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SODIUM VALPROAT E oral

SOFOSBUVIR/DACLATASVIR = SOF/DCV oral

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SOFOSBUVIR/VELPATASVIR = SOF/VEL oral
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 SPIRONOLACT ONE oral

SULFADIAZINE oral

SULFADOXINE/PYRIMET HAMINE = SP oral

SULFAMET HOXAZOLE (SMX)/T RIMET HOPRIM (T MP) oral

T ENOFOVIR DISOPROXIL FUMARAT E = T DF oral

T HIAMINE = VITAMIN B1 oral

T INIDAZOLE oral

T RAMADOL oral

T RANEXAMIC acid oral

T RICLABENDAZOLE oral

T RIHEXYPHENIDYL oral

T RINIT RIN oral

ULIPRISTAL oral

VALPROIC acid = VPA = SODIUM VALPROAT E oral

VITAMIN A oral

VITAMIN B1 oral

VITAMIN B3 oral

VITAMIN B6 oral

VITAMIN B9 oral

VITAMIN C oral

VITAMIN D2 oral

VITAMIN D3 oral

VITAMIN PP oral

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 ABACAVIR = ABC oral
Last updated: October 2024

Prescription under medical supervision

Therapeutic action
Antiretroviral, HIV nucleoside reverse transcriptase inhibitor

Indications
HIV infection, in combination with other antiretrovirals

Forms and strengths

Fixed-dose combinations with lamivudine (3T C):
120 mg abacavir/60 mg lamivudine breakable and dispersible tablet
600 mg abacavir/300 mg lamivudine tablet

Dosage
T he daily dose can be administered once daily or in 2 divided doses.
Child 1 month and over and adult:

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 Daily dose
Weight 120/60 mg tablet 600/300 mg tablet
ABC/3TC

½ tab x 2
3 to < 6 kg 120/60 mg –
or 1 tab x 1

½ tab morning and 1 tab evening

6 to < 10 kg 180/90 mg –
or 1 ½ tab x 1

1 tab x 2
10 to < 14 kg 240/120 mg –
or 2 tab x 1

1 tab morning and 1 ½ tab evening

14 to < 20 kg 300/150 mg –
or 2 ½ tab x 1

1 ½ tab x 2
20 to < 25 kg 360/180 mg –
or 3 tab x 1

≥ 25 kg 600/300 mg – 1 tab x 1

Duration
Depending on the efficacy and tolerance of abacavir.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe hepatic impairment or history of hypersensitivity reaction
to abacavir that led to discontinuation of treatment.
Administer with caution to patients with hypertension, diabetes, hyperlipidaemia (might increase the
risk of coronary disease).
May cause:
hypersensitivity reactions: fever, rash, gastrointestinal disturbances (nausea, vomiting, diarrhoea,
abdominal pain), pharyngitis, cough, dyspnoea, malaise, headache, lethargy, myalgia, arthralgia;
We use alactic acidosis,
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Do not cut, crush or chew the 600/300 mg tablets.
Also comes in fixed-dose combination 60 mg abacavir/30 mg lamivudine/5 mg dolutegravir
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dispersible tablet. Preferably use this formulation when available in children.

Page 20 / 663
 Storage
– – Below 25 °C

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 ACETAMINOPHEN oral
See PARACETAMOL oral

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 ACETYLSALICYLIC acid = ASPIRIN = ASA
oral
Last updated: April 2024

Prescription under medical supervision

Due to their better safety profile, prefer paracetamol or ibuprofen for pain and fever
management.

Therapeutic action
Analgesic, antipyretic, non steroidal anti-inflammatory (NSAID)
Platelet antiaggregant (at low dose)

Indications
Mild pain, fever
Secondary prevention of severe pre-eclampsia

Forms and strengths

300 mg tablet
75 mg enteric coated tablet

Dosage and duration

Pain and fever
Adolescent over 16 years and adult: 300 mg to 1 g every 4 to 6 hours (max. 4 g daily), for 1 to 3 days

Prevention of pre-eclampsia:
We75use
to 150 mg once
a selection daily
of our ownfrom
and the 12th tocookies
third-party the 36thonweek of gestation.
the pages StopEssential
of this website: treatment 5 to 10
cookies, daysare
which
before in
required the expected
order date
to use the of delivery.
website; functional cookies, which provide better easy of use when using the website;
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not administer to patients with allergy to aspirin and NSAID, gastroduodenal ulcer, coagulation
disorders, haemorrhage, severe renal, hepatic or cardiac impairment.
Do not administer to children for pain or fever (use paracetamol).
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Administer with caution to older patients or patients with asthma.

Page 23 / 663
 Do not exceed indicated doses, particularly in older patients. Intoxications are severe, possibly
fatal.
May cause:
allergic reactions, epigastric pain, gastroduodenal ulcer, haemorrhage;
dizziness, tinnitus (early signs of overdose);
Reye’s syndrome in children (encephalopathy and severe hepatic disorders).
For all cases above, stop aspirin.
Do not combine with methotrexate, anticoagulants or NSAID.
Monitor combination with insulin (increased hypoglycaemia) and corticosteroids.
Pregnancy:
pain and fever: avoid. CONT RA-INDICAT ED from the beginning of the 6th month. Use
paracetamol.
prevention of pre-eclampsia: do not exceed 150 mg daily.
Breast-feeding: avoid. Use paracetamol.

Remarks
Take during meals, preferably with a lot of water.
Do not crush enteric coated tablets.
Aspirin may be administered in secondary prevention of atherothrombosis, at a dose of 75 to 300
mg daily.
Also comes in 500 mg tablets and 300 mg dispersible tablets.

Storage
– Below 25 °C
Do not use if tablets have a strong smell of vinegar. A slight vinegar smell is always present.

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Page 24 / 663
 ACICLOVIR oral
Prescription under medical supervision

Therapeutic action
Antiviral active against herpes simplex virus and varicella zoster virus

Indications
Treatment of recurrent or extensive oral and oesophageal herpes in immunocompromised patients
Treatment of herpetic kerato-uveitis
Treatment of genital herpes
Secondary prophylaxis of herpes in patients with frequent and/or severe recurrences
Treatment of severe forms of zoster: necrotic or extensive forms, facial or ophthalmic zoster

Forms and strengths

200 mg and 800 mg tablets
Also comes in 40 mg/ml oral suspension.

Dosage and duration

Treatment of recurrent or extensive oral and oesophageal herpes in immunocompromised
patients, treatment of herpetic kerato-uveitis
Child under 2 years: 200 mg 5 times daily for 7 days
Child 2 years and over and adult: 400 mg 5 times daily for 7 days

Treatment of genital herpes

Child 2 years and over and adult: 400 mg 3 times daily for 7 days; in immunocompromised patients,
continue treatment until clinical resolution

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Secondary of our own
prophylaxis ofand third-party
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Child 2 years and over and adult: 400 mg 2 times daily
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Treatment
time of severe forms of zoster
at "Settings".
Adult: 800 mg 5 times daily for 7 days

Contra-indications,
Settings adverse effects, precautions Decline Accept

Page 25 / 663
 Do not administer to patients with hypersensitivity to aciclovir.
May cause: headache, skin rash, allergic reactions, gastrointestinal disturbances, raised
transaminases, neurologic disorders in patients with renal impairment and elderly patients; rarely,
haematological disorders.
Reduce dosage in patients with renal impairment.
Drink a lot of liquid during treatment.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
For the treatment of herpes simplex, aciclovir should be started as soon as possible (within 96
hours) after the appearance of lesions to reduce severity and duration of infection.
For the treatment of herpes zoster, aciclovir should be start preferably within 72 hours after the
appearance of lesions. Aciclovir administration does not reduce the likelihood of developing
zosterassociated pain but reduces the overall duration of this pain.

Storage
- Below 25 °C

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Page 26 / 663
 ALBENDAZOLE oral
Prescription under medical supervision

Therapeutic action
Anthelminthic

Indications
Ascariasis (Ascaris lumbricoides), enterobiasis (Enterobius vermicularis), hookworm infections
(Ancylostoma duodenale, Necator americanus)
Trichuriasis (Trichuris trichiura), strongyloidiasis (Strongyloides stercoralis)
Trichinellosis (Trichinella sp)

Forms and strengths

400 mg tablet

Dosage and duration

Ascariasis, enterobiasis, hookworm infections
Child over 6 months and adult: 400 mg single dose
Child over 6 months but under 10 kg: 200 mg single dose
In the event of enterobiasis, a second dose may be given after 2 to 4 weeks.

Trichuriasis, strongyloidiasis
Child over 6 months and adult: 400 mg once daily for 3 days
Child over 6 months but under 10 kg: 200 mg once daily for 3 days

Trichinellosis
Child over 2 years: 5 mg/kg 2 times daily for 10 to 15 days
We use a selection
Adult: 400 mgof2our owndaily
times and third-party
for 10 to 15 cookies
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Contra-indications, adverse effects, precautions
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allnot
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time at "Settings".
Do not administer to patients with ocular cysticercosis.
May cause:
Settings gastrointestinal disturbances, headache, dizziness; Decline Accept
neurological disorders (headache, seizures) in patients with undiagnosed neuro cysticercosis.
Page 27 / 663
 Pregnancy: avoid during the first trimester
Breast-feeding: no contra-indication

Remarks
Tablets are to be chewed or crushed: follow manufacturer's recommendations.
In the treatment of strongyloidiasis, ivermectin is more effective than albendazole.
Albendazole is also used in the treatment of cutaneous larva migrans (Ancylostoma
braziliense and caninum), larval cestode infections (hydatid disease, certain forms of
neurocysticercosis) and in mass treatment for lymphatic filariasis (check national
recommendations).

Storage
- Below 25 °C

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Page 28 / 663
 ALBUTEROL aerosol
See SALBUTAMOL aerosol

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Page 29 / 663
 ALBUTEROL nebuliser solution
See SALBUTAMOL nebuliser solution

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Page 30 / 663
 ALUMINIUM HYDROXIDE/MAGNESIUM
HYDROXIDE oral
Therapeutic action
Antacid

Indications
Stomach pain associated with gastritis and peptic ulcer

Forms and strengths

400 mg aluminium hydroxide/400 mg magnesium hydroxide chewable tablet

Dosage
Child over 5 years: rarely indicated. When necessary: half a tablet 3 times daily
Adult: 1 to 2 tablets 3 times daily 20 minutes to one hour after meals, or 1 tablet during painful
attacks

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Decreases intestinal absorption of many drugs. Do not administer simultaneously with:
atazanavir, chloroquine, digoxin, doxycycline, iron salts, gabapentin, itraconazole, levothyroxine
(take at least 2 hours apart).
ciprofloxacin (take ciprofloxacin 2 hours before or 4 hours after antacids), dolutegravir
(take dolutegravir 2 hours before or 6 hours after antacids), velpatasvir (take 4 hours apart).
Pregnancy:
We use a selection no contra-indication
of our own and third-party cookies on the pages of this website: Essential cookies, which are
Breast-feeding:
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website; functional cookies, which provide better easy of use when using the website;
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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at "Settings".
tablets.
T here are numerous preparations of aluminium and/or magnesium hydroxide and different dosages.
Antacids are not included in the WHO list of essential medicines.
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Page 31 / 663
 Storage
Below 25 °C

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Page 32 / 663
 AMITRIPTYLINE oral
Last updated: March 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of amitriptyline, patients
should be kept under close surveillance.

Therapeutic action
Tricyclic antidepressant

Indications
Neuropathic pain
Major depression (preferably use selective serotonin re-uptake inhibitors for this indication)

Forms and strengths

25 mg tablet

Dosage
Neuropathic pain
Adult: 25 mg once daily at bedtime (Week 1); 50 mg once daily at bedtime (Week 2); 75 mg once
daily at bedtime (as of Week 3)

Major depression
Adult: 25 mg once daily at bedtime. Depending on efficacy and tolerance, increase over 8 to 10
days, up to 75 mg once daily at bedtime.

Do not exceed 150 mg daily. Reduce the dose by half in older patients.
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Duration
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Neuropathic
cookies, pain:to
which are used 3 display
to 6 months after
relevant painand
content relief is obtained.
advertising. If pain
If you reappears,
choose recommence
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all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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depression: at least 9 months. Discontinue treatment gradually (over 4 weeks). If signs of
relapse or withdrawal occur, increase the dose then decrease it more gradually.

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Contra-indications, adverse effects, precautions
Page 33 / 663
 Do not administer to patients with recent myocardial infarction, arrhythmia, closed-angle
glaucoma, prostate disorders.
Administer with caution and carefully monitor use in older patients and in patients with epilepsy,
chronic constipation, renal or hepatic impairment (reduce the dose by half), history of bipolar
disorders and suicidal ideation.
May cause:
drowsiness (caution when driving or operating machinery), orthostatic hypotension, sexual
dysfunction;
anticholinergic effects: dry mouth, constipation, blurred vision, tachycardia, disorders of
micturition. Treatment should be discontinued in the event of severe reactions (confusional
state, urinary retention, cardiac rhythm disorders);
Administer with caution and monitor combination with: CNS depressants (opioid analgesics,
sedatives, H1 antihistamines, etc.), drugs known to have anticholinergic effects (atropine,
chlorpromazine, promethazine, etc.), drugs which lower the seizure threshold (antipsychotics,
mefloquine, etc.), serotonergic drugs (SSRI, tricyclic antidepressants, ondansetron, tramadol, etc.),
anti-hypertensive drugs.
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, maintain
amitriptyline at effective dose. Observe the neonate the first few days (risk of agitation, tremors,
hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under treatment in the
3rd trimester of pregnancy. If treatment for major depression starts during pregnancy, preferably
use sertraline.
Breast-feeding: monitor the child for excessive somnolence.

Remarks
Sedative effect occurs following initial doses, analgesic effect is delayed for 7 to 10 days and the
antidepressant effect is delayed for at least 4 weeks. T his must be explained to the patient.
For neuropathic pain, amitriptyline is often administered in combination with carbamazepine or
gabapentin.

Storage
– Below 25 °C

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Page 34 / 663
 AMLODIPINE oral
Last updated: March 2024

Prescription under medical supervision

Therapeutic action
Antihypertensive vasodilator (calcium channel blocker)

Indications
Hypertension

Forms and strengths

5 mg tablet

Dosage
Adult: 5 mg once daily. Increase to 10 mg once daily if necessary (max. 10 mg daily).
In older patients or patients with hepatic impairment, start with 2.5 mg once daily then increase
gradually if necessary.

Duration
According to clinical response.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe hypotension, shock, unstable heart failure after acute
myocardial infarction.
May cause:
headache, dizziness, sensation of flushing or warmth, fatigue, ankle oedema (common at the
We use astart
selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
of treatment);
required hypotension,
in order to use palpitations,
the website; functional
abdominal cookies, which provide
pain, nausea, better
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hyperplasia.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Administer with caution and monitor use with:
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of allother antihypertensive
cookies. You can accept drugs (riskindividual
and reject of hypotension);
cookie types and revoke your consent for the future at any
drugs with hypotensive effects (e.g. haloperidol, amitriptyline);
time at "Settings".
fluconazole, erythromycin, fluoxetine, ritonavir (effects of amlodipine increased, particularly the
antihypertensive effect);
Settings Decline Accept
rifampicin, phenytoin, phenobarbital, carbamazepine (effects of amlodipine decreased).

Page 35 / 663
 Pregnancy: no contra-indication. For the management of hypertension in pregnancy, use labetalol.
Breast-feeding: avoid

Remarks
Also comes in telmisartan 40 mg/amlopidine 5 mg coformulated tablet.

Storage
– – Below 25 °C

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Page 36 / 663
 AMOXICILLIN oral
Last updated: April 2024

Prescription under medical supervision

Therapeutic action
Penicillin antibacterial

Indications
Acute otitis media, streptococcal tonsillitis, sinusitis, bronchitis, pneumonia with no signs of severity
Infection due to Helicobacter pylori (in combination with omeprazole and clarithromycin),
leptospirosis, uncomplicated cutaneous anthrax
Uncomplicated typhoid fever if the strain is susceptible (recent drug susceptibility test)
Completion treatment following therapy with parenteral penicillins or cephalosporins

Forms and strengths

250 mg and 500 mg tablets or capsules
250 mg dispersible scored tablet, for paediatric use
125 mg/5 ml powder for oral suspension:
to be reconstituted with filtered water
to be administered using a measuring device (oral syringe, measuring spoon, or cup with
graduations)

Dosage
Usual dosage (e.g. leptospirosis, tonsillitis, infection due to H. pylori)
Child: 25 mg/kg (max. 1 g) 2 times daily
Adult: 1 g 2 times daily

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Page 37 / 663
 125 mg/5 ml 250 mg 500 mg
Age Weight Daily dose
susp. tablet tablet

< 3 months < 6 kg 125 mg x 2 5 ml x 2 ½ tab x 2 –

3 to < 24 months 6 to < 12 kg 250 mg x 2 10 ml x 2 1 tab x 2 –

2 to < 8 years 12 to < 25 kg 500 mg x 2 20 ml x 2 2 tab x 2 1 tab x 2

≥ 8 years and adult ≥ 25 kg 1gx2 – 4 tab x 2 2 tab x 2

High dosage (e.g. pneumonia, typhoid fever, resistant pneumococcal infections, cutaneous
anthrax)
Child: 30 mg/kg (max. 1 g) 3 times daily
Adult: 1 g 3 times daily

125 mg/5 250 mg 500 mg

Age Weight Daily dose
ml susp. tablet tablet

< 3 months < 6 kg 125 mg x 3 5 ml x 3 ½ tab x 3 –

3 to < 24 months 6 to < 12 kg 250 mg x 3 10 ml x 3 1 tab x 3 –

2 to < 8 years 12 to < 25 kg 500 mg x 3 20 ml x 3 2 tab x 3 1 tab x 3

≥ 8 years and adult ≥ 25 kg 1gx3 – 4 tab x 3 2 tab x 3

Duration
Otitis media, bronchitis, pneumonia: 5 days
Tonsillitis: 6 days
Leptospirosis, H. pylori infection: 7 days
Sinusitis:
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Cutaneous anthrax: 7website;
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Contra-indications, adverse effects, precautions
time at "Settings".
Do not administer to penicillin-allergic patients or patients with mononucleosis.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may
Settings occur). Accept
Decline

Page 38 / 663
 May cause: gastrointestinal disturbances, allergic reactions, sometimes severe. In the event of
allergic reaction, stop treatment immediately.
Reduce dosage in patients with severe renal impairment.
Do not combine with methotrexate.
Pregnancy and breast-feeding: no contra-indication

Storage
– – Below 25 °C
For the oral suspension (powder or reconstituted suspension): follow manufacturer’s instructions.

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Page 39 / 663
 AMOXICILLIN/CLAVULANIC acid = CO-
AMOXICLAV oral
Prescription under medical supervision

Therapeutic action
Combination of two antibacterials. T he addition of clavulanic acid to amoxicillin extends its
spectrum of activity to cover beta-lactamase producing Gram-positive and Gram-negative
organisms, including some Gram-negative anaerobes.

Indications
Animal bites, if antibiotic therapy or antibiotic prophylaxis is clearly indicated
Second line treatment of acute otitis media and acute bacterial sinusitis, when amoxicillin alone
given at high dose failed
Acute uncomplicated cystitis (no systemic signs) in girls over 2 years
Postpartum upper genital tract infection
Parenteral to oral switch therapy in severe infections (e.g. severe pneumonia)

Forms and strengths

T he ratio of amoxicillin and clavulanic acid varies according to the manufacturer:

Ratio 8:1 500 mg amoxicillin/62.5 mg clavulanic acid tablet

500 mg amoxicillin/62.5 mg clavulanic acid/5 ml powder for oral suspension

Ratio 7:1 875 mg amoxicillin/125 mg clavulanic acid tablet

400 mg amoxicillin/57 mg clavulanic acid/5 ml, powder for oral suspension
200 mg amoxicillin/28.5 mg clavulanic acid dispersible tablet
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Dosage
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(expressed
time in amoxicillin)
at "Settings".

Animal bites; second line treatment of acute otitis media and acute sinusitis
Settings
Child < 40 kg: 25 mg/kg 2 times daily Decline Accept
Child ≥ 40 kg and adult:
Page 40 / 663
 Ratio 8:1: 2000 mg daily = 2 tablets of 500/62.5 mg 2 times daily
Ratio 7:1: 1750 mg daily = 1 tablet of 875/125 mg 2 times daily

Acute uncomplicated cystitis in girls > 2 years

12.5 mg/kg 2 times daily

Postpartum upper genital tract infection; parenteral to oral switch therapy in severe infections
Child < 40 kg: 50 mg/kg 2 times daily
Child ≥ 40 kg and adult:
Ratio 8:1: 3000 mg daily = 2 tablets of 500/62.5 mg 3 times daily
Ratio 7:1: 2625 mg daily = 1 tablet of 875/125 mg 3 times daily

Duration
Animal bites: 5 to 7 days
Otitis media: 5 days
Sinusitis: 7 to 10 days
Cystitis: 3 days
Upper genital tract infection: 7 days
Parenteral to oral switch therapy in severe pneumonia: to complete a total of 10 to 14 days of
treatment.

Contra-indications, adverse effects, precautions

Do not administer to penicillin-allergic patients and patients with history of hepatic disorders during
a previous treatment with co-amoxiclav.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur).
Administer with caution to patients with hepatic impairment; reduce dosage and give every 12 or 24
hours in patients with severe renal impairment.
May cause: gastrointestinal disturbances (mainly diarrhoea); allergic reactions sometimes severe
(stop treatment immediately); jaundice and cholestatic hepatitis in the event of prolonged
treatment (> 10 to 15 days).
T he dose of clavulanic acid should not exceed 12.5 mg/kg daily or 375 mg daily.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
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Also comes in formulations with a ratio of amoxicillin/clavulanic acid of 4:1: 125 mg
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time amoxicillin/31.25
at "Settings". mg clavulanic acid/5 ml powder for oral suspension and 500 mg amoxicillin/125 mg
clavulanic acid tablet. T he maximum dose (expressed in amoxicillin) that can be given with these
formulations is 50 mg/kg daily, without exceeding 1500 mg daily.
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Storage
Page 41 / 663
 – – Below 25 °C

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Page 42 / 663
 ARTEMETHER/LUMEFANTRINE = AL oral
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria
Treatment of uncomplicated malaria due to other Plasmodium species, when chloroquine cannot
be used
Completion treatment following parenteral therapy for severe malaria

Forms and strengths

Co-formulated tablets of artemether/lumefantrine, in blister packs, for a complete treatment for
one individual
T here are 5 different blister packs corresponding to 4 different categories of weight:
20 mg artemether/120 mg lumefantrine dispersible tablet, blister pack of 6 tablets
20 mg artemether/120 mg lumefantrine dispersible tablet, blister pack of 12 tablets
20 mg artemether/120 mg lumefantrine tablet, blister pack of 18 tablets
20 mg artemether/120 mg lumefantrine tablet, blister pack of 24 tablets
80 mg artemether/480 mg lumefantrine tablet, blister pack of 6 tablets

Dosage and duration

T he treatment is administered 2 times daily for 3 days. On D1, the first dose is given at 0 hour and
the second dose at 8-12 hours. Subsequent doses on D2 and D3 are given 2 times daily (morning
and evening).

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 20/120 mg tablet 80/480 mg tablet
Weight
D1 D2 D3 D1 D2 D3

5 to < 15 kg 1 disp tab x 2 1 disp tab x 2 1 disp tab x 2 – – –

15 to < 25 kg 2 disp tab x 2 2 disp tab x 2 2 disp tab x 2 – – –

25 to < 35 kg 3 tab x 2 3 tab x 2 3 tab x 2 – – –

≥ 35 kg 4 tab x 2 4 tab x 2 4 tab x 2 1 tab x 2 1 tab x 2 1 tab x 2

Contra-indications, adverse effects, precautions

May cause: headache, dizziness and gastrointestinal disturbances.
Administer with caution to patients taking drugs that prolong the QT interval: amiodarone, other
antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron,
etc.
re-administer the full dose.
If the patient vomits within 30 minutes after administration: re-administer the full dose. If the patient
vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Take with meals or a fat containing drink (e.g. milk).
Lumefantrine is also called co-artemether.

Storage
- - Below 30 °C
Leave tablets in blisters until use. Once a tablet is removed from its blister, it must be administered
immediately.
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Page 44 / 663
 ARTESUNATE/AMODIAQUINE = AS/AQ oral
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria
Treatment of uncomplicated malaria due to other Plasmodium species, when chloroquine cannot
be used
Completion treatment following parenteral therapy for severe malaria

Forms and strengths

Co-formulated tablets of artesunate (AS)/amodiaquine (AQ), in blister packs, for a complete
treatment for one individual
T here are 4 different blister packs corresponding to 4 different categories of weight:
25 mg AS/67.5 mg AQ base tablet blister pack of 3 tablets
50 mg AS/135 mg AQ base tablet blister pack of 3 tablets
100 mg AS/270 mg AQ base tablet blister pack of 3 tablets
100 mg AS/270 mg AQ base tablet blister pack of 6 tablets

Dosage and duration

Tablets are to be taken once daily for 3 days.

Weight Tablets D1 D2 D3

4.5 to < 9 kg 25 mg AS/67.5 mg AQ base 1 tab 1 tab 1 tab

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required
9 to <in18
order
kg to use the website; functional cookies,
50 mg AS/135 mg which provide better easy1of
AQ base use when1using
tab tab the website;
1 tab
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use18
of all 100 mg AS/270 mg AQ base
to cookies.
< 36 kg You can accept and reject individual cookie types and revoke your consent 1
1 tab fortab
the future1attab
any
time at "Settings". blister pack of 3 tab

100 mg AS/270 mg AQ base

≥ 36 kg
Settings 2 tab 2 Decline
tab 2Accept
tab
blister pack of 6 tab

Page 45 / 663
 Contra-indications, adverse effects, precautions
Do not administer in the event of previous severe adverse reaction to treatment with amodiaquine
(e.g. hypersensitivity reaction, hepatitis, leucopenia, agranulocytosis).
Do not administer to patients taking efavirenz.
Avoid combination with drugs that prolong QT interval: amiodarone, other antimalarials,
antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron, etc.
May cause: gastrointestinal disturbances, pruritus, somnolence or insomnia, cough.
If the patient vomits within 30 minutes after administration, re-administer the full dose. If the patient
vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
For patients unable to swallow the tablets (e.g. young children), the tablets can be dispersed by
gentle agitation for approximately one minute in a small amount of water. After administration, give
children some sugar or sugared water to cover amodiaquine’s bitter taste.

Storage
- - Below 30 °C
Leave tablets in blisters until use. Once a tablet is removed from its blister, it must be administered
immediately.

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Page 46 / 663
 ASCORBIC acid = VITAMIN C oral
Therapeutic action
Vitamin

Indications
Treatment and prevention of scurvy (vitamin C deficiency)

Forms and strengths

250 mg chewable tablet
500 mg tablet

Dosage and duration

Treatment of scurvy:
T he optimal dose has not been established. For information:
Child 1 month to 11 years: 100 mg 3 times daily
Child 12 years and over and adult: 250 mg 3 times daily
or
Child 1 month to 3 years: 100 mg 2 times daily
Child 4 to 11 years: 250 mg 2 times daily
Child 12 years and over and adult : 500 mg 2 times daily

Treatment is administered at least 2 weeks or longer (until symptoms resolve), then preventive
treatment is given as long as the situation requires.

Prevention of scurvy:
Child and adult: 50 mg daily, as long as the situation requires

Contra-indications, adverse effects, precautions

We use a selection
Ascorbic acidofisour own
well and third-party
tolerated cookiesdoses.
at indicated on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better
May cause: gastrointestinal disturbances and nephrolithiasis easy >
at doses of1use when may
g daily; usinginterfere
the website;
with
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
the measurement of glucose in blood and urine at doses ≥ 2 g daily.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofPregnancy: no contra-indication,
all cookies. You doindividual
can accept and reject not exceed 1 g types
cookie daily.and revoke your consent for the future at any
time Breast-feeding:
at "Settings". no contra-indication

Storage
Settings Decline Accept
– – Below 25 °C
Page 47 / 663
 ASPIRIN oral
See ACET YLSALICYLIC ACID = ASA

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 48 / 663
 ATAZANAVIR = ATV oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretroviral, HIV protease inhibitor

Indications
HIV infection, in combination with ritonavir (booster) and other antiretrovirals

Forms and strengths

200 mg capsule
300 mg atazanavir/100 mg ritonavir tablet

Dosage
Child 10 to < 25 kg: one 200 mg capsule once daily (+ 100 mg ritonavir once daily)
Child ≥ 25 kg and adult: one 300 mg/100 mg tablet once daily

Duration
Depending on the efficacy and tolerance of atazanavir and ritonavir.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe hepatic impairment.
Administer with caution and monitor use in patients with haemophilia (increased bleeding) or mild to
moderate hepatic impairment.
May cause:
We use ajaundice,
selection gastrointestinal
of our own and third-party cookies
disturbances, on the pages
headache, of this website:
insomnia, fatigue,Essential cookies,
peripheral which are
neuropathy,
required asymptomatic
in order to use the website; functional cookies, which provide better easy of use when
hyperbilirubinaemia, cholelithiasis, urolithiasis, conduction disorders, using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
hyperglycaemia, hyperlipidaemia, lipodystrophy;
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of allskin rash You
cookies. sometimes severe,
can accept hepatic
and reject disorders;
individual cookieintypes
this event, stopyour
and revoke treatment
consentimmediately.
for the future at any
time Do not combine with rifampicin or omeprazole (decreased plasma concentrations of atazanavir):
at "Settings".
replace rifampicin with rifabutin;
if omeprazole is necessary, do not exceed 20 mg daily and take each drug 12 hours apart.
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Page 49 / 663
 Administer with caution and monitor combination with drugs that prolong the QT interval
(amiodarone, co-artemether, mefloquine, quinine, haloperidol, etc.).
Do not administer simultaneously with antacids containing aluminium or magnesium hydroxide. Take
2 hours apart.
Atazanavir in combination with ritonavir reduces the efficacy of implants and oral contraceptives:
use injectable medroxyprogesterone or an intrauterine device or an oral contraceptive containing at
least 30 micrograms of ethinylestradiol per tablet.
Pregnancy: no contra-indication; monitor bilirubin levels and/or signs of jaundice in neonates.

Remarks
Take with meals together with ritonavir.
Do not open the capsules.
Also comes in 100 mg, 150 mg and 300 mg capsules, not in combination with ritonavir.

Storage
– Below 25 °C

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Page 50 / 663
 AZITHROMYCIN oral
Last updated: June 2025

Prescription under medical supervision

Therapeutic action
Macrolide antibacterial

Indications
Trachoma, conjunctivitis due to Chlamydia trachomatis
Cervicitis and urethritis due to Chlamydia trachomatis (in combination with a treatment for
gonorrhoea), donovanosis, chancroid, early syphilis
Cholera (if the strain is susceptible), typhoid fever, yaws, leptospirosis, louse-borne and tick-borne
relapsing fevers
Pertussis, diphtheria, pneumonia due to Mycoplasma pneumoniae and Chlamydophila
pneumoniae
Second-line treatment of shigellosis
Streptococcal tonsillitis, acute otitis media, in penicillin-allergic patients only

Forms and strengths

250 mg and 500 mg tablets
200 mg/5 ml powder for oral suspension, to be reconstituted with filtered water

Dosage and duration

Trachoma, cholera, cervicitis and urethritis due to C. trachomatis, chancroid, early syphilis
Child: 20 mg/kg (max. 1 g) single dose
Adult: 1 g single dose (2 g single dose in early syphilis)

Yaws
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Child
required inand
orderadult:
to use30themg/kg (max.
website; 2 g) single
functional dosewhich provide better easy of use when using the website;
cookies,
performance cookies,
Conjunctivitis duewhich
to C. we use to generate aggregated data on website use and statistics; and marketing
trachomatis
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Child: 20 mg/kg (max. 1 g) once daily for 3 days
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Adult: 1 g once daily for 3 days
at "Settings".
Typhoid fever
Child: 10 to 20 mg/kg (max. 1 g) once daily for 7 days
Settings Decline Accept
Adult: 500 mg to 1 g once daily for 7 days or 1 g on D1 then 500 mg once daily from D2 to D7
Page 51 / 663
 Donovanosis (granuloma inguinale)
Adult: 1 g on D1 then 500 mg once daily until healing of lesions

Pertussis
Child under 6 months: 10 mg/kg once daily for 5 days
Child 6 months and over: 10 mg/kg (max. 500 mg) on D1 then 5 mg/kg (max. 250 mg) once daily
from D2 to D5
Adult: 500 mg on D1 then 250 mg once daily from D2 to D5

Pneumonia due to M. pneumoniae and C. pneumoniae

Child: 10 mg/kg (max. 500 mg) once daily for 5 days
Adult: 500 mg on D1 then 250 mg once daily from D2 to D5

Leptospirosis
Child: 10 mg/kg (max. 500 mg) on D1 then 5 mg/kg (max. 250 mg) once daily on D2 and D3
Adult: 1 g on D1 then 500 mg once daily on D2 and D3

Shigellosis
Child: 12 mg/kg (max. 500 mg) on D1 then 6 mg/kg (max. 250 mg) once daily from D2 to D5
Adult: 500 mg on D1 then 250 mg once daily from D2 to D5

Diphtheria
Child: 10 to 12 mg/kg (max. 500 mg) once daily for 14 days
Adult: 500 mg once daily for 14 days

Relapsing fevers (louse-borne and tick-borne)

Child: 10 mg/kg (max. 500 mg) single dose for louse-borne relapsing fever and once daily for 7 to 10
days for tick-borne relapsing fever
Adult: 500 mg single dose for louse-borne relapsing fever and once daily for 7 to 10 days for tick-
borne relapsing fever

Streptococcal tonsillitis, only in penicillin-allergic patients

Child: 20 mg/kg (max. 500 mg) once daily for 3 days
Adult: 500 mg once daily for 3 days

Acute otitis media, only in penicillin-allergic patients

Child: 10 mg/kg (max. 500 mg) once daily for 3 days

Contra-indications, adverse effects, precautions

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Do in
required notorder
administer towebsite;
to use the patientsfunctional
with allergy to azithromycin
cookies, which provideorbetter
anothereasymacrolide,
of use whenand to the
using patients
website;
with severe
performance hepatic
cookies, whichimpairment.
we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant under
Administer with caution to children content6and advertising.
weeks If youofchoose
of age (risk "Accept pyloric
hypertrophic all", youstenosis)
consent to
andthe
use ofpatients
all cookies.
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riskcan acceptfor
factors andQTreject individual cookie
prolongation types and revoke
(e.g. electrolyte your consent
disturbances, for the future
pre-existing at any
cardiac
time at "Settings".
and renal disorders, older patients).
May cause:
Settings gastrointestinal disturbances, reversible hearing disorders, electrolytes disturbances,
DeclineQT Accept
prolongation;
Page 52 / 663
 rarely: hypersensitivity reactions (including severe cutaneous reactions such as Stevens-
Johnson, Lyell and DRESS syndromes) and life-threatening hepatotoxicity. In these cases, stop
treatment. Signs and symptoms of hypersensitivity reaction (e.g. fever, rash, mouth ulcers,
bleeding) and hepatic disorders (e.g. anorexia, nausea, general malaise, dark urine, pale stools,
hepatomegaly, jaundice) require immediate medical attention.
Do not administer simultaneously with antacids (aluminium or magnesium hydroxide, etc.).
Administer 2 hours apart.
Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co-
artemether, fluconazole, haloperidol, mefloquine, moxifloxacin, ondansetron, pentamidine, quinine,
etc.).
Administer with caution and monitor use in patients taking digoxin (increased digoxin toxicity plasma
levels).
Pregnancy and breast-feeding: no contra-indication

Remarks
Azithromycin is also used for septicaemia of pulmonary or gynaecological origin (child: 10 to 20
mg/kg (max. 1 g) once daily; adult: 500 mg to 1 g once daily), in combination with other
antibacterials.
Also comes in 250 mg or 500 mg capsules, to be taken one hour before or 2 hours after a meal.

Storage
- - Below 25 °C
For the oral suspension (powder or reconstituted suspension): follow manufacturer’s instructions.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 53 / 663
 BECLOMETASONE metered dose inhaler
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Steroidal anti-inflammatory drug (inhaled corticosteroid)

Indications
Long term treatment of chronic asthma (maintenance and symptomatic treatment), alone
or in combination with a beta-2 agonist bronchodilator

Forms and strengths

Solution or suspension for inhalation in pressurised metered dose inhalers, delivering 50, 100 or 250
micrograms of beclometasone dipropionate/puff

Dosage
Start at the step most appropriate to initial severity. Always try to administer the lowest effective
dose.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 54 / 663
 Asthma
6 to 11 years 12 years and over and adult
severity

Intermittent Only when symptomatic:

asthma _ 200 to 500 micrograms, in combination
with salbutamol

Mild 50 to 100 micrograms (low dose) 100 to 250 micrograms (low dose)
persistent 2 times daily 2 times daily
asthma

Moderate 50 to 100 micrograms (low dose) 100 to 250 micrograms (low dose)
persistent 2 times daily, in combination with 2 times daily, in combination with
asthma salmeterol salmeterol

OR (if salmeterol is not available) OR (if salmeterol is not available)

150 to 200 micrograms (medium dose) 300 to 500 micrograms (medium dose)
2 times daily 2 times daily

Severe 150 to 200 micrograms (medium dose) 300 to 500 micrograms (medium dose)
persistent 2 times daily, in combination with 2 times daily, in combination with
asthma salmeterol salmeterol
OR (if salmeterol is not available)
> 500 micrograms (high dose) 2 times daily

In all cases, do not exceed 2000 micrograms daily.

Duration
As long as required. Re-evaluate after 2 to 3 months if doses are adequate or need to be
increased or decreased.

Administration technique
Shake the inhaler. Remove the mouthpiece cover.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Inhale deeply
performance while
cookies, whichactivating
we use tothe inhaler.
generate Hold breath
aggregated data10on seconds before
website use exhaling.and marketing
and statistics;
If hand-breath
cookies, co-ordination
which are used is difficult,
to display relevant use
content a spacer
and to facilitate
advertising. administration
If you choose "Accept all",and
youimprove
consentthe
to the
use ofefficacy of treatment.
all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Contra-indications, adverse effects, precautions
Settings
Do not administer to patients with untreated respiratory infection. Decline Accept
May cause:
Page 55 / 663
 throat irritation, hoarseness and cough at the beginning of treatment; oro-pharyngeal
candidiasis;
adrenal suppression with high doses for prolonged periods.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
When beclometasone is given with salbutamol, preferably use combination inhaler. If not available,
beclometasone should be inhaled right after salbutamol.
Relief of symptoms may require several days or weeks of continuous therapy.
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).
Also comes in a combination metered dose inhaler with formoterol.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 56 / 663
 BECLOMETASONE/FORMOTEROL metered
dose inhaler
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Combination of inhaled corticosteroid (beclometasone) and long-acting beta-2 agonist
bronchodilator (formoterol)

Indications
Long term treatment of chronic asthma (maintenance and symptomatic treatment)

Forms and strengths

Solution or suspension for inhalation in pressurised metered dose inhaler, delivering 100 micrograms
of beclometasone dipropionate (extrafine particles) and 6 micrograms of formoterol fumarate/puff

Dosage
Start at the step most appropriate to initial severity.
Child 12 years and over and adult:

Asthma severity 100/6 micrograms per puff

Intermittent asthma
Only when symptomatic:
1 puff
Mild persistent asthma

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1 puff (low dose) 2 times daily
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Moderate
performance persistent
cookies, whichasthma and data on website use and statistics; and marketing
we use to generate aggregated
cookies, which are used to display relevant content and 1advertising.
puff whenIfsymptomatic
you choose "Accept all", you consent to the
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2 puffs (medium dose) 2 times daily
Severe persistent asthma and
Settings 1 puff when symptomatic Decline Accept

Page 57 / 663
 In all cases, do not exceed 8 puffs/day

Duration
As long as required. Re-evaluate after 2 to 3 months if doses are adequate or need to be
increased or decreased.

Administration technique
Shake the inhaler. Remove the mouthpiece cover.
Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece.
Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.
Hand-breath co-ordination is very difficult in older patients and patients with severe dyspnoea. Use
a spacer to facilitate administration and improve the efficacy of treatment.

Contra-indications, adverse effects, precautions

Do not administer to patients with untreated respiratory infection.
May cause:
throat irritation, hoarseness and cough at the beginning of treatment; oro-pharyngeal
candidiasis; adrenal suppression with high doses for prolonged periods;
headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Relief of symptoms may require several days or weeks of continuous therapy.
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).
100 micrograms of beclometasone dipropionate extrafine particles is equivalent to
250 micrograms of beclometasone dipropionate non-extrafine particles.
Beclometasone/formoterol may also be available as a dry powder inhaler. Doses are the same as
for metered dose inhaler.
Manufacturers may express the content per inhaler actuation in "metered dose" or "delivered
dose".
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Storage
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which
Before are between
use: used to display relevant
2 ºC and 8 °C.content
Do notand advertising. If you choose "Accept all", you consent to the
freeze.
use ofAfter
all cookies. You
first use: can accept
below 25 ºCand
forreject individual
3 months cookie types and revoke your consent for the future at any
maximum.
time at "Settings".

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Page 58 / 663
 BIPERIDEN oral
Prescription under medical supervision

Therapeutic action
Anticholinergic antiparkinson drug

Indications
First-line treatment of extrapyramidal reactions induced by antipsychotics

Forms and strengths

2 mg tablet

Dosage
Adult: 2 mg once daily, then increase if necessary up to 2 mg 2 to 3 times daily (max. 12 mg daily)
Administer at the lowest effective dose in elderly patients and do not exceed 10 mg daily.

Duration
As long as the antipsychotic treatment lasts.

Contra-indications, adverse effects, precautions

Do not administer to patients with closed-angle glaucoma, prostate disorders, gastrointestinal
obstruction or atony.
Administer with caution and carefully monitor use in elderly patients (risk of confusion,
hallucinations).
May cause: anticholinergic effects (dry mouth, constipation, blurred vision, tachycardia, disorders
of micturition), confusion, hallucinations, memory impairment.
We use a selection
Avoid of ourcombination
or monitor own and third-party cookies
with other drugsonknown
the pages
to of thisanticholinergic
have website: Essential cookies,
effects which are
(atropine,
required in order to use the website; functional cookies,
amitriptyline, chlorpromazine, promethazine, etc.). which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Pregnancy: re-evaluate whether the antipsychotic treatment is still necessary; if treatment is
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofcontinued,
all cookies.administer biperiden
You can accept at the
and reject lowest effective
individual dose
cookie types andand observe
revoke the child
your consent forifthe
thefuture
mother
at any
rd
time was under treatment in the 3 trimester (risk of anticholinergic effect, e.g. tremors, abdominal
at "Settings".
distension).
Breast-feeding: if treatment is necessary, administer at the lowest effective dose and observe the
Settings Decline Accept
child (risk of anticholinergic effects, e.g. tachycardia, constipation, thickening of bronchial

Page 59 / 663
 secretions).

Remarks
Also comes in 4 mg extended-release tablet, administered once daily.
Biperiden is also used in the treatment of Parkinson’s disease.

Storage
- - Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 60 / 663
 BISACODYL oral
Therapeutic action
Stimulant laxative

Indications
Prevention of constipation in patients taking opioid analgesics (codeine, morphine, etc.)
Short-term, symptomatic treatment of constipation

Forms and strengths

5 mg enteric-coated tablet

Dosage
Child over 3 years: 5 to 10 mg once daily
Adult: 10 to 15 mg once daily

Duration
Prevention of constipation in patients taking opioids: start bisacodyl when analgesic treatment
continues more than 48 hours. Tablets must be taken daily, at night (onset of effect within 6 to 12
hours after administration), until the end of the opioid treatment. Regular follow up
(frequency/consistency of stools) is essential in order to adjust dosage correctly.
Treatment of constipation: until the patient passes stools, maximum 7 days.

Contra-indications, adverse effects, precautions

Do not administer to patients with Crohn's disease, ulcerative colitis, intestinal obstruction,
undiagnosed abdominal pain and dehydration.
May cause: diarrhoea, abdominal cramps, hypokalaemia.
In the event of diarrhoea: exclude a faecal impaction or intestinal obstruction, stop treatment for
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24 hours and then start again with a half dose.
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aggregated theondaily dose.
website useStop treatment
and statistics; andif marketing
pain continues.
Do which
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monitor patients taking drugs that induce hypokalaemia (furosemide, amphotericin B,
corticosteroids, etc.) or cardiac glycosides.
Pregnancy and breast-feeding: avoid; for routine prevention of constipation due to opioids, use
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lactulose.

Page 61 / 663
 Remarks
To prevent constipation in patients taking opioids, use lactulose if the patient’s stools are solid; use
bisacodyl if the patient’s stools are soft.
In children from 6 months to 3 years, do not use the oral route. Use only 5 mg paediatric
suppositories (one suppository daily).
Swallow tablets whole; do not crush or chew.
Bisacodyl is equivalent to senna, the representative example of laxative stimulants in the WHO list
of essential medicines.
T he treatment must be accompanied by dietary measures (plenty of fluids and fibre).

Storage
Below 25 °C

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 BISOPROLOL oral
Prescription under medical supervision

Therapeutic action
Cardioselective beta-blocker

Indications
Hypertension, treatment of chronic stable angina pectoris
Chronic stable heart failure in combination with a converting enzyme inhibitor (enalapril)

Forms and strengths

2.5 mg breakable tablet
10 mg breakable in ¼ tablet

Dosage
Hypertension, angina pectoris
Adult: 5 to 10 mg once daily, preferably in the morning (max. 20 mg daily)
In patients with renal or hepatic impairment: start with 2.5 mg once daily then increase, if necessary,
according to clinical response (max. 10 mg daily)

Heart failure
Adult: start with 1.25 mg once daily and increase according to the table below, as long as the drug
is well tolerated (heart rate, blood pressure, signs of worsening heart failure)

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 Weeks Daily dose Tablet(s)

Week 1 1.25 mg once daily 2.5 mg tab: ½ tab daily

2.5 mg tab: 1 tab daily

Week 2 2.5 mg once daily or
10 mg tab: ¼ tab daily

Week 3 3.75 mg once daily 2.5 mg tab: 1½ tab daily

Week 4 to 8 5 mg once daily 10 mg tab: ½ tab daily

2.5 mg tab: 1 tab daily + 10 mg tab: ½ tab daily

Week 9 to 12 7.5 mg once daily or
10 mg tab: ¾ tab daily

10 mg once daily
From week 13 10 mg tab: 1 tab daily
(max. 10 mg daily)

Duration
According to clinical response. Do not stop treatment abruptly, decrease doses gradually.

Contra-indications, adverse effects, precautions

Do not administer to patients with asthma, chronic obstructive bronchopneumonia, acute heart
failure, severe hypotension, bradycardia < 50/minute, atrio-ventricular heart blocks, Raynaud's
syndrome.
May cause:
bradycardia, hypotension, worsening of heart failure (reduce dose);
bronchospasm in patients with an obstructive respiratory disease;
hypoglycaemia, gastrointestinal disturbances, headache, fatigue, muscle weakness, erectile
dysfunction.
Administer
We use with
a selection caution
of our to patients
own and with
third-party diabetes
cookies on the(risk of of
pages hypoglycaemia).
this website: Essential cookies, which are
In the
required eventtoofuse
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the website; shock, riskcookies,
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digoxin, amiodarone, content and advertising.
diltiazem, verapamil If youofchoose
(risk "Accept all", you consent to the
bradycardia);
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
tricyclic antidepressants, antipsychotics, anti-hypertensive drugs (risk of hypotension).
time at "Settings".
Pregnancy and breast-feeding: use labetalol, particularly for the management of hypertension in
pregnancy.
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Storage
Page 64 / 663
 – – Below 25 °C

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Page 65 / 663
 BUDESONIDE/FORMOTEROL metered dose
inhaler
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Combination of inhaled corticosteroid (budesonide) and long-acting beta-2 agonist bronchodilator
(formoterol)

Indications
Long term treatment of chronic asthma (maintenance and symptomatic treatment)

Forms and strengths

Solution or suspension for inhalation in pressurised metered dose inhaler, delivering 80 micrograms
of budesonide and 4.5 micrograms of formoterol fumarate/puff

Dosage
Start at the step most appropriate to initial severity.
Moderate persistent asthma
Child 6 to 11 years: 1 puff once daily (very low dose) and 1 puff when symptomatic (max. 8 puffs
daily)

Severe persistent asthma

Child 6 to 11 years: 1 puff 2 times daily (low dose) and 1 puff when symptomatic (max. 8 puffs daily)

Duration
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Administration
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can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Shake the inhaler. Remove the mouthpiece cover.
Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece.
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Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.

Page 66 / 663
 Hand-breath co-ordination is difficult in children. Use a spacer to facilitate administration and
improve the efficacy of treatment.

Contra-indications, adverse effects, precautions

Do not administer to children with untreated respiratory infection.
May cause:
throat irritation, hoarseness and cough at the beginning of treatment; oro-pharyngeal
candidiasis; adrenal suppression with high doses for prolonged periods;
headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Relief of symptoms may require several days or weeks of continuous therapy.
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).
Budesonide/formoterol may also be available as a dry powder inhaler. Doses are the same as for
metered dose inhaler.
Manufacturers may express the content per inhaler actuation in "metered dose" or "delivered
dose".

Storage
– Below 25 °C

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Page 67 / 663
 BUTYLSCOPOLAMINE oral
See HYOSCINE BUT YLBROMIDE oral

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Page 68 / 663
 CABERGOLINE oral
Prescription under medical supervision

Therapeutic action
Long-lasting lactation inhibitor

Indications
Inhibition of lactation or suppression of established lactation in case of intrauterine foetal death or
neonatal death

Forms and strengths

0.5 mg scored tablet

Dosage and duration

Lactation inhibition
1 mg single dose on the first day post-partum

Lactation suppression
0.25 mg every 12 hours for 2 days

Contra-indications, adverse effects, precautions

Do not administer to patients with postpartum hypertension or psychosis, preeclampsia,
valvulopathy, and history of pulmonary, retroperitoneal or pericardial fibrosis.
May cause: hypotension, valvulopathy, dizziness, headache, nausea, drowsiness, hallu cinations.
Do not combine with chlorpromazine, haloperidol, metoclopramide, promethazine (effect of
cabergoline antagonised), methylergometrine (risk of vasoconstriction and hypertensive crisis), and
macrolides (effect of cabergoline increased).
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Pregnancy:
required in order toCONT
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time T
athe use of cabergoline is not recommended to inhibit lactation in women who chose to not
"Settings".
breastfeed: it is not justified to expose women to the adverse effects of cabergoline, lactation will
stop spontaneously.
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Cabergoline is not included in the WHO list of essential medicines.

Page 69 / 663
 Cabergoline is a dopamine agonist also used in the treatment of Parkinson’s disease.

Storage
– – Below 25 °C

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 CALCIUM FOLINATE = FOLINIC acid oral
Prescription under medical supervision

Therapeutic action
Antidote to folate antagonists

Indications
Prevention of haemotological toxicity of pyrimethamine when pyrimethamine is used as prophylaxis
for, or in the treatment of toxoplasmosis or isosporiasis in immunodeficient patients

Forms and strengths

15 mg tablet
Also comes in 5 mg and 25 mg capsules.

Dosage
When pyrimethamine is used as primary or secondary prophylaxis for toxoplasmosis
Adult: 25 to 30 mg once weekly
During treatment of toxoplasmosis
Adult: 10 to 25 mg once daily
During treatment of isosporiasis
Adult: 5 to 15 mg once daily

Duration
For the duration of the pyrimethamine treatment

Contra-indications, adverse effects, precautions

Pregnancy: NO CONT RA-INDICAT ION
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Breast-feeding: own and third-party
CONT RA-INDICAT cookies
ION on the pages of this website: Essential cookies, which are
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Folic acid cannot be used as an alternative to folinic acid for the treatment of toxoplasmosis: folic
time at "Settings".
acid reduces the antiprotozoal activity of pyrimethamine.
Calcium folinate is also called calcium leucovorin.
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Page 71 / 663
 Storage
- below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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 CARBAMAZEPINE = CBZ oral
Last updated: October 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of CBZ, patients should be
kept under close surveillance.

Therapeutic action
Antiseizure (antiepileptic), mood stabilizer

Indications
Epilepsy generalised tonic-clonic seizures and focal (partial) seizures
Neuropathic pain (alone or combined with amitriptyline)
Prevention of recurrence of bipolar disorder

Forms and strengths

200 mg tablet
100 mg/5 ml oral solution, to be administered using a measuring device (oral syringe, measuring
spoon, or cup with graduations).

Dosage
Start with a low dose then increase gradually based on patient's response and tolerance.

Epilepsy
Child 1 month to 11 years: start with 5 mg/kg once daily or 2.5 mg/kg 2 times daily; increase the
daily dose by increments of 2.5 to 5 mg/kg every 3 to 7 days, up to 5 mg/kg 2 or 3 times daily if
necessary (max. 20 mg/kg daily).
We use a selection
Child 12 years ofand
our own
over:and third-party
start with 100cookies
to 200onmg theonce
pagesdaily
of this
or website:
50 to 100Essential cookies,
mg 2 times which are
daily;
required in order to use the website; functional cookies, which provide better easy of use when using the website;
increase the daily dose by increments of 100 to 200 mg every week, up to 200 to 400 mg 2 or 3
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
times
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Adult: start with 100 to 200 mg once daily
use of all cookies. You can accept and reject individual or 50 to 100
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types 2 times
revokedaily;
your increase thethedaily
consent for dose
future by
at any
time increments
at "Settings".of 100 to 200 mg every week, up to 400 mg 2 or 3 times daily if necessary (max. 2 g
daily).

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Neuropathic pain

Page 73 / 663
 Adult: start with 200 mg once daily at bedtime for one week, then 200 mg 2 times daily for one
week, then 200 mg 3 times daily

Prevention of recurrence of bipolar disorder

Adult: start with 100 mg 2 times daily; increase the daily dose by increments of 200 mg every week,
up to 200 mg 2 or 3 times daily if necessary (max. 1200 mg daily)

Duration
Epilepsy, prevention of recurrence of bipolar disorder: as long as required. Do not stop treatment
abruptly, even if changing to another medication.
Neuropathic pain: continue several months after pain relief is obtained, then attempt to stop
treatment.

Contra-indications, adverse effects, precautions

Do not administer to patients with atrioventricular block, history of bone marrow depression.
Administer with caution to patients with glaucoma, urinary retention, hepatic or renal impairment,
heart failure or blood disorders and to older patients.
May cause:
headache, dizziness, confusional state and agitation in older patients; drowsiness (caution when
driving or operating machinery);
gastrointestinal and visual disturbances, vitamin D deficiency (consider supplementation),
osteoporosis, leucopenia (often transitory), rash;
rarely: haematologic disorders (agranulocytosis, anaemia, bone marrow depression),
hypersensitivity reactions (including severe cutaneous reactions such as Stevens-Johnson, Lyell
and DRESS syndromes), pancreatitis, hepatitis, cardiac conduction defect. In these cases, stop
treatment. Early symptoms such as fever, rash, mouth ulcers and bleeding require immediate
medical attention.
Hypersensitivity reactions to CBZ are more common in individuals from China and Southeast
Asia.
If possible, perform at least FBC, liver enzymes and serum sodium levels, at baseline then regularly
during treatment.
Avoid or monitor the combination with:
rifampicin, mefloquine (reduced effect of CBZ);
erythromycin, isoniazid, fluoxetine, omeprazole, protease inhibitors, fluconazole, valproic acid,
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generate aggregated analgesics,
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and statistics; and marketing
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display relevant antidepressants,
content and advertising. other"Accept
If you choose antiseizure
all", medications,
you consent to etc.
the
use of all(increased
cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
sedation).
time CBZ
at "Settings".
may reduce the effect of many drugs:
diazepam, midazolam, oral anticoagulants, corticosteroids, tricyclic antidepressants,
Settings antipsychotics, protease inhibitors, rifampicin, itraconazole, doxycycline, tramadol, etc. Adjust
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dosage if necessary.
Page 74 / 663
 implants and oral contraceptives: use injectable medroxyprogesterone or an intrauterine device.
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy:
Epilepsy and bipolar disorder: avoid (risk of neural tube defects, cardiac and facial
malformations, hypospadias).
In case of pregnancy during treatment of epilepsy, prefer a safer drug (levetiracetam). If CBZ
is the only option, provide counselling about the risks to the child; use the lowest effective
dose.
Administer folic acid high dose (5 mg daily) during the first trimester. Start as soon as
possible, including during the preconception period in case of planned pregnancy.
CBZ plasma concentrations may decrease during pregnancy. Monitor clinical
response; increase dose if needed then resume the usual dose after delivery. Monitor the
child for a few days (risk of withdrawal symptoms).
Neuropathic pain: not recommended
Breast-feeding: administer with caution (excreted in milk); reduce the dose if increased during
pregnancy and monitor the child (risk of drowsiness, poor feeding and transient hepatic
impairment).

Remarks
CBZ is not recommended for myoclonic, atonic and absence seizures (risk of worsening
symptoms).

Storage
– – Below 25 °C

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Page 75 / 663
 CEFALEXIN oral
Last updated: January 2024

Prescription under medical supervision

Therapeutic action
First-generation cephalosporin antibacterial

Indications
Skin infections due to staphylococci and/or streptococci: impetigo, furuncle, erysipelas and
superficial cellulitis

Forms and strengths

250 mg capsule
125 mg/5 ml powder for oral suspension,:
to be reconstituted with filtered water
to be administered using a measuring device (oral syringe, measuring spoon, or cup with
graduations)

Dosage
Neonate under 7 days: 25 mg/kg 2 times daily
Neonate 7 to 28 days: 25 mg/kg 3 times daily
T he exact dose should be calculated according to the newborn’s weight.
Child 1 month to under 12 years: 12.5 to 25 mg/kg 2 times daily
Child 12 years and over and adult: 1 g 2 times daily

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 125 mg/5 ml 250 mg
Age Weight Daily dose
oral susp. capsule

1 to < 5 months 4 to < 7 kg 125 mg x 2 5 ml x 2 −

5 months to < 3 years 7 to < 15 kg 187.5 mg x 2 7.5 ml x 2 −

3 to < 6 years 15 to < 20 kg 250 mg x 2 10 ml x 2 –

6 to < 12 years 20 to < 40 kg 500 mg x 2 – 2 cap x 2

≥ 12 years and adult ≥ 40 kg 1gx2 – 4 cap x 2

Duration
Impetigo, furuncle: 7 days
Erysipelas, cellulitis: 7 to 10 days

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to cephalosporin.
Administer with caution to patients with allergy to penicillin (cross-sensitivity may occur) and severe
renal impairment (reduce the dose).
May cause: gastrointestinal disturbances (particularly diarrhoea), allergic reactions (skin eruption,
fever, pruritus).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Take preferably between meals.

Storage
We use– a selection
– Below
of our25 °C and third-party cookies on the pages of this website: Essential cookies, which are
own
For theinoral
required suspension
order (powderfunctional
to use the website; or reconstituted
cookies, suspension):
which providefollow manufacturer’s
better easy of use when instructions.
using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 77 / 663
 CEFIXIME oral
Last updated: September 2022

Prescription under medical supervision

Therapeutic action
T hird-generation cephalosporin antibacterial

Indications
Typhoid fever
Acute cystitis in girls over 2 years, pregnant women and lactating women
Acute pyelonephritis in adults
Cervicitis and urethritis due to Neisseria gonorrhoeae (in combination with a treatment for
chlamydia)
Second-line treatment of shigellosis

Forms and strengths

200 mg tablet
100 mg/5 ml powder for oral suspension, to be reconstituted with filtered water

Dosage
Typhoid fever
Child: 10 mg/kg (max. 200 mg) 2 times daily
Adult: 200 mg 2 times daily

Acute cystitis in girls over 2 years and shigellosis

Child: 8 mg/kg (max. 400 mg) once daily
Adult: 400 mg once daily
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Acute cystitis in pregnant and lactating women, acute pyelonephritis in adult
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Cervicitis
use and urethritis
of all cookies. You can accept andNeisseria
due to gonorrhoeae
reject individual cookie types and revoke your consent for the future at any
time Child: 8 mg/kg (max. 400 mg) single dose
at "Settings".
Adult: 400 mg single dose

Duration
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Page 78 / 663
 Typhoid fever and acute pyelonephritis: 10 to 14 days
Acute cystitis: 3 days for girls and 5 days for adults
Shigellosis: 5 days

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to cephalosporins.
Administer with caution to penicillin-allergic patients (cross-sensitivity may occur) and in patients
with severe renal impairment (reduce dosage).
May cause: gastrointestinal disturbances (especially diarrhoea), headache, dizziness, allergic
reactions (rash, pruritus, fever). In the event of allergic reaction, stop treatment immediately.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Storage
– – Below 25 °C
For the oral suspension (powder or reconstituted suspension): follow manufacturer’s instructions.

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Page 79 / 663
 Activated CHARCOAL oral
Therapeutic action
Adsorbent

Indications
Poisoning by drugs, in particular: paracetamol, aspirin, ibuprofen, chloroquine, quinine, dapsone,
phenobarbital, carbamazepine, digoxin
Poisoning by other toxic substances: certain plants (datura, lantana, etc.), certain domestic,
industrial or agricultural chemicals

Forms and strengths

Granules for oral suspension, in 50 g bottle, to be reconstituted with 250 ml of water

Dosage and duration

T he dose of charcoal has to be administered as soon as possible (preferably within one hour after
ingestion of the toxic compound) and swallowed within a limited period, e.g., in 15 to 20 minutes:
Child under 1 year: 1 g per kg
Child from 1 to 12 years: 25 g
Child over 12 years and adult: 50 g

If the dose of charcoal is not entirely swallowed or the toxic substance was ingested in large quantities
or over 2 hours beforehand: follow the treatment for 24 hours after poisoning, by administering half or
a quarter of the initial dose of charcoal every 4 or 6 hours, depending on the tolerance and
cooperation of the patient.

Contra-indications, adverse effects, precautions

Do not administer in case of poisoning by caustic or foaming products, or hydrocarbons: risk of
aggravation
We use a selection of lesions
of our own during vomitingcookies
and third-party (caustic
onproducts),
the pages ofaspiration pneumonia
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which provide vomiting
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of use whenproducts).
using the website;
performance cookies,is which
T he charcoal we useintopoisoning
ineffective generate aggregated data(ethanol,
by: alcohols on website use andglycol,
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methanol, isopropyl
cookies,
alcohol, etc.), organophosphorus and carbamate insecticides, metals (lithium, iron salts, etc.). to the
which are used to display relevant content and advertising. If you choose "Accept all", you consent
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
May cause: black colouring of stools (normal), constipation; vomiting in the event of rapid
time at "Settings".
administration of large quantities.
Do not administer charcoal simultaneously with other drugs by oral route. Administer 2 hours apart.
Settings
Pregnancy: no contra-indication Decline Accept
Breast-feeding: no contra-indication
Page 80 / 663
 Remarks
To facilitate the administration of charcoal and avoid vomiting in children, mask the taste (mix with
fruit juice, syrup) and administer the suspension slowly in small quantities.
If there is a specific antidote to the drug ingested, use it in complement.

Storage
- Below 25 °C

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Page 81 / 663
 CHLOROQUINE sulfate or phosphate oral
Last updated: December 2023

Given that resistance of P. falciparum to chloroquine is widespread, this drug must not be
used for the treatment of falciparum malaria.

Therapeutic action
Antimalarial

Indications
Treatment of malaria due to:
chloroquine-sensitive P. vivax
P. ovale, P. malariae and P. knowlesi

Forms and strengths

155 mg chloroquine base tablet
T he dose written on the labels is sometimes in chloroquine salt and sometimes in chloroquine base
which leads to frequent confusion. WHO recommends prescriptions and labels in chloroquine
base. 155 mg base = approx. 200 mg sulfate = approx. 250 mg phosphate or diphosphate.

Dosage and duration

Child and adult:
Day 1: 10 mg base/kg
Day 2: 10 mg base/kg
Day 3: 5 mg base/kg

Contra-indications, adverse effects, precautions

Do not administer to patients with retinopathy.
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Mayincause:
required order togastrointestinal
use the website; disturbances, headache,
functional cookies, transitory
which provide pruritus
better easy of(lasting
use when72 using
hours),
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we use to generate disturbances.
data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising.
If the patient vomits within 30 minutes after administration: If you choose "Accept
re-administer all",
the full you consent
dose. to the
If the patient
use ofvomits
all cookies. You can
between accept and
30 minutes andreject individual
1 hour cookie types andre-administer
after administration, revoke your consent
half of for
thethe future at any
dose.
time at "Settings".
T here is a narrow margin between the therapeutic and toxic dose. Doses of 20 mg base/kg in
children and 2 g base in adults are considered toxic.
Avoid combination with drugs that prolong QT interval: amiodarone, other
Settings Decline Accept
antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron,
Page 82 / 663
 etc.
Do not administer simultaneously with antacids (aluminium/magnesium hydroxide, etc.) or calcium
carbonate: administer 2 hours apart.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Also comes in 100 mg chloroquine base tablet and 50 mg chloroquine base/5 ml syrup.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 83 / 663
 CHLORPROMAZINE oral
Last updated: February 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of chlorpromazine, patients
should be kept under close surveillance.

Therapeutic action
Sedative antipsychotic

Indications
Acute or chronic psychosis, in the event of intolerance or treatment failure with
other antipsychotics (preferably use haloperidol for this indication)

Forms and strengths

25 mg and 100 mg tablets

Dosage
Adult: 25 to 50 mg once daily in the evening for one week. Increase gradually to 50 mg in the
morning and 100 mg in the evening; if insufficient, administer 100 mg 3 times daily.
Reduce the dose by half in older patients.
Use the lowest effective dose, especially in the event of prolonged treatment.

Duration
Acute psychosis: at least 3 months
Chronic psychosis: at least one year
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Discontinue
required treatment
in order to use thegradually (over 4 weeks).
website; functional cookies,If which
signs provide
of relapse occur,
better easy increase theusing
of use when dosethe
then
website;
performance
decrease itcookies, which we use to generate aggregated data on website use and statistics; and marketing
more gradually.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Contra-indications,
use adverse
of all cookies. You can accept effects,
and reject precautions
individual cookie types and revoke your consent for the future at any
time at "Settings".
Do not administer to patients with cardiac disorders (heart failure, recent myocardial infarction,
conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), closed-angle
Settings Decline Accept
glaucoma, prostate disorders, Parkinson's disease and history of neuroleptic malignant syndrome.

Page 84 / 663
 Administer with caution and carefully monitor use in older patients and patients with hypokalaemia,
hypotension, renal or hepatic impairment, history of seizures.
May cause:
drowsiness (caution when driving/operating machinery), dyskinesia, extrapyramidal symptoms,
weight gain, orthostatic hypotension, hyperprolactinaemia, anticholinergic effects (dry mouth,
blurred vision, urinary retention, constipation, tachycardia);
hyperglycaemia, photosensitivity, impaired thermoregulation; agranulocytosis, neuroleptic
malignant syndrome (unexplained hyperthermia with neuromuscular disorders), rare but requiring
immediate treatment discontinuation.
In case of extrapyramidal symptoms, try reducing the dose of chlorpromazine or, if
the extrapyramidal symptoms are severe, add biperiden or trihexyphenidyl.
Avoid or monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.);
drugs with anticholinergic effects (amitriptyline, atropine, promethazine, etc.), antidiabetics,
lithium;
antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone,
chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, use the lowest
effective dose. Observe the neonate the first few days (risk of agitation, tremors,
hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under
treatment in the 3rd trimester. If treatment starts during pregnancy, preferably use haloperidol.
Breast-feeding: if absolutely necessary, use the lowest effective dose.

Remarks
Do not crush tablets (risk of contact dermatitis).

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 85 / 663
 CIMETIDINE oral
Prescription under medical supervision

Therapeutic action
Antiulcer agent (histamine H2-receptor antagonist)

Indications
Prophylaxis of acid pulmonary aspiration syndrome in anaesthesia:
in patients with a full stomach (emergency caesarean section, etc.)
when a difficult intubation is expected

Forms and strengths

200 mg effervescent tablet
Also comes 800 mg effervescent tablet.

Dosage and duration

Adult: 200 to 400 mg single dose, if possible one hour before anaesthetic induction

Contra-indications, adverse effects, precautions

May cause: diarrhoea, headache, dizziness, skin rash, fever.
Do not administer with an antacid (aluminium hydroxide, etc.).

Remarks
Effervescent cimetidine can be replaced by effervescent ranitidine, another H2-receptor
antagonist, as a single dose of 150 mg.
T he onset of acid inhibition with cimetidine non-effervescent tablets (200 mg, 400 mg and 800 mg
We use
filma coated
selectiontablets)
of our own and third-party
or ranitidine cookies on the tablets
non-effervescent pages of(150
this website:
mg and Essential cookies,
300 mg film which
coated are
tablets)
required in order to use the website; functional cookies, which provide better easy of use when using
occurs 30 minutes after administration. T he effervescent tablets containing sodium citrate have a the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
more rapid onset of action, and can thus be used for emergency surgery.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofOmeprazole, another
all cookies. You antiulcer
can accept agentindividual
and reject (proton pump
cookieinhibitor),
types andisrevoke
not compatible with
your consent for emergency
the future at any
time situations
at "Settings".as it must be administered at least 4 hours before surgery.
Cimetidine in film coated tablets is also used in the treatment of gastro-oesophageal reflux and
peptic ulcer. Use by preference ranitidine or omeprazole for these indications.
Settings Decline Accept

Page 86 / 663
 Storage
- - Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 87 / 663
 CIPROFLOXACIN oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Fluoroquinolone antibacterial

Indications
Shigellosis, uncomplicated cutaneous anthrax
Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis in non-pregnant women in the
event of previous treatment failure
Plague, alone or in combination with other antibacterials
Completion treatment following therapy with parenteral ciprofloxacin

Forms and strengths

250 mg and 500 mg tablets
250 mg/5 ml granules and solvent for oral suspension

Dosage
Shigellosis, uncomplicated cutaneous anthrax
Child 1 month and over: 15 mg/kg (max. 500 mg) 2 times daily
Adult: 500 mg 2 times daily

Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis

Adult: 500 mg 2 times daily

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Page 88 / 663
 Age Weight 250 mg/5 ml 250 mg tablet 500 mg tablet
susp.

1 to < 3 months 4 to < 6 kg 1.5 ml x 2 – –

3 to < 7 months 6 to < 8 kg 2 ml x 2 – –

7 months to < 2 years 8 to < 12 kg 2.5 ml x 2 – –

2 to < 3 years 12 to < 15 kg 4 ml x 2 – –

3 to < 8 years 15 to < 26 kg 5 ml x 2 1 tab x 2 –

8 to < 11 years 26 to < 36 kg 8 ml x 2 – –

≥ 11 years and adult ≥ 36 kg – 2 tab x 2 1 tab x 2

Plague
Child 1 month and over: 15 mg/kg 2 to 3 times daily (max. 750 mg 2 times daily or 500 mg 3 times
daily)
Adult: 750 mg 2 times daily (500 mg 3 times daily in pregnant women)

Duration
Shigellosis, cystitis: 3 days
Cutaneous anthrax: 7 to 14 days depending on severity
Pyelonephritis, plague: 10 to 14 days
Prostatitis: 14 days (if signs and symptoms are ongoing after 14 days, continue the same
treatment for a further 14 days)

Contra-indications, adverse effects, precautions

Do not administer to patients with history of allergy or serious adverse effects due to a
fluoroquinolone, e.g. tendinitis, tendon rupture.
Administer
We use a selectionwith caution
of our to epileptic
own and third-partypatients
cookies (risk ofpages
on the seizures),
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website: andcookies,
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website; functional cookies, which provide better easy of use when using the website;
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the dose which we use
by half to generate
in patients aggregated
with data on website use and statistics; and marketing
renal impairment.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
May cause: gastrointestinal disturbances, neurological disorders (headache, dizziness, confusion,
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time hallucinations,
at "Settings". seizures), allergic reaction, peripheral neuropathy, photosensitivity (protect skin from
sun exposure), joint and muscle pain, tendinitis (especially Achilles tendinitis), QT interval
prolongation, hypo/hyperglycaemia, haemolytic anaemia in patients with G6PD deficiency. In the
Settings
event of allergic reaction, severe neurological disorders, peripheral neuropathy, joint Decline Accept
or muscle pain
or tendinitis, stop treatment immediately.
Page 89 / 663
 Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co-
artemether, fluconazole, haloperidol, mefloquine, ondansetron, pentamidine, quinine, etc.).
Monitor patients taking glibenclamide (risk of hypoglycaemia), NSAIDs (risk of seizure) and
corticosteroids (risk of tendinitis).
Do not administer simultaneously with:
antacids (aluminium or magnesium hydroxide, etc.): take ciprofloxacin 2 hours before or 4 hours
after antacids;
iron salts, calcium, zinc sulfate: take 2 hours apart.
Drink a lot of liquid during treatment (risk of crystalluria).
Pregnancy: reserved for severe infections, when there is no therapeutic alternative.
Breast-feeding: no contra-indication

Remarks
Ciprofloxacin is also used:
as first-line treatment of typhoid fever in some countries, however fluoroquinolone resistance is
endemic in Asia and is increasing in several parts of the world;
as an alternative to first-line treatment for septicaemia (child: 15 to 20 mg/kg (max. 750 mg) 2
times daily; adult: 500 to 750 mg 2 times daily), in combination with other antibacterials.

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 90 / 663
 CLARITHROMYCIN oral
Prescription under medical supervision

Therapeutic action
Macrolide antibacterial

Indications
Eradication of Helicobacter pylori, in combination with omeprazole and amoxicillin

Forms and strengths

500 mg tablet

Dosage and duration

Adult: 500 mg 2 times daily for 7 days

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to clarithromycin or another macrolide.
May cause:
headache, taste disturbances, insomnia, gastrointestinal disturbances, reversible hearing
disorders;
heart rhythm disorders (QT prolongation);
hypersensitivity reactions sometimes severe (in this event, stop treatment immediately).
Administer with caution and reduce dosage by half in patients with severe renal impairment.
Avoid combination with drugs that prolong the QT interval: amiodarone, antimalarials,
antipsychotics, efavirenz, fluconazole, fluoroquinolones, hydroxyzine, ondansetron, etc.
Administer with caution and monitor combination with: oral antidiabetics, atorvastatin,
carbamazepine, daclatasvir, digoxin, phenytoin, rifabutin (increased plasma concentrations of these
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
drugs).
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Pregnancy:
performance avoid
cookies, (safety
which nottoestablished)
we use generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant
Breast-feeding: no contra-indication content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

Clarithromycin is also used for the treatment of non-tuberculous mycobacterial infections.

Settings Decline Accept

Page 91 / 663
 Storage
Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 92 / 663
 CLINDAMYCIN oral
Last update: September 2022

Prescription under medical supervision

Therapeutic action
Lincosamide antibacterial

Indications
Severe staphylococcal and/or streptococcal infections (e.g. erysipelas, cellulitis, pneumonia):
in betalactam-allergic patients
in infections due to methicillin-resistant Staphylococcus aureus
Uncomplicated cutaneous anthrax
Completion treatment following therapy with parenteral clindamycin

Forms and strengths

150 mg and 300 mg capsules

Dosage
Child: 10 to 13 mg/kg (max. 600 mg) 3 times daily
Adult: 600 mg 3 times daily

Age Weight 150 mg capsule 300 mg capsule

1 to < 6 years 10 to < 20 kg 1 cap x 3 –

6 to < 9 years 20 to < 30 kg – 1 cap x 3

We9use
to a<selection
13 yearsof our own and third-party
30 to <cookies
45 kg on the pages 3
ofcap
this xwebsite:
3 Essential cookies,– which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
≥ 13 years and adult ≥ 45 kg – 2 cap x 3
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

Duration
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Erysipelas, cellulitis: 7 to 10 days

Page 93 / 663
 Cutaneous anthrax: 7 to 14 days depending on severity
Pneumonia: 10 to 14 days

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to lincosamides or history of pseudomembranous colitis.
Reduce dosage in patients with hepatic impairment.
May cause: pseudomembranous colitis, rash, jaundice, severe allergic reactions. In these cases,
stop treatment.
In the event of pseudomembranous colitis, treat for Clostridium difficile infection (oral
metronidazole).
Pregnancy: no contra-indication
Breast-feeding: use only when there is no therapeutic alternative. Check infant’s stools (risk of
pseudomembranous colitis).

Remarks
Take capsules with a full glass of water (risk of esophageal irritation).
If needed, open the capsule and mix the content into a spoon with food or fruit juice to mask the
unpleasant taste.
Clindamycin is use in combination with quinine for the treatment of malaria in pregnant women (10
mg/kg 2 times daily for 7 days).

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 94 / 663
 CLOXACILLIN oral
Prescription under medical supervision

Therapeutic action
Penicillin antibacterial

Indications
Impetigo (preferably use cefalexin for this indication)

Forms and strengths

250 mg and 500 mg capsules

Dosage and duration

Child over 10 years: 15 mg/kg 3 times daily for 7 days (max. 3 g daily)
Adult: 1 g 3 times daily for 7 days

Age Weight 250 mg capsule 500 mg capsule

10 to < 13 years 30 to < 45 kg 2 cap x 3 1 cap x 3

13 to < 15 years 45 to < 55 kg 3 cap x 3 –

Adult ≥ 55 kg 4 cap x 3 2 cap x 3

Contra-indications, adverse effects, precautions

We use
Doa not
selection of our to
administer own and third-party
patients cookies
with allergy on the pages of this website: Essential cookies, which are
to penicillin.
required
Administer with caution to patients with allergywhich
in order to use the website; functional cookies, provide better easy
to cephalosporins of use when using
(cross-sensitivity maythe website;
occur) or
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
severe renal impairment (reduce the dosage).
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofMay cause: gastrointestinal
all cookies. You can accept anddisturbances (particularly
reject individual diarrhoea),
cookie types allergic
and revoke your reactions
consent forsometimes
the future at any
time severe; rarely, haematological disorders.
at "Settings".
Do not combine with methotrexate (increased methotrexate toxicity).
Pregnancy: no contra-indication
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Breast-feeding: no contra-indication

Page 95 / 663
 Remarks
Take between meals.
Dicloxacillin, flucloxacillin and oxacillin are antibacterials used for the same indication.
Also comes in powder for oral solution 125 mg/5 ml and 1 g capsules.

Storage
- Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 96 / 663
 CO-AMOXICLAV oral
See AMOXICILLIN/CLAVULANIC acid oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 97 / 663
 CO-ARTEMETHER oral
See ART EMET HER/LUMEFANT RINE = AL oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 98 / 663
 CODEINE oral
Last updated: October 2024

Prescription under medical supervision

Use for short term treatment (risk of dependence and tolerance).

Due to the numerous and potentially severe adverse effects of codeine, patients
should be kept under close surveillance.

Therapeutic action
Opioid analgesic

Indications
Moderate pain, alone or in combination with a non-opioid analgesic

Forms and strengths

30 mg codeine phosphate tablet

Dosage
Child over 12 years and adult: 30 to 60 mg every 4 to 6 hours; maximum 240 mg daily

Duration
According to clinical evolution; as short as possible.

Contra-indications, adverse effects, precautions

Doa not
We use administer
selection of our to
ownpatients with acute
and third-party respiratory
cookies depression
on the pages or asthma
of this website: attack.
Essential cookies, which are
required in order
May cause: to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which
constipation, we use
nausea, to generate
vomiting, aggregated
drowsiness, data on website use and statistics; and marketing
dizziness;
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
rarely: respiratory depression, allergic reactions, dependence, withdrawal syndrome.
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not combine with:
at "Settings".
other agonist opioids such as morphine (increased risk of respiratory depression);​​
agonist-antagonist opioids such as buprenorphine, nalbuphine, pentazocine (competitive
Settings action). Decline Accept
Reduce dosage in patients with renal or hepatic impairment and in elderly patients.
Page 99 / 663
 Management of respiratory depression includes assisted ventilation and/or administration of
naloxone.
Pregnancy: no contra-indication. T he newborn infant may develop withdrawal symptoms,
respiratory depression and drowsiness in the event of prolonged administration of large doses at
the end of the 3rd trimester. In this event, closely monitor the newborn infant.
Breast-feeding: use with caution, for a short period (2-3 days), at the lowest effective dose.
Monitor the mother and the infant: in the event of excessive drowsiness, stop treatment.

Remarks
Administer an appropriate laxative (e.g. lactulose) if analgesic treatment continues more than 48
hours.
In some countries, codeine is on the list of narcotics: follow national regulations.

Storage
- Below 25 °C

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performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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 COLECALCIFEROL = VITAMIN D3 oral
Prescription under medical supervision

Therapeutic action
Vitamin necessary for the intestinal absorption of calcium and phosphate and for normal bone
calcification

Indications
Prevention and treatment of vitamin D deficiencies (rickets, osteomalacia)

Forms and strengths

10 000 IU/ml oral solution, in 10 ml vial
50 000 IU/ml oral solution, in 2 ml ampoule (100 000 IU)

Dosage and duration

Colecalciferol and ergocalciferol are used at the same doses:

Prevention of vitamin D deficiencies

Term neonate: 400 to 800 IU once daily until 6 months of age
Term neonate in contexts of high prevalence of vitamin D deficiency: 600 to 1200 IU once daily until
6 months of age
Pregnant woman: 100 000 IU single dose (one 2 ml ampoule) in the 6th or 7th month of pregnancy

Treatment of vitamin D deficiencies

Child < 3 months: 2 000 IU once daily for 3 months
Child from 3 to < 12 months: 2 000 IU once daily for 3 months or 50 000 IU single dose
Child from 12 months to < 12 years: 3 000 to 6 000 IU once daily for 3 months or 150 000 IU single
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Child < 12 months: 400 IU once daily
time at "Settings".
Child ≥ 12 months and adult: 600 IU once daily

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Page 101/ 663

 Contra-indications, adverse effects, precautions
Do not administer to patients with hypercalcaemia, hypercalciuria, calcic lithiasis, severe renal
impairment.
Stop treatment if signs of overdosage occur: headache, anorexia, nausea, vomiting, increased
thirst, polyuria.
Avoid combination with thiazide diuretics, e.g. hydrochlorothiazide (decreased urinary calcium
excretion).
Monitor, if possible, calcaemia and calciuria during curative treatment.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. When curative treatment is being administered to the
mother, do not give vitamin D to the child.

Remarks
T he number of IU per drop of oral solution varies according to manufacturers. Check instructions
for use.
Preferably use the vials of oral solution that, once opened, keep for 6 months.
During the first 3 months of curative treatment, administer a supplement of 500 mg of calcium once
daily.

Storage
– Below 25 °C

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 CO-TRIMOXAZOLE = SULFAMETHOXAZOLE
(SMX)/TRIMETHOPRIM (TMP) oral
Last updated: December 2024

Prescription under medical supervision

Therapeutic action
Combination of two antibacterials: a sulfonamide (sulfamethoxazole) and
a diaminopyrimidine antifolate (trimethoprim)

Indications
Treatment of cerebral toxoplasmosis, pneumocystosis, isosporiasis, cyclosporiasis and brucellosis
Prophylaxis of pneumocystosis, toxoplasmosis and isosporiasis
Second-line treatment of pertussis
Uncomplicated typhoid fever if the strain is susceptible (recent drug susceptibility test)

Forms and strengths

400 mg SMX/80 mg T MP and 800 mg SMX/160 mg T MP tablets
100 mg SMX/20 mg T MP dispersible tablet

Dosage
Treatment of cerebral toxoplasmosis
Child 6 weeks and over and adult: 25 mg SMX/5 mg T MP/kg 2 times daily

Treatment of pneumocystosis
Child 4 weeks and over: 50 mg SMX/10 mg T MP/kg (max. 1600 mg SMX/320 mg T MP) 2 times
daily
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Adult: 1600 mgof our own andmg
SMX/320 third-party cookies
T MP 3 times on the pages of this website: Essential cookies, which are
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Adult: 800 mg SMX/160 mg T MP 2content
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Prophylaxis of pneumocystosis, toxoplasmosis and isosporiasis
Child 4 weeks and over: 50 mg SMX/10 mg T MP/kg (max. 800 mg SMX/160 mg T MP) once daily, as
long as necessary
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Adult: 800 mg SMX/160 mg T MP once daily, as long as necessary
Page 103/ 663
 Treatment of pertussis, brucellosis and typhoid fever
Child 6 weeks and over: 20 mg SMX/4 mg T MP/kg (max. 800 mg SMX/160 mg T MP) 2 times daily
Adult: 800 mg SMX/160 mg T MP 2 times daily

Duration
Cyclosporiasis: 7 days
Isosporiasis: 7 to 10 days
Typhoid fever, pertussis: 14 days
Pneumocystosis: 21 days
Cerebral toxoplasmosis: 4 to 6 weeks
Brucellosis: 6 weeks

Contra-indications, adverse effects, precautions

Do not administer:
to children under 6 weeks (risk of neonatal hyperbilirubinemia and haemolysis), except for the
treatment and prophylaxis of pneumocystosis;
to patients with severe renal or hepatic impairment or with history of hypersensitivity
to sulfonamides.
May cause:
haemolytic anaemia in patients with G6PD deficiency, haematologic disorders
(thrombocytopenia, leucopenia, agranulocytosis, megaloblastic anaemia due to folic acid
deficiency);
hypersensitivity reactions (including severe cutaneous reactions such as Stevens-Johnson, Lyell
and DRESS syndromes). Early symptoms such as fever, rash, mouth ulcers and bleeding require
immediate medical attention.
In all these cases, stop treatment immediately.
gastrointestinal disturbances, hepatic or renal disorders (crystalluria, etc.), metabolic disorders
(hyperkalaemia, hypoglycaemia, hyponatraemia);, neuropathy, photosensitivity (protect skin
from sun exposure).
In the event of prolonged treatment, monitor full blood count if possible.
Avoid or monitor combination with:
drugs inducing hyperkalaemia such as potassium salts, spironolactone, enalapril, NSAIDs,
heparin (increased risk of hyperkalaemia);
We use aphenytoin
selection of(increased
our own and third-party
plasma cookies on the
concentrations of pages of this website: Essential cookies, which are
phenytoin);
required zidovudine
in order to use the website; functional cookies, which provide
(increased risk of haematotoxicity), antidiabetics better(increased
easy of userisk
when using the website;
of hypoglycaemia).
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Drink plenty of water during treatment to reduce risk of crystalluria.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofPregnancy: risk of
all cookies. You cancongenital
accept and malformations
reject individual (first
cookietrimester)
types andand
revokeneonatal haemolysis
your consent for theand
future at any
time hyperbilirubinaemia
at "Settings". (after 36 weeks of pregnancy).
For prophylaxis and treatment of pneumocystosis in HIV-exposed and HIV-infected women,
the benefits outweigh the risks. If used after 36 weeks of pregnancy, observe the child for signs
Settings Decline Accept
of anaemia or jaundice.

Page 104/ 663

 For other indications: avoid if possible.
Breast-feeding: avoid in women breastfeeding neonates and in women breastfeeding infants that
are premature, low birth weight, jaundiced, or ill (same risk as neonates). If used, observe the child
for signs of anaemia or jaundice.

Remarks
Preferably take during meals.

Storage
– Below 25 °C

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Page 105/ 663

 DAPSONE oral
Last updated: October 2023

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of dapsone, patients should
be kept under close surveillance.

Therapeutic action
Sulfone antibacterial, antileprotic

Indications
Prophylaxis of toxoplasmosis and pneumocystosis, in combination with pyrimethamine and folinic
acid
Treatment of pneumocystosis, in combination with trimethoprim
Paucibacillary and multibacillary leprosy, in combination with rifampicin and clofazimine

Forms and strengths

50 mg and 100 mg tablets

Dosage
Prophylaxis of pneumocystosis only
Child: 2 mg/kg once daily (max. 100 mg daily)
Adult: 100 mg once daily

Prophylaxis of toxoplasmosis and pneumocystosis

Child: 2 mg/kg once daily (max. 25 mg daily)
Adult: 200 mg once weekly or 50 mg once daily
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Treatment
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Adult: 100 mg once daily display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".and multibacillary leprosy
Paucibacillary
Child under 10 years: 2 mg/kg once daily
Child from 10 to 14 years: 50 mg once daily
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Child 15 years and over and adult: 100 mg once daily

Page 106/ 663

 Duration
Prophylaxis of toxoplasmosis and pneumocystosis: as long as necessary
Treatment of pneumocystosis: 21 days
Paucibacillary leprosy: 6 months
Multibacillary leprosy: 12 months

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to sulfones or severe anaemia (first treat anaemia).
Administer with caution to patients with renal or hepatic impairment.
May cause: haemolytic anaemia in patients with G6PD deficiency, dose-related haemolytic
anaemia, neutropenia, methaemoglobinaemia, pruritus, rash, gastrointestinal disturbances,
peripheral neuropathies, agranulocytosis; hypersensitivity reactions during the first month of
treatment (fever, jaundice, hepatitis, adenopathy, exfoliative dermatitis, etc.) requiring permanent
discontinuation of treatment.
Monitor blood count and transaminases if possible.
Monitor combination with zidovudine (increased haematological toxicity).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Storage
– – Below 25 °C

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Page 107/ 663

 DARUNAVIR = DRV oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretroviral, HIV protease inhibitor

Indications
HIV infection, in combination with ritonavir (booster) and other antiretrovirals

Forms and strengths

75 mg, 150 mg, 400 mg and 600 mg tablets
400 mg darunavir/50 mg ritonavir tablet

Dosage
Patients with no previous use of protease inhibitors
Single formulations
Child 14 to < 35 kg: 600 mg once daily (+ 100 mg ritonavir once daily)
Child ≥ 35 kg and adult: 800 mg once daily (+ 100 mg ritonavir once daily)
Fixed-dose combination
Child ≥ 40 kg and ≥ 12 years and adult: two 400/50 mg tablets once daily

Patients with previous use of protease inhibitors

Single formulations
Child 14 to < 25 kg: 375 mg 2 times daily (+ 50 mg ritonavir 2 times daily)
Child 25 to < 35 kg: 400 mg 2 times daily (+ 100 mg ritonavir 2 times daily)
Child ≥ 35 kg and adult: 600 mg 2 times daily (+ 100 mg ritonavir 2 times daily)
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Duration
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Depending
cookies, which areonused
theto
efficacy and tolerance
display relevant contentof
anddarunavir andIfritonavir.
advertising. you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Contra-indications,
time at "Settings". adverse effects, precautions
Do not administer to children under 3 years; and to patients with severe hepatic impairment or
Settings
allergy to sulfonamides (risk of cross-sensitivity). Decline Accept

Page 108/ 663

 Do not combine with rifampicin (decreased plasma concentrations of darunavir). Replace rifampicin
with rifabutin.
Administer with caution and monitor use in patients with haemophilia (increased bleeding) or mild to
moderate hepatic impairment.
May cause:
gastrointestinal disturbances, headache, insomnia, fatigue, dizziness, peripheral neuropathy,
renal disorders, myocardial infarction, hypertension, tachycardia, hyperglycaemia,
hyperlipidaemia, lipodystrophy;
skin rash sometimes severe, hepatic disorders; in this event, stop treatment immediately.
Darunavir in combination with ritonavir reduces the efficacy of implants and oral contraceptives:
use injectable medroxyprogesterone or an intrauterine device.
Pregnancy: no contra-indication; use 2 times daily dosing due to decreased plasma concentrations
of darunavir during pregnancy.

Remarks
Take with meals together with ritonavir.

Storage
– Below 25 °C

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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 109/ 663

 DESOGESTREL oral
Prescription under medical supervision

Therapeutic action
Hormonal contraceptive, progestogen

Indications
Oral contraception

Forms and strengths

0.075 mg (75 micrograms) tablet

Dosage
One tablet daily to be taken at the same time each day, on a continuous basis, including during
menstruation.
Contraception may be started at any moment of the cycle if it is reasonably certain the woman is
not pregnant, including when switching from another form of contraception. Contraception will be
effective as of the 3rd tablet.
Use condoms for the first 2 days of the pack if the pill is started:
more than 5 days after the start of menstruation;
more than 28 days postpartum if not breastfeeding;
more than 7 days after an abortion.
If a pill is missed, it should be taken as soon as possible and usual treatment continued. T he missed
pill and next scheduled pill can be taken together.
If the missed pill is more than 12 hours overdue, the effectiveness of the contraceptive is reduced.
Use:
We use acondoms for
selection of the
our following
own 2 days;cookies on the pages of this website: Essential cookies, which are
and third-party
required emergency contraception
in order to use if the woman
the website; functional haswhich
cookies, had intercourse in easy
provide better the 5ofdays preceding
use when thewebsite;
using the missed
performance
pill. cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Duration
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
If there are no adverse effects, as long as this method of contraception is desired.

Settings Decline Accept

Contra-indications, adverse effects, precautions
Page 110/ 663
 Do not administer to women with breast cancer, severe or recent liver disease, unexplained vaginal
bleeding, active thromboembolic disorders.
May cause: amenorrhoea, menstrual disturbances, nausea, weight gain, breast tenderness, mood
changes, acne, headache.
Enzyme-inducing drugs (rifampicin, rifabutine, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital,
phenytoin, carbamazepine, griseofulvin, etc.) reduce the effectiveness of the contraceptive.
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Remarks
Desogestrel is a possible alternative when oestroprogestogens are contra-indicated or poorly
tolerated. It has a wider window for error and may therefore be is preferred to levonorgestrel which
must be taken at strictly the exact same time daily.

Storage
- Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 111/ 663

 DEXAMETHASONE oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Long-acting steroidal anti-inflammatory drug (corticosteroid)

Indications
Symptomatic treatment of severe allergic and inflammatory reactions

Forms and strengths

2 mg and 4 mg tablets

Dosage and duration

Dosage varies according to indication, reaction severity and clinical response:
Child: 0.15 to 0.6 mg/kg (max. 16 mg) once daily
Adult: 0.5 to 24 mg (max. 40 mg) once daily
Duration varies according to indication. Due to dexamethasone’s long half-life, a treatment of 1 or 2
days is usually sufficient in asthma or croup. In the event of treatment longer than 10 days, decrease
doses gradually to avoid adrenal suppression.

Contra-indications, adverse effects, precautions

In case of systemic infection, only administer if patient is under antimicrobial treatment.
May cause (if prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth
retardation, increased susceptibility to infections, sodium and water retention (oedema and
hypertension), osteoporosis, hypokalaemia, digitalis toxicity due to potassium loss in patients
taking digitalis glycosides.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Pregnancy
required in order toand
usebreast-feeding: no contra-indication;
the website; functional use the
cookies, which provide lowest
better easy effective dose.
of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time 0.75 mg of dexamethasone has the same anti-inflammatory activity as 5 mg of prednisolone or
at "Settings".
prednisone and 20 mg of hydrocortisone.

Storage
Settings Decline Accept

Page 112/ 663

 – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 113/ 663

 DIAZEPAM oral
Last updated: February 2024

Prescription under medical supervision

Do not exceed the recommended duration of treatment (risk of dependence and

tolerance).

Therapeutic action
Anxiolytic, sedative, antiseizure (anticonvulsant), muscle relaxant

Indications
Severe anxiety, insomnia, and agitation

Forms and strengths

2 mg and 5 mg tablets

Dosage and duration

Anxiety
Adult: 2.5 to 5 mg 2 times daily for 2 to 3 weeks max. reducing the dose by half the last days before
stopping treatment

Insomnia
Adult: 2 to 5 mg once daily at bedtime for 7 days max.
Agitation
Adult: 10 mg single dose

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Contra-indications, adverse effects, precautions
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Do not administer to patients with severe respiratory insufficiency, severe hepatic impairment or
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofacute alcohol
all cookies. intoxication.
You can accept and reject individual cookie types and revoke your consent for the future at any
time Administer
at "Settings".with caution:
to older patients and patients with renal or hepatic impairment (reduce the dose by half);
to patients with history of drug/substance abuse or mental health disorders.
Settings Decline Accept
May cause:

Page 114/ 663

 hypotension, muscle weakness, ataxia, hypotonia, drowsiness (caution when driving/operating
machinery), lethargy, confusion, impaired concentration, memory loss, hyperactive or aggressive
behaviour;
withdrawal syndrome or rebound effect if prolonged treatment is discontinued abruptly;
respiratory depression and coma in the event of overdose.
Avoid or monitor in combination with:
drugs containing alcohol, opioid analgesics, antipsychotics, first-generation antihistamines
(hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased
sedation);
enzyme inducers such as rifampicin, rifabutin, nevirapine, phenobarbital, phenytoin,
carbamazepine, etc. (reduced effect of diazepam);
omeprazole, macrolides, ritonavir, isoniazid, fluconazole, itraconazole, etc.
(increased diazepam toxicity);
phenytoin (increased phenytoin toxicity).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy and breast-feeding: avoid (passage through the placenta and breast milk)

Remarks
Diazepam is subject to international controls: follow national regulations.
Diazepam is also used in the treatment of pre-delirium tremens (alcohol withdrawal) in adults: 10 mg
every 6 hours for 1 to 3 days, then reduce and stop over 7 days.

Storage
– – Below 25 °C

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performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 115/ 663

 DIETHYLCARBAMAZINE = DEC oral
Last updated: November 2023

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of DEC, patients should be
kept under close surveillance.

Therapeutic action
Anthelminthic (antifilarial)

Indications
Lymphatic filariasis

Forms and strengths

100 mg breakable tablet

Dosage
Child under 10 years: 0.5 mg/kg on D1, then increase the dose gradually over 3 days to 1 mg/kg 3
times daily
Child over 10 years and adult: 1 mg/kg on D1, then increase the dose gradually over 3 days to 2
mg/kg 3 times daily

Duration
W. bancrofti: 12 days
B. malayi, B. timori: 6 to 12 days

WeContra-indications,
use a selection of our ownadverse effects,
and third-party precautions
cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance
Do not cookies, which
administer we use towith
to patients generate aggregated data
onchocerciasis on website
or heavy Loa use
loa and statistics; and marketing
microfilareamia; to infants,
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
older patients and patients with heart or renal diseases.
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not administer during acute attacks (risk of severe reactions).
at "Settings".
Administer with caution in patients with history of seizures.
May cause:
Settings nausea, vomiting, headache, dizziness, drowsiness, fever, joint pain, urticaria, transientDecline Accept
haematuria, subcutaneous nodules, lymphangitis, localized oedema;
Page 116/ 663
 in patients with associated onchocerciasis: severe ocular damages (optic nerve lesions, retinal
lesions);
in patients with associated loiasis: encephalitis (potentially fatal) if Loa loa microfilaraemia is
high.
Reduce dosage in patients with renal impairment.
Pregnancy: CONT RA-INDICAT ED (treatment may be deferred until after delivery)
Breast-feeding: not recommended

Remarks
In countries with a national programme for the elimination of bancroftian filariasis, the combination
diethylcarbamazine + albendazole is administered as a single annual dose for 4 to 6 years. T his
regimen is only suitable for countries that are free from Onchocerca volvulus and/or Loa loa.

Storage
– Between 15 °C and 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 117/ 663

 DIGOXIN oral
Last updated: February 2024

Prescription under medical supervision

Due to narrow margin between therapeutic and toxic dose, patients should be kept under
close surveillance.

Therapeutic action
Cardiotonic

Indications
Supraventricular arrhythmias (fibrillation, flutter, paroxysmal tachycardia)
Heart failure

Forms and strengths

250 micrograms (0.25 mg) tablet

Dosage
Adult: 125 to 250 micrograms (0.125 to 0.25 mg) once daily
Reduce the dose by half in older patients and in patients with renal impairment.

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Doa not
We use administer
selection of our to
ownpatients with bradycardia,
and third-party ill defined
cookies on the pages ofarrhythmia, coronary
this website: Essentialartery disease.
cookies, which are
required in order to use the website; functional cookies, which provide
It is essential to monitor heart rate in the initial stage of treatment.better easy of use when using the website;
performance
May cause cookies, which
in the weofuse
event to generategastrointestinal
overdose: aggregated data disturbances
on website use(nausea,
and statistics; and marketing
vomiting, diarrhoea),
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
blurred vision, headache, confusion, conduction and rhythm disorders. If so, reduce dose or stop
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time treatment.
at "Settings".
Do not combine with calcium, particularly by IV route (serious arrhythmias).
Monitor combination with:
Settings amiodarone, macrolides, itraconazole, quinine, chloroquine (increased digoxin concentration);
Decline Accept

Page 118/ 663

 potassium-depleting drugs: diuretics, corticosteroids, amphotericin B (increased risk of digoxin
toxicity).
Monitor if possible serum potassium level in patients taking potassium-depleting drugs and serum
creatinine level in patients with renal impairment.
Do not administer simultaneously with antacids such as aluminium hydroxide, etc., administer 2
hours apart.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 119/ 663

 DIHYDROARTEMISININ/PIPERAQUINE =
DHA/PPQ oral
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria
Treatment of uncomplicated malaria due to other Plasmodium species, when chloroquine cannot
be used
Completion treatment following parenteral therapy for severe malaria

Forms and strengths

Co-formulated tablets of dihydroartemisinin (DHA)/piperaquine (PPQ), in blister pack, for a
complete treatment for one individual
T here are 5 different blister packs:
20 mg DHA/160 mg PPQ tablets blister pack of 3 tablets
40 mg DHA/320 mg PPQ tablets blister pack of 3 tablets
40 mg DHA/320 mg PPQ tablets blister pack of 6 tablets
40 mg DHA/320 mg PPQ tablets blister pack of 9 tablets
40 mg DHA/320 mg PPQ tablets blister pack of 12 tablets

Dosage and duration

Child 5 to < 25 kg: 2.5 to 10 mg/kg daily of DHA + 20 to 32 mg/kg daily of PPQ
Child 25 kg and over and adult: 2 to 10 mg/kg daily of DHA + 16 to 27 mg/kg daily of PPQ
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 Weight 20 mg/160 mg tablet 40 mg/320 mg tablet

5 to < 8 kg 1 tab –

8 to < 11 kg 1½ tab –

11 to < 17 kg – 1 tab

17 to < 25 kg – 1½ tab

25 to < 36 kg – 2 tab

36 to < 60 kg – 3 tab

60 to < 80 kg – 4 tab

≥ 80 kg – 5 tab

Tablets are to be taken once daily for 3 days.

Contra-indications, adverse effects, precautions

Do not administer in the event of cardiac disorders (bradycardia, heart rhythm disorders,
congestive heart failure).
Do not combine with drugs that prolong the QT interval: amiodarone, other
antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron,
etc.
Administer with caution to patients > 60 years or with renal or hepatic impairment.
May cause: cardiac disorders (QT prolongation, tachycardia); rarely, gastrointestinal disturbances,
pruritus, hepatic disorders, joint and muscle pain.
Monitor combination with: antiretrovirals (increased blood levels of these drugs), enzymes inducers
such as rifampicin, carbamazepine, phenytoin, phenobarbital (reduced blood levels of DHA/PPQ).
If the patient vomits within 30 minutes after administration, re-administer the full dose. If the patient
vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
We use a selection no
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Remarks
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Take 3 hours before or after meals, with a glass of water.
T he tablets may be crushed and mixed with water.
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Storage
Page 121/ 663
 - - Below 25 °C

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Page 122/ 663

 DOLUTEGRAVIR = DTG oral
Last updated: October 2024

Prescription under medical supervision

Therapeutic action
Antiretroviral, inhibitor of HIV integrase

Indications
HIV infection, in combination with other antiretrovirals

Forms and strengths

10 mg dispersible tablet
50 mg tablet

Dosage
T he daily dose is administered once daily.
Child 1 month and over and adult:

Weight Daily dose Tablets

3 to < 6 kg 5 mg ½ disp tab 10 mg

6 to < 10 kg 15 mg 1 ½ disp tab 10 mg

10 to < 14 kg 20 mg 2 disp tab 10 mg

14 to < 20 kg 25 mg 2 ½ disp tab 10 mg

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required in order to use the website; functional cookies,
30 mg which provide better easy3ofdisp
use tab
when10using
mg the website;
≥ 20 kg cookies, which we use to generate aggregated data on website use and statistics; and marketing
performance
or 50 mg or 1 tab 50 mg
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

Duration
Settings Decline Accept
Depending on the efficacy and tolerance of dolutegravir.

Page 123/ 663

 Contra-indications, adverse effects, precautions
Administer with caution to patients with severe hepatic impairment or coinfection with hepatitis
B or hepatitis C virus.
May cause:
insomnia, depression, anxiety, dizziness, headache, skin rash, gastrointestinal disturbances
(nausea, vomiting, diarrhoea, etc.);
rarely: hepatotoxicity, hypersensitivity reactions.
Do not administer simultaneously with antacids (aluminium or magnesium hydroxide, etc.), ferrous
salts, calcium and zinc salts (effect of dolutegravir decreased). Take these drugs at least 6 hours
before or 2 hours after dolutegravir.
In patients taking:
metformin: monitor closely blood glucose level and renal function and adjust dose as needed
(effect of metformin increased). Do not exceed 1 g of metformin daily.
enzyme-inducing drug (e.g. rifampicin, carbamazepine, phenytoin, phenobarbital, efavirenz,
nevirapine): double the daily dose of dolutegravir (effect of dolutegravir decreased), e.g. 30 mg
2 times daily rather than 30 mg once daily, and maintain the double dose for 2 weeks after
enzyme-inducing drug treatment completion.
In adolescents and women of childbearing age, offer hormonal contraception or an intrauterine
device.
Pregnancy: small increased risk of neural tube defects but the benefits outweigh the risks. T he
administration of folic acid during the first trimester may reduce this risk.

Remarks
T hree 10 mg dispersible tablets are equivalent to one 50 mg tablet.
In children 20 kg and over, preferably use 50 mg tablet unless they cannot swallow tablets.
Do not cut, crush or chew dispersible tablets. T hey can be swallowed or dispersed in a small
amount of water.
Dolutegravir is also used for HIV post-exposure prophylaxis in combination with other
antiretrovirals.
Also comes in fixed-dose combinations:
300 mg tenofovir /300 mg lamivudine /50 mg dolutegravir. Preferably use this formulation when
available in adolescents 30 kg and over and adults. In patients taking enzyme-inducing drugs,
administer the fixed-dose combination in the morning and dolutegravir 50 mg in the evening.
We use a60 mg abacavir/30
selection of our ownmg
andlamivudine/5 mg dolutegravir
third-party cookies on the pagesdispersible tablet.
of this website: Preferably
Essential usewhich
cookies, this are
required formulation when
in order to use available
the website; in children
functional 3 months
cookies, whichofprovide
age and over
better andofweighing
easy use whenfrom
using6the
to website;
under 25
performance
kg. cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Storage
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– – Below 25 °C

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Page 124/ 663

 DOXYCYCLINE oral
Last updated: September 2023

Prescription under medical supervision

In children under 8 years, doxycycline can be used in treatments no longer than 21 days.

Therapeutic action
Cycline antibacterial

Indications
Cholera, uncomplicated cutaneous anthrax, louse-borne and tick-borne relapsing fevers, epidemic
typhus and other rickettsioses, plague, brucellosis, leptospirosis, lymphogranuloma venereum
Lymphatic filariasis, alternative to ivermectin in onchocerciasis
Alternative to first-line treatments of treponematosis, atypical pneumonia (Mycoplasma
pneumoniae, Chlamydophila pneumoniae), cervicitis and urethritis due to Chlamydia trachomatis
(in combination with a treatment for gonorrhoea), donovanosis, syphilis

Forms and strengths

100 mg tablet

Dosage
Louse-borne relapsing fever, epidemic typhus, cholera
Child: 4 mg/kg (max. 100 mg) single dose
Adult: 200 mg (300 mg in cholera) single dose

Plague
Child under 45 kg: 4.4 mg/kg (max. 200 mg) on D1 then 2.2 mg/kg (max. 100 mg) 2 times daily
We use a selection
Child of our
45 kg and overown
andand third-party
adult: 200 mg cookies
on D1on the 100
then pagesmgof 2this website:
times dailyEssential cookies, which are
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Other indications
cookies, which
Child underare45used
kg:to display
2 to relevant
2.2 mg/kg content
(max. 100and
mg)advertising. If you choose "Accept all", you consent to the
2 times daily
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Child 45 kg and over and adult: 100 mg 2 times daily
time at "Settings".
In severe infections, a loading dose (as for plague) is recommended.

Duration
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Page 125/ 663

 Rickettsiosis: 5 to 7 days or until 3 days after fever has disappeared
Leptospirosis, cervicitis and urethritis due to C. trachomatis: 7 days
Cutaneous anthrax, tick-borne relapsing fever: 7 to 10 days
Plague, atypical pneumonia: 10 to 14 days
Early syphilis, bejel, pinta, lymphogranuloma: 14 days
Filariasis: minimum 4 weeks
Late latent syphilis: 30 days
Brucellosis: 6 weeks
Donovanosis: until complete healing of lesions

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to cyclines.
Do not administer treatments longer than 21 days in children under 8 years (risk of discolouration of
teeth).
Administer with caution to patients with hepatic or renal impairment.
May cause: gastrointestinal disturbances, allergic reactions, photosensitivity (protect exposed skin
from sun exposure), oesophageal ulcerations (take tablets during meals with a glass of water in an
upright position and at least 1 hour before going to bed).
Do not give simultaneously with ferrous salts, zinc sulfate, calcium carbonate, antiacids
(aluminium/magnesium hydroxide, etc.): administer 2 hours apart.
Monitor combination with hepatic enzyme inducers: rifampicin, phenobarbital, phenytoin,
carbamazepine, etc. (reduction of the doxycycline efficacy).
Pregnancy: avoid during the 2nd and 3rd trimester (risk of discolouration and malformation of
teeth). Use only for severe infections when doxycycline is the most effective option, and the
benefits outweigh the risks. No contra-indication for single dose treatments.
Breast-feeding: avoid if possible (risk of infant teeth discolouration) or do not exceed 10 days of
treatment if there is no alternative.

Remarks
Doxycycline is also used:
as an alternative to first-line treatment for septicaemia of pulmonary origin (dose as for plague),
in combination with other antibacterials;
for prophylaxis of plague, scrub typhus and leptospirosis.

Storage
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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25 °C
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Page 126/ 663

 EFAVIRENZ = EFV = EFZ oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretroviral, HIV-1 non nucleoside reverse transcriptase inhibitor

Indications
HIV-1 infection, in combination with other antiretrovirals

Forms and strengths

200 mg breakable tablet, 200 mg capsule and 600 mg tablet

Dosage
T he daily dose is administered once daily at bedtime, on an empty stomach.
Child 3 years and over and adult:

Weight Daily dose Tablets or capsules

1 tab 200 mg
10 to < 14 kg 200 mg
or 1 cap 200 mg

14 to < 25 kg 300 mg 1 tab 200 mg + ½ tab 200 mg

2 tab 200 mg
25 to < 35 kg 400 mg
or 2 cap 200 mg

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2 tab 200 mg cookies, which are
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functional cookies, which provide better easy of use when using the website;
≥ 35 kg or 2 cap 200 mg
or 600 mg
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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time at "Settings".

Duration
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Depending on the efficacy and tolerance of efavirenz.

Page 127/ 663

 Contra-indications, adverse effects, precautions
Do not administer to children under 3 years and to patients with severe hepatic impairment.
Do not combine with amodiaquine (risk of hepatotoxicity).
Administer with caution to patients with psychiatric disorders (or history of) or epilepsy.
Administer with caution and monitor combination with:
central nervous system depressants (opioids, benzodiazepines, phenobarbital, etc.),
carbamazepine, phenytoin, oral anticoagulants;
QT prolonging drugs (amiodarone, co-artemether, mefloquine, quinine, haloperidol, etc.).
May cause:
neuropsychiatric disorders: dizziness, headache, insomnia, drowsiness, abnormal dreaming,
anxiety, aggressive behaviour, impaired concentration, seizures, depression, suicidal ideation;
hepatotoxicity and gastrointestinal disturbances;
skin reactions, possibly severe (Stevens-Johnson syndrome).
Efavirenz reduces the efficacy of implants and oral contraceptives: use injectable
medroxyprogesterone or an intrauterine device.
Pregnancy: no contra-indication

Remarks
Capsules can be opened and their content mixed into a spoon with a small amount of food.
Also comes in fixed-dose combinations (tenofovir/emtricitabine/efavirenz
or tenofovir/lamivudine/efavirenz). Preferably use these formulations when available.

Storage
– – Below 25 °C

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Page 128/ 663

 ENALAPRIL oral
Prescription under medical supervision

Therapeutic action
Angiotensin converting enzyme inhibitor (ACE)

Indications
Hypertension
Chronic heart failure

Forms and strengths

5 mg and 20 mg tablets

Dosage
Hypertension
Adult: start with 5 mg once daily, then increase the dose gradually every 1 to 2 weeks, according to
blood pressure, up to 10 to 20 mg once daily (max. 40 mg daily)
In elderly patients, patients taking a diuretic or patients with renal impairment: start with 2.5 mg
once daily then adapt dose according to renal function.

Chronic heart failure

Adult:
Week 1: 2.5 mg once daily for 3 days then 5 mg once daily
Week 2: 10 mg once daily for 3 days then 20 mg once daily
T he usual dose is 10 to 20 mg once daily or 5 to 10 mg 2 times daily depending on tolerance (max.
40 mg daily).
Reduce dosage in patients with renal impairment.
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Duration
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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According toused to display
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response
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Contra-indications, adverse effects, precautions
time at "Settings".

Do not administer to patients with history of enalapril-related angioedema.

Settings Decline Accept
May cause:

Page 129/ 663

 hypotension, dizziness, headache, gastrointestinal disturbances, dry cough, renal impairment,
hyperkalaemia, hyponatraemia;
allergic reactions, angioedema; hypoglycaemia, haematological disorders.
Avoid or monitor combination with: potassium-sparing diuretics and/or potassium chloride (risk
of hyperkalaemia); non steroidal anti-inflammatory drugs and/or diuretics (risk of renal impairment).
Monitor combination with:
other antihypertensive drugs (risk of hypotension);
drugs that provoke hypotension (e.g. haloperidol, amitriptyline);
oral antidiabetics and insulin (risk of hypoglycaemia).
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication at recommended doses

Storage
– Below 25 °C

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Page 130/ 663

 ERGOCALCIFEROL = VITAMIN D2 oral
See COLECALCIFEROL = VITAMIN D3 oral

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Page 131/ 663

 ERYTHROMYCIN oral
Last updated: January 2024

Prescription under medical supervision

Therapeutic action
Macrolide antibacterial

Indications
Alternative to first-line antibiotic treatment of:
Louse-borne relapsing fever, leptospirosis
Acute otitis media, pharyngitis and sinusitis; diphtheria, pertussis, atypical pneumonia due to
Mycoplasma pneumoniae or Chlamydophila pneumoniae
Leg ulcer
Cervicitis and urethritis due to Chlamydia trachomatis (in combination with a treatment for
gonorrhoea), donovanosis, chancroid, lymphogranuloma venereum, syphilis
Trachoma
Neonatal conjunctivitis due to Chlamydia trachomatis
Completion treatment following parenteral therapy with erythromycin

Forms and strengths

250 mg and 500 mg tablets
125 mg/5 ml powder for oral suspension: ,
to be reconstituted with filtered water
to be administered using a measuring device (oral syringe, measuring spoon, or cup with
graduations)

Dosage
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relapsing and third-party cookies on the pages of this website: Essential cookies, which are
fever
required in order to use the website;
Child under 5 years: 250 mg singlefunctional
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Child 5 years and over and adult: 500 mg single dose
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Diphtheria
time at "Settings".
Child under 40 kg: 10 to 15 mg/kg (max. 500 mg) 4 times daily
Child 40 kg and over and adult: 500 mg 4 times daily
Settings
Neonatal conjunctivitis due to C. trachomatis Decline Accept
Neonate: 12.5 mg/kg 4 times daily
Page 132/ 663
 Other indications
Child: 30 to 50 mg/kg daily in divided doses

125 mg/5 ml 250 mg 500 mg

Age Weight Daily dose
susp. tablet tablet

1 to < 2 months 4 to < 5 kg 62.5 mg x 2 2.5 ml x 2 ¼ tab x 2 −

2 to < 12 months 5 to < 10 kg 125 mg x 2 5 ml x 2 ½ tab x 2 ¼ tab x 2

1 to < 3 years 10 to < 15 kg 250 mg x 2 10 ml x 2 1 tab x 2 ½ tab x 2

3 to < 8 years 15 to < 25 kg 250 mg x 3 10 ml x 3 1 tab x 3 ½ tab x 3

8 to < 11 years 25 to < 35 kg 500 mg x 2 − 2 tab x 2 1 tab x 2

11 to < 13 years 35 to < 45 kg 500 mg x 3 − 2 tab x 3 1 tab x 3

Adult: 500 mg 4 times daily or 1 g 2 to 3 times daily

Duration
Leptospirosis, pertussis, cervicitis and urethritis, chancroid, leg ulcer: 7 days
Sinusitis: 7 to 10 days
Pharyngitis, otitis: 10 days
Atypical pneumonia: 10 to 14 days
Diphtheria, early syphilis, lymphogranuloma venereum, donovanosis, conjunctivitis due to C.
trachomatis, trachoma: 14 days
Late latent syphilis: 30 days

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to erythromycin or another macrolide.
Avoid or administer with caution to children under 6 months and particularly to neonates under 2
weeks (risk of hypertrophic pyloric stenosis).
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Administer
required in order with
to usecaution to patients
the website; with
functional hepaticwhich
cookies, or renal impairment
provide (max.
better easy 1.5when
of use g daily forthe
using adult with
website;
severe renal
performance impairment),
cookies, electrolyte
which we use disturbances
to generate or at
aggregated data onincreased
website userisk
andofstatistics;
cardiovascular morbidity.
and marketing
cookies,
Maywhich aregastrointestinal
cause: used to display relevant content and
disturbances, advertising.
reversible If you
hearing choose "Accept
disorders, all", you
heart rhythm consent to
disorders (QTthe
use ofprolongation);
all cookies. You can accept
allergic and reject
reactions individual
sometimes cookieIn
severe. types
the and
eventrevoke your consent
of allergic for the
reaction, future
stop at any
treatment
time at "Settings".
immediately.
Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co-
artemether, fluconazole, haloperidol, mefloquine, moxifloxacin, ondansetron, pentamidine,
Settings Decline quinine,
Accept
etc.).
Page 133/ 663
 Administer with caution and monitor use in patients taking carbamazepine, digoxin or warfarin
(plasma concentrations of these drugs increased).
Pregnancy and breast-feeding: no contra-indication

Remarks
Take tablets preferably one hour before or 2 hours after a meal.

Storage
– – Below 25 °C
For the oral suspension (powder or reconstituted suspension): follow manufacturer’s instructions.

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Page 134/ 663

 ETHAMBUTOL = E oral
Last updated: August 2022

Prescription under medical supervision

Therapeutic action
First line antituberculosis antibacterial (bacteriostatic activity)

Indications
Tuberculosis, in combination with other antituberculosis antibacterials

Forms and strengths

100 mg and 400 mg tablets
50 mg and 100 mg dispersible tablets

Dosage
Child and adult: 15 to 25 mg/kg once daily
Do not exceed 1200 mg daily.
Patient with renal impairment: 15 to 25 mg/kg 3 times weekly

Duration
According to protocol

Contra-indications, adverse effects, precautions

Do not administer to patients with severe renal impairment or pre-existing optic neuritis (e.g.
diabetic retinopathy).
May cause: dose-related retrobulbar optic neuritis, exacerbated in renal impairment. Patients
We use a selection
should of ourthat
be warned own they
and third-party cookies on
must immediately the pages
stop of thisand
treatment website:
seek Essential cookies, which
medical attention in theare
required
event of visual disturbances such as blurred vision, reduced visual acuity, green-red colour website;
in order to use the website; functional cookies, which provide better easy of use when using the
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
blindness. Visual alterations are usually reversible a few weeks after stopping ethambutol.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofT all
he cookies.
dosage Youmustcan
beaccept
carefully
and adjusted to the cookie
reject individual body weight, especially
types and forconsent
revoke your childrenfor
under 5 years,
the future as
at any
time itat is more difficult to detect visual alterations at this age.
"Settings".
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
Settings Decline Accept

Page 135/ 663

 Remarks
For patients sensitive to first-line antituberculosis treatment, ethambutol is given as part of a fixed
dose combination.

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 136/ 663

 ETHINYLESTRADIOL/LEVONORGESTREL
oral
Last updated: October 2021

Prescription under medical supervision

Therapeutic action
Combined hormonal contraceptive, oestrogen-progestogen

Indications
Oral contraception
Abnormal uterine bleeding (especially functional uterine bleeding unrelated to pregnancy)

Forms and strengths

28-day pack: 21 active tablets of 0.03 mg (30 micrograms) ethinylestradiol + 0.15 mg (150
micrograms) levonorgestrel and 7 inactive tablets (ferrous salts)

Dosage and duration

Oral contraception
Adolescent and adult: one tablet daily, to be taken preferably at the same time each day, on a
continuous basis, including during menstruation.
Explain to the woman which are the active and inactive tablets. Careful not to start with inactive
tablets.
Contraception may be started at any moment of the cycle if it is reasonably certain the woman
is not pregnant, including when switching from another form of contraception. Contraception will
be effective as of the 8th tablet.
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Use condoms for the first 7 days of the pack if the tablets are started:
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performancemore than
cookies, 5 days
which we after
use to the start aggregated
generate of menstruation;
data on website use and statistics; and marketing
more
cookies, which are than
used 28 days postpartum
to display if not
relevant content breastfeeding;
and advertising. If you choose "Accept all", you consent to the
use of all cookies.
more You
thancan accept
7 days and an
after reject individual cookie types and revoke your consent for the future at any
abortion.
time at "Settings".
Continue treatment as long as this method of contraception is desired and well tolerated.
If one or two active tablets are missed, take one tablet as soon as possible and then continue
Settings treatment as usual. 2 tablets can be taken at the same time: the missed tablet Decline
and the daily
Accept
tablet.
Page 137/ 663
 If 3 or more successive active tablets are missed, contraceptive effectiveness is compromised.
Take one tablet as soon as possible, then continue treatment as usual and use condoms for the
next 7 days.
if the tablets are missed during the 1st week of a pack (1st to 7th tablet) or if the woman has
had intercourse in the 5 days before forgetting the tablets, use emergency contraception.
if the tablets are missed during the 3rd week of the pack (15th to 21st tablet), finish all the
active tablets and start a new pack the next day, without taking the inactive tablets. If it is
not possible to start a new pack immediately, use condoms for the next 7 days.
Persistent abnormal uterine bleeding despite tranexamic acid therapy or heavy bleeding
when tranexamic acid is CONTRA-INDICATED
Adolescent and adult: one tablet 3 times daily for 7 days
Long-term treatment of functional uterine bleeding
Adolescent and adult: one tablet daily (as for contraception). Continue treatment according to
clinical response.

Contra-indications, adverse effects, precautions

Do not administer to women with breast cancer, hypertension, uncontrolled or complicated
diabetes, history of thromboembolic disorders, coronary insufficiency, valvular disease, stroke,
severe or recent hepatic disease, migraine with neurological signs, renal impairment,
hyperlipidaemia, to women smokers over age 35.
May cause: reduced menstrual flow, nausea, weight gain, breast tenderness, mood changes, acne
and headache. Other rare and severe adverse effects require discontinuation of treatment:
hypertension, cardiovascular and thromboembolic disorders, jaundice, migraine, visual disturbances.
Enzyme-inducing drugs (rifampicin, rifabutine, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital,
phenytoin, carbamazepine, griseofulvin, etc.) reduce the effectiveness of the contraceptive.
Clinical examinations must be carried out before (blood pressure, breasts) and during treatment
(blood pressure).
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: CONT RA-INDICAT ED before 6 weeks postpartum; not recommended between 6
weeks and 6 months (except if it is the only available or acceptable contraceptive method); no
contra-indication after 6 months.

Remarks
We use a selection of our own andare
Oestrogen-progestogens third-party
easier tocookies
take on theprogestogen-only
that pages of this website: Essential
tablets cookies,
in that they dowhich
notare
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requiring taking the tablet at an exact time of day. Taking ethinylestradiol/levonorgestrel at theusing the website;
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same time every day helps avoid forgetting tablets.
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use ofAlso comes You
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the future of
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time interruption
at "Settings".between two packs. 28-day packs help improve compliance.

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Page 138/ 663
 FERROUS salts oral
Therapeutic action
Antianaemia drug

Indications
Prevention of iron-deficiency
Treatment of iron-deficiency anaemia

Forms and strengths

140 mg/5 ml syrup of ferrous fumarate containing approximately 45 mg/5 ml of elemental iron
200 mg ferrous fumarate or sulfate tablet containing approximately 65 mg of elemental iron

Dosage
(expressed as elemental iron)

Prevention of iron-deficiency
Neonate: 4.5 mg once daily
Child 1 month to < 12 years: 1 to 2 mg/kg once daily (max. 65 mg daily)
Child ≥ 12 years and adult: 65 mg once daily

Treatment of iron-deficiency anaemia

Neonate: 1 to 2 mg/kg 2 times daily
Child 1 month to < 6 years: 1.5 to 3 mg/kg 2 times daily
Child 6 to < 12 years: 65 mg 2 times daily
Child ≥ 12 years and adult: 65 mg 2 to 3 times daily

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 Prevention Treatment

Age Weight
45 mg/5 ml 65 mg 45 mg/5 65 mg
syrup tablet ml syrup tablet

< 1 month < 4 kg 0.5 ml – 0.5 ml x 2 –

1 month to < 1 year 4 to < 10 kg 1 ml – 1.5 ml x 2 –

1 to < 6 years 10 to < 20 kg 2.5 ml – 2.5 ml x 2 –

6 to < 12 years 20 to < 40 kg 5 ml – – 1 tab x 2

≥ 12 years and adult ≥ 40 kg – 1 tab – 1 tab x 2 or 3

Duration
Prevention: during risk period (pregnancy, malnutrition)
Treatment: 3 months

Contra-indications, adverse effects, precautions

Do not administer to patients with other forms of anaemia.
May cause: abdominal pain, nausea, vomiting, diarrhoea or constipation, black stools.
Do not exceed recommended doses in children (risk of overdose). 20 mg/kg of elemental iron (60
mg/kg of ferrous fumarate or sulfate) is considered toxic.
Do not give simultaneously with doxycycline, ciprofloxacin,
dolutegravir, antacids (aluminium hydroxide or magnesium, etc.), levodopa or zinc sulfate (reduced
absorption of both drugs). Administer each drug at least 2 hours apart.
Adminstration in combination with ascorbic acid (vitamin C) increases iron absorption.
Rince mouth or drink water after administration of syrup (risk of tooth staining).
Pregnancy and breast-feeding: no contra-indication

Remarks
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To reduce gastrointestinal disturbances, take during meals and gradually increase dosage.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Forwhich
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display during
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Page 140/ 663

 FERROUS salts/FOLIC acid oral
Last updated: October 2023

Indications
Prevention of iron and folic acid deficiency, mainly during pregnancy
Treatment of iron-deficiency anaemia

Forms and strengths

Tablet of 185 mg ferrous fumurate or sulfate (60 mg of elemental iron) + 400 micrograms folic acid
(vitamin B 9)

Dosage
See dosage of ferrous salts

Remarks
T his fixed-dose combination is not effective for the treatment of folic acid deficiency because of
its low dose.

Storage
– Below 25 °C

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 FLUCONAZOLE oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Antifungal

Indications
Oesophageal candidiasis
Moderate to severe oropharyngeal candidiasis
Secondary prophylaxis of recurrent candidiasis in immunocompromised patients
Cryptococcal meningitis, after treatment with amphotericin B + flucytosine or in combination with
amphotericin B or flucytosine
Secondary prophylaxis of cryptococcal infections

Forms and strengths

50 mg and 200 mg capsules
50 mg/5 ml oral suspension

Dosage and duration

Oesophageal candidiasis, oropharyngeal candidiasis, secondary prophylaxis of recurrent
candidiasis
Child 1 month and over: 3 to 6 mg/kg (max. 200 mg) once daily
Adult: 50 to 200 mg (max. 400 mg) once daily
T he treatment lasts 14 to 21 days for oesophageal candidiasis; 7 to 14 days for oropharyngeal
candidiasis; as long as required for secondary prophylaxis.

WeCryptococcal
use a selectionmeningitis
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Page 142/ 663

 12 mg/kg once daily for 1 week
Child
then 6 to 12 mg/kg once daily for 8 weeks
After treatment with ≥ 1 month
Max. 800 mg once daily
amphotericin B +
flucytosine
1200 mg once daily for 1 week
Adult
then 800 mg once daily for 8 weeks

or

12 mg/kg once daily for 2 weeks (with amphotericin B or

Child flucytosine)
≥ 1 month then 6 to 12 mg/kg once daily for 8 weeks
In combination with
Max. 800 mg once daily
amphotericin B
or flucytosine
1200 mg once daily for 2 weeks (with amphotericin B or
Adult flucytosine)
then 800 mg once daily for 8 weeks

Secondary prophylaxis of cryptococcal infections

Child: 6 mg/kg (max. 200 mg) once daily, as long as required
Adult: 200 mg once daily, as long as required

Contra-indications, adverse effects, precautions

Administer with caution to patients with hepatic or renal impairment, cardiac disorders (bradycardia,
heart rhythm disorders, etc.).
Reduce the dose by half in patients with renal impairment.
May cause: gastrointestinal disturbances, headache, skin reactions sometimes severe,
anaphylactic reactions; severe hepatic disorders, haematologic (leukopenia, thrombocytopenia)
and cardiac disorders (QT-prolongation). Stop treatment in the event of anaphylactic reaction,
hepatic disorders or severe skin reaction.
In the event of prolonged treatment, monitor hepatic function.
Do not administer simultaneously with rifampicin, administer 12 hours apart (rifampicin in the
morning, fluconazole in the evening).
Avoid
We use or monitor
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required drugs that
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quinine);
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certain antiretrovirals (e.g. nevirapine, zidovudine): increased plasma concentrations of these
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Page 143/ 663

 Remarks
As in neonates the half-life of fluconazole is prolonged, it should be administered every 72 hours
(neonates < 14 days) or every 48 hours (neonates ≥ 14 days).
For the treatment of histoplasmosis, fluconazole is less effective than itraconazole. In patients
unable to tolerate itraconazole, the dose of fluconazole is:
child: 10 to 12 mg/kg (max. 400 mg) once daily for 6 to 12 weeks
adult: 400 mg on D1 then 200 to 400 mg once daily for 6 to 12 weeks
For the treatment of genital candidiasis (vulvovaginitis, balanitis), fluconazole is only used if local
treatment fails: 150 mg single dose in adults.

Storage
– Below 25 °C
Once reconstituted, oral suspension keeps for 2 weeks.

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 FLUCYTOSINE oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Antifungal

Indications
Cryptococcocal meningitis (induction phase), in combination with amphotericin B or fluconazole

Forms and strengths

500 mg capsule and tablet

Dosage
Child over 1 week and adult: 25 mg/kg 4 times daily

Duration
One week if in combination with amphotericin B
2 weeks if in combination with fluconazole

Contra-indications, adverse effects, precautions

Administer with caution and monitor use in patients > 60 years or with renal impairment or
haematological disorders.
Reduce the dose by half (25 mg/kg 2 times daily) in patients with renal impairment.
May cause: gastrointestinal disturbances, haematological disorders (leukopenia,
thrombocytopenia, less frequently, agranulocytosis), increase in transaminase levels, allergic
We use a selection
reactions of our ownsevere;
sometimes and third-party cookies
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halucinations.
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Monitor blood count and liver and renal function until the endbetter
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of treatment.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Pregnancy and breast-feeding: flucytosine is generally not recommended. It is teratogenic in
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofanimals and its
all cookies. Yousafety in pregnant
can accept orindividual
and reject lactating cookie
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been established.
your consent However, taking
for the future at any
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at "Settings".
the absence of a safer alternative, it may be used despite the potential risks for the child.

Remarks
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Page 145/ 663

 For children, tablets may be crushed.
Also comes in 250 mg capsule and tablet.

Storage
– Below 25 °C

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Page 146/ 663

 FLUOXETINE oral
Last updated: March 2024

Prescription under medical supervision

Therapeutic action
Antidepressant, selective serotonin re-uptake inhibitor (SSRI)

Indications
Major depression
Generalised anxiety
Severe post-traumatic stress disorder

Forms and strengths

20 mg capsule

Dosage
Major depression
Adult: 20 mg on alternate days for one week, then 20 mg once daily. In case of insufficient
response after 3 weeks, increase up to 40 mg daily max.
Generalised anxiety, severe post-traumatic stress disorder
Adult: 20 mg once daily

Duration
Major depression: at least 9 months. Discontinue treatment gradually (e.g. half dose once daily for
2 weeks then on alternate days for 2 weeks). If signs of relapse or withdrawal occur, increase the
dose then decrease it more gradually.
Generalised
We use a selection anxiety, severe
of our own post-traumatic
and third-party cookiesstress
on the disorder: 2 towebsite:
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Essential symptoms resolve.
which are
required in order to use the website; functional cookies, which
Discontinue treatment gradually (over at least 2 weeks). provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications, adverse effects, precautions
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Administer
at "Settings".with caution and monitor use in patients with epilepsy, diabetes, hepatic impairment
(reduce dose or frequency of administration) or severe renal impairment; history of gastrointestinal
bleeding, bipolar disorders, suicidal ideation (in young adults) or closed-angle glaucoma.
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May cause:
Page 147/ 663
 gastrointestinal disturbances, drowsiness (caution when driving or operating machinery); fatigue,
headache, dizziness, seizures, sexual dysfunction, blurred vision, hyponatraemia especially in
older patients;
mental disorders: anxiety, insomnia, agitation, aggressive behaviour, suicidal ideation in young
adults;
withdrawal symptoms very frequent if discontinued abruptly: dizziness, paraesthesia,
nightmares, anxiety, tremors and headaches.
Avoid combination with:
aspirin, NSAIDs and warfarin (risk of bleeding);
serotonergic drugs: other SSRI, tricyclic antidepressants, ondansetron, tramadol, etc. (risk of
serotonin syndrome).
Monitor combination with: carbamazepine, phenytoin, risperidone (increased plasma
concentrations), drugs which lower the seizure threshold (antipsychotics, mefloquine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, maintain
fluoxetine at effective dose or consider switching to another SSRI if the woman plans to breast-
feed. Observe the neonate (risk of agitation, tremors, hypotony, respiratory difficulties, sleeping
disorders, etc.) if the mother was under treatment in the 3rd trimester. If treatment starts during
pregnancy, preferably use sertraline.
Breast-feeding: avoid; consider switching to sertraline or if not available, paroxetine.

Remarks
Do not open the capsules.
It is necessary to wait at least 2 to 3 weeks before assessing the antidepressant effect. T his must
be explained to the patient.

Storage
– – Below 25 °C

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 FOLIC acid = VITAMIN B9 oral
Prescription under medical supervision

Therapeutic action
Antianaemia drug

Indications
Treatment of folate-deficient megaloblastic anaemias: severe malnutrition, repeated attacks of
malaria, intestinal parasitosis, etc.

Forms and strengths

5 mg tablet

Dosage and duration

Child under 1 year: 0.5 mg/kg once daily for 4 months
Child over 1 year and adult: 5 mg once daily for 4 months; 15 mg once daily in malabsorption states

Contra-indications, adverse effects, precautions

Do not combine with sulfadiazine-pyrimethamine in patients with toxoplasmosis nor sulfadoxine-
pyrimethamine in patients with malaria: folic acid reduces the efficacy of these treatments.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Folic acid must not be used for the treatment of anaemia due to antifolates (pyrimethamine,
trimethoprim or methotrexate). Use folinic acid.
We use a selection
Folic of ourused
acid is also ownfor
andprimary
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andcookies on theprophylaxis
secondary pages of thisofwebsite: Essential
neural tube cookies,
defects andwhich
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prophylaxis of acute anaemia in patients with sickle-cell anaemia. better easy of use when using the website;
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– Below 25 °C

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Page 149/ 663

 FOSFOMYCIN TROMETAMOL oral
Prescription under medical supervision

Therapeutic action
Phosphonic acid derivative antibacterial

Indications
Acute uncomplicated cystitis in women, without fever nor flank pain
Asymptomatic bacteriuria in pregnant women

Forms and strengths

Granules for oral solution in 3 g sachet, to be dissolved in filtered water

Dosage and duration

3 g single dose

Contra-indications, adverse effects, precautions

Do not administer to patients with severe renal impairment, allergy to fosfomycin.
May cause: gastrointestinal disturbances, skin rash; rarely, allergic reactions.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
In the treatment of cystitis, symptoms should improve within 3 days of treatment. If not, the patient
should consult again. Treatment failure may be due to the presence of naturally fosfomycin-
resistant organisms (Staphylococcus saprophyticus).
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absorption).
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Fosfomycin is not included in the WHO list of essential medicines.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 150/ 663

 FUROSEMIDE oral
Prescription under medical supervision

Therapeutic action
Loop diuretic

Indications
Oedema associated with renal, hepatic or congestive heart failure

Forms and strengths

20 mg and 40 mg tablets

Dosage
Adult: start with 20 mg once daily. Increase, if necessary, according to clinical response up to 80 mg
once daily or 2 times daily (max. 160 mg daily). Once oedema decrease, reduce to 20 to 40 mg
once daily.

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Do not administer to patients with dehydration, severe hypokalaemia and hyponatraemia.
May cause:
dehydration, hypotension, hypokalaemia, hyponatraemia, hyperuricemia;
renal impairment, deafness, photosensitivity.
Avoid or monitor combination with NSAIDs, ACE inhibitors (risk of renal impairment); ototoxic
We use a selection
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(e.g. aminoglycosides, quinine); cookies on the pagesplasma
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drugs that provoke hypotension (e.g. haloperidol, amitriptyline) and antihypertensive drugs (risk
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cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
potassium-depleting drugs (e.g. corticosteriods, laxatives, amphotericin B), sodium-depleting
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drugs (e.g. SSRI, carbamazepine);
oral antidiabetics and insulin (risk of hyperglycaemia).
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Pregnancy: administer only if clearly needed

Page 151/ 663

 Breast-feeding: CONT RA-INDICAT ED (excreted in milk and reduces milk production)

Remarks
Preferably take in the morning.
A potassium-rich diet (dates, bananas, mangos, oranges, tomatoes, etc.) is recommended during
treatment. If potassium level is < 3.5 mmol/litre, administer a sustained-release potassium
supplement.
Diuretics are not indicated in the treatment of nutritional oedema or oedema associated with pre-
eclampsia.

Storage
- Below 25 °C

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 GLIBENCLAMIDE oral
Prescription under medical supervision

Therapeutic action
Sulfonylurea antidiabetic

Indications
Second-line treatment of type 2 diabetes, in patients under 60 years:
as monotherapy, when metformin is not tolerated or contra-indicated
in combination with metformin, when glycaemic control is inadequate with metformin alone

Forms and strengths

5 mg scored tablet

Dosage and duration

Adult:
Week 1: 2.5 mg once daily in the morning
Week 2: 5 mg once daily in the morning
Increase if necessary in increments of 2.5 mg weekly, according to blood glucose levels.
T he usual dose is 5 mg 2 times daily (max. 15 mg daily).

Contra-indications, adverse effects, precautions

Do not administer in the event of:
allergy to sulfonamides;
type 1 diabetes, juvenile diabetes, ketoacidosis;
severe renal or hepatic impairment.
May cause: hypoglycaemia, especially in patients over 60 years; gastrointestinal disturbances,
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Monitorcookies,
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which with:
we use to generate aggregated data on website use and statistics; and marketing
cookies, diuretics,
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angiotensin-converting enzymeandinhibitors,
advertising. If you chooseanti-inflammatory
non-steroidal "Accept all", you consent
drugs,to the
use of allazole
cookies. You can accept
antifungals and rejectmiconazole),
(fluconazole, individual cookie types and revoke
ciprofloxacin, your consent
erythromycin, for the future at any
co-trimoxazole
time at "Settings".
(enhanced hypoglycaemic effect);
rifampicin (decreased hypoglycaemic effect);
Settings drugs increasing blood glucose levels: corticosteroids, hydrochlorothiazide, salbutamol, Decline Accept
chlorpromazine.
Page 153/ 663
 Avoid combination with alcohol (antabuse reaction and risk of hypoglycaemia).
Pregnancy: avoid. Insulin is the drug of choice for the treatment of type 2 diabetes in pregnant
women (improved glycaemic control; reduced risk of foetal anomalies and neonatal complications).
Breast-feeding: CONT RA-INDICAT ED

Remarks
Take with meals.
For doses greater than 5 mg/day, divide the daily dose into 2 doses.

Storage
- Below 25 °C

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 GLICLAZIDE oral
Prescription under medical supervision

Therapeutic action
Sulfonylurea antidiabetic

Indications
Second-line treatment of type 2 diabetes, in patients over 60 years:
as monotherapy, when metformin is not tolerated or contra-indicated
in combination with metformin, when glycaemic control is inadequate with metformin alone

Forms and strengths

80 mg scored tablet

Dosage and duration

Adult:
Weeks 1 and 2: 40 mg once daily in the morning
Increase if necessary in increments of 40 mg every 2 weeks, according to blood glucose levels
(Weeks 3 and 4: 80 mg once daily in the morning).
T he usual dose is 80 to 160 mg daily (max. 240 mg daily).

Contra-indications, adverse effects, precautions

Do not administer in the event of:
allergy to sulfonamides;
type 1 diabetes, juvenile diabetes, ketoacidosis;
severe renal or hepatic impairment.
May cause: hypoglycaemia, gastrointestinal disturbances, weight gain; rarely, allergic reactions.
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Monitor
required combination
in order with: functional cookies, which provide better easy of use when using the website;
to use the website;
diuretics,
performance angiotensin-converting
cookies, which we use to generate enzyme inhibitors,
aggregated data onnon-steroidal anti-inflammatories,
website use and azole
statistics; and marketing
cookies, antifungals
which are used to display relevant content and advertising. If you choose "Accept all", you
(fluconazole, miconazole), ciprofloxacin, erythromycin, co-trimoxazole (enhanced consent to the
use of allhypoglycaemic
cookies. You caneffect);
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rifampicin (decreased hypoglycaemic effect);
drugs increasing blood glucose levels: corticosteroids, hydrochlorothiazide, salbutamol,
Settings chlorpromazine. Decline Accept
Avoid combination with alcohol (risk of hypoglycaemia).
Page 155/ 663
 Pregnancy: avoid. Insulin is the drug of choice for the treatment of type 2 diabetes in pregnant
women (improved glycaemic control; reduced risk of foetal anomalies and neonatal complications).
Breast-feeding: CONT RA-INDICAT ED

Remarks
Take with meals (reduced risk of gastrointestinal disturbances).
For doses greater than 80 mg daily, divide the daily dose into 2 doses.
Also comes in 30 and 60 mg modified release tablets.

Storage
- Below 25 °C

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Page 156/ 663

 GLYCERYL TRINITRATE = NITROGLYCERIN =
TRINITRIN oral
Last updated: August 2021

Prescription under medical supervision

Therapeutic action
Vasodilator, antianginal

Indications
Short-term prophylaxis and treatment of acute angina
Adjunctive therapy in acute heart failure (acute pulmonary oedema)

Forms and strengths

0.5 mg sublingual tablet

Dosage
Short-term prophylaxis of acute angina
Adult: 0.5 to 1 mg sublingually taken 5 to 10 minutes before a precipitating event (physical exertion,
stress, etc.)

Treatment of acute angina

Adult: 0.5 to 1 mg sublingually, to be repeated 1 to 3 times at 3-4 minute intervals

Adjunctive therapy in acute heart failure (acute pulmonary oedema)

Adult: 0.5 mg sublingually, to be repeated 1 to 2 times at 5 minute intervals if necessary. T he
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110 mmHg.
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Page 157/ 663

 Contra-indications, adverse effects, precautions
Do not administer to patients with obstructive cardiomyopathy, hypotension, shock, severe
anaemia, intracranial hypertension or neurologic injury.
May cause:
orthostatic hypotension (especially in older patients), headache, nausea, flushing of the
face, haemolytic anaemia in patients with G6PD deficiency;
severe hypotension with risk of circulatory collapse in the event of overdose.
Avoid combination or use the lowest effective dose in patients taking another nitrate derivative, a
vasodilator, a diuretic or an antihypertensive drug (enhances hypotensive effects), and in older
patients.
Do not combine with sildenafil or other drugs used for erectile dysfunction (risk
of severe hypotension, syncope and acute coronary syndrome).
Pregnancy: not recommended (safety is not established)
Breast-feeding: not recommended (safety is not established)

Remarks
Antianginal effect appears within less than 5 minutes and persists for less than 1 hour.
Tolerance to nitrates develops with prolonged use and can be overcome by short periods of nitrate
withdrawal, and not by dose escalation.
Sustained-release formulations are used for the long-term management of acute angina and the
treatment of heart failure.

Storage
- - Below 25 °C, preferably in airtight glass container

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Page 158/ 663

 GRISEOFULVIN oral
Prescription under medical supervision

Therapeutic action
Antifungal

Indications
Dermatophyte infections of the scalp (scalp ringworm)
Dermatophyte infections of the skin and folds, in the event of extended lesions or if the topical
treatment has failed

Forms and strengths

125 mg and 500 mg tablets

Dosage
Child 1 to 12 years: 10 to 20 mg/kg once daily (max. 500 mg daily)
Child 12 years and over and adult: 500 mg once daily; 1 g once daily in severe infections

Age Weight 125 mg tablet 500 mg tablet

1 to < 2 years 10 to < 13 kg 1 tab ¼ tab

2 to < 7 years 13 to < 24 kg 2 tab ½ tab

7 to < 12 years 24 to < 35 kg 4 tab 1 tab

≥ 12 years and adult ≥ 35 kg 4 to 8 tab 1 to 2 tab

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Duration
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Scalp: 6 weeks minimum
at "Settings".
Skin and folds: 4 to 6 weeks

Contra-indications, adverse effects, precautions

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Page 159/ 663

 Do not administer to patients with hepatic impairment, lupus erythematous, porphyria (may trigger
attacks of acute porphyria).
May cause: gastrointestinal disturbances, headache, skin reactions (eruption, urticaria, etc.);
photosensitivity (protect exposed skin from sun exposure).
In women, use a non-hormonal contraception or injectable medroxyprogesterone during treatment
and up to one month after the end of treatment.
Monitor patients taking warfarin (anticoagulant effect decreased).
Avoid alcohol during treatment (antabuse effect).
Pregnancy and breast-feeding: CONT RA-INDICAT ED. Apply a topical treatment (miconazole 2%
cream or Whitfield ointment) in order to limit the lesions until it is possible to use griseofulvin.

Remarks
Take with meals.
For young children, crush the tablet and mix it with a liquid.

Storage
Below 25 °C

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Page 160/ 663

 HALOPERIDOL oral
Last updated: February 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of haloperidol, patients should
be kept under close surveillance.

Therapeutic action
Antipsychotic

Indications
Acute confusional state (delirium) and acute alcohol intoxication
Acute or chronic psychosis
Acute manic episode
Agitation or aggressive behaviour in patients with acute or chronic psychosis, in combination with
promethazine

Forms and strengths

0.5 mg, 1.5 mg and 5 mg tablets
2 mg/ml oral solution with pipette graduated in mg

Dosage
Acute confusional state (delirium) and acute alcohol intoxication
Adult: 0.5 to 1 mg 2 times daily

Acute or chronic psychosis

Adult: 0.5 to 1 mg 2 times daily. Gradually increase up to 10 mg daily if necessary (max. 15 mg daily).
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and reject individualwith acute
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5 mg, to be repeated after 60 minutes if necessary

Reduce the dose by half in older patients (max. 5 mg daily).

Use the lowest effective dose, especially in the event of prolonged treatment.
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Page 161/ 663

 Duration
Delirium and acute alcohol intoxication: as short as possible (max. 7 days)
Acute psychosis: at least 3 months
Chronic psychosis: at least one year
Manic episode: 8 weeks after remission of symptoms
Discontinue treatment gradually (over 4 weeks). If signs of relapse occur, increase the dose then
decrease it more gradually.

Contra-indications, adverse effects, precautions

Do not administer to patients with cardiac disorders (heart failure, recent myocardial infarction,
conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease
and history of neuroleptic malignant syndrome.
Administer with caution and carefully monitor use in older patients and patients with hypokalaemia,
hypotension, hyperthyroidism, renal or hepatic impairment, history of seizures.
May cause: drowsiness (caution when driving/operating machinery), extrapyramidal symptoms, early
or tardive dyskinesia, anticholinergic effects (constipation, dry mouth), hyperprolactinaemia, weight
gain, sexual dysfunction, QT-prolongation, ventricular arrhythmia, orthostatic
hypotension; neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular
disorders), rare but requiring immediate treatment discontinuation.
In case of extrapyramidal symptoms, try reducing the dose of haloperidol or, if the extrapyramidal
symptoms are severe, add biperiden or trihexyphenidyl.
Avoid or monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.);
fluoxetine, paroxetine, sertraline, ritonavir (increased plasma concentrations of haloperidol);
carbamazepine, rifampicin, phenobarbital, phenytoin (decreased plasma concentrations of
haloperidol);
antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone,
chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, use the lowest
effective dose. Observe the neonate the first few days (risk of agitation, tremors,
hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under
treatment in the 3rd trimester.
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Page 162/ 663

 HYDROCHLOROTHIAZIDE oral
Prescription under medical supervision

Therapeutic action
T hiazide diuretic

Indications
Hypertension
Oedema associated with renal, hepatic or congestive heart failure

Forms and strengths

12.5 mg and 25 mg tablets

Dosage
Hypertension
Adult: 12.5 to 25 mg once daily in the morning (max. 25 mg daily)

Oedema associated with renal, hepatic or congestive heart failure

Adult: 25 mg once daily in the morning or 25 mg 2 times daily (max. 100 mg daily)

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Do not administer to patients with severe renal failure.
Administer with caution in patients with hypokalaemia, hyponatraemia and in elderly patients.
We use
Maya selection
cause: of our own and third-party cookies on the pages of this website: Essential cookies, which are
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You can accept and with
rejectNSAIDs (risk
individual of renal
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and revoke your (increased
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future at any
time concentrations
at "Settings". of lithium).
Monitor combination with:
drugs that provoke hypotension (e.g. haloperidol, amitriptyline) and antihypertensive drugs (risk
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of hypotension);

Page 163/ 663

 potassium-depleting drugs (e.g. corticosteriods, laxatives, amphotericin B), sodium-depleting
drugs (e.g. SSRI, carbamazepine), drugs enhancing hypercalcemic effect (e.g. calcium,
ergocalciferol);
oral antidiabetics and insulin (risk of hyperglycaemia).
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: CONT RA-INDICAT ED

Remarks
A potassium-rich diet (dates, bananas, mangos, oranges, tomatoes, etc.) is recommended during
treatment. If potassium level is < 3.5 mmol/litre, administer a sustained-released potassium
supplement.
Diuretics are not indicated in the treatment of nutritional oedema.

Storage
- Below 25 °C

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Page 164/ 663

 HYDROXYZINE oral
Last updated: February 2024

Prescription under medical supervision

Therapeutic action
Sedating H1 antihistamine

Indications
Moderate anxiety
Insomnia

Forms and strengths

25 mg tablet

Dosage
Moderate anxiety
Adult: 25 to 50 mg 2 times daily (max. 100 mg daily)
Reduce the dose by half in older patients.
Insomnia
Adult: 25 mg once daily at bedtime

Duration
Moderate anxiety: as short as possible (max. 2 weeks)
Insomnia: 7 to 10 days

Contra-indications, adverse effects, precautions

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Do not administer to patients with closed-angle glaucoma, prostate disorders, dementia, history of
required in order to use the website; functional cookies, which provide better easy of use when using the website;
QT interval
performance prolongation.
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use offluconazole,
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pentamidine, types and
quinine, revoke your consent for the future at any
etc.).
time Administer
at "Settings".with caution (max. 50 mg daily) and monitor use in older patients or patients with hepatic
impairment or severe renal impairment.
May cause:
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drowsiness (caution when driving/operating machinery), headache, dizziness;
Page 165/ 663
 anticholinergic effects (dry mouth, constipation, blurred vision, tachycardia, disorders of
micturition);
rarely: seizures, QT interval prolongation, allergic reactions.
Administer with caution and monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, etc.);
anticholinergic drugs (atropine, amitriptyline, chlorpromazine, promethazine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy and breast-feeding: avoid

Storage
– – Below 25 °C

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Page 166/ 663

 HYOSCINE BUTYLBROMIDE =
BUTYLSCOPOLAMINE oral
Last updated: November 2024

Prescription under medical supervision

Do not exceed recommended doses, especially in children and older patients (risk of
severe anticholinergic effects).

Therapeutic action
Antispasmodic

Indications
Spasms of the gastrointestinal tract and genitourinary tract

Forms and strengths

10 mg tablet

Dosage
Adult: 10 to 20 mg, to be repeated up to 3 or 4 times daily if necessary

Duration
According to clinical response; no prolonged treatment.
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Do which
cookies, not administer
are used totodisplay
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relevant disorders,
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If you choose disorders,
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all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time May
at "Settings".
cause: urinary retention, dryness of the mouth, constipation, blurred vision, tachycardia.
Administer with caution and under close supervision to patients taking other anticholinergic drugs
(antidepressants, antipsychotics, H-1 antihistamines, antiparkinsonians, etc.).
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Administer with caution to patients with fever (may affect thermoregulation).

Page 167/ 663

 Pregnancy: no contra-indication; NO PROLONGED T REAT MENT
Breast-feeding: no contra-indication; NO PROLONGED T REAT MENT

Remarks
Oral antispasmodic drugs are not included in the WHO list of essential medicines.

Storage
– – Below 25 °C

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Page 168/ 663

 IBUPROFEN oral
Prescription under medical supervision

Therapeutic action
Analgesic, antipyretic, non-steroidal anti-inflammatory (NSAID)

Indications
Mild to moderate pain, fever, rheumatic diseases

Forms and strengths

200 mg and 400 mg enteric-coated tablets
100 mg/5 ml oral suspension, with pipette graduated per kg of body weight (each kg graduation
corresponds to 10 mg ibuprofen)

Dosage
Pain, fever
Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily (max. 30 mg/kg daily)
Child 12 years and over and adult: 200 to 400 mg 3 to 4 times daily (max. 1200 mg daily)
In post-operative period, ibuprofen should be given on a regular basis, every 8 hours, rather than “as
needed”.

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Page 169/ 663

 200 mg 400 mg
Age Weight 100 mg/5 ml susp.
tablet tablet

1 pipette filled up to the graduation

3 months to < 6
5 to < 20 kg corresponding to the child's weight – –
years
x3

1 pipette filled up to the graduation

6 to < 10 years 20 to < 30 kg corresponding to the child's weight 1 tab x 3 –
x3

10 to < 12 years 30 to < 40 kg – 1 tab x 4 –

2 tab x 3
≥ 12 years and adult ≥ 40 kg or 1 tab x 3
–
1 tab x 4

Rheumatic diseases
Child: up to 40 mg/kg daily maximum
Adult: up to 3200 mg daily maximum

Duration
According to clinical response
Post-operative pain: 8 days max.

Contra-indications, adverse effects, precautions

Do not administer to children under 3 months, patients with allergy to NSAID, peptic ulcer,
coagulation defects, haemorrhage, surgery with risk of major blood loss, severe renal or hepatic
impairment, severe heart failure, severe malnutrition, uncorrected dehydration or hypovolaemia,
severe infection.
May cause: allergic reactions, epigastric pain, peptic ulcer, haemorrhage, renal impairment.
Administer with caution to elderly or asthmatic patients.
Do not combine with: methotrexate, anticoagulants and other NSAIDs.
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Monitor
required combination
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Breast-feeding: no contra-indication
cookies, which are used to display relevant content andterm
(short advertising.
treatment)If you choose "Accept all", you consent to the
use ofPregnancy:
all cookies. You canCONT
avoid. acceptRA-INDICAT
and reject individual
ED from cookie types and of
the beginning revoke
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th month. Usefor paracetamol.
the future at any
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Remarks
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Take with meals. Doses must be taken at least 4 hours apart.

Page 170/ 663

 Clean the graduated pipette after use. Shake the bottle before use.
If ibuprofen alone does not provide pain relief, combine with paracetamol and/or an opioid
analgesic.

Storage
– – Below 25 °C
Once opened, oral suspension must be stored between 8 °C and 15 °C.

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Page 171/ 663

 IODIZED OIL oral
Therapeutic action
Iodine supplementation

Indications
Prevention and treatment of severe iodine deficiency

Forms and strengths

190 mg capsule of iodine

Dosage and duration

Child under 1 year: 1 capsule (190 mg) once a year
Child from 1 to < 6 years: 2 capsules (380 mg) once a year
Child from 6 to 15 years: 3 capsules (570 mg) once a year
Pregnant woman or women of childbearing age: 2 capsules (380 mg) once a year

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to iodine or hyperthyrodism.
Do not administer to patients over 45 years.
May cause: allergic reactions, dysthyroidism.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
For young children, open the capsule and empty the contents into the child’s mouth.
Also comes in 10 ml ampoules containing 480 mg/ml to be administered by IM injection using a
glass syringe.
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- - Below 25 °C
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Page 172/ 663

 IPRATROPIUM bromide metered dose
inhaler
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Bronchodilator, anticholinergic drug

Indications
Severe asthma attack, in combination with salbutamol

Forms and strengths

Solution for inhalation in pressurised metered dose inhaler, delivering 20 micrograms of
ipratropium/puff

Dosage and duration

Child and adult: 4 to 8 puffs (80 to 160 micrograms) every 20 minutes for the first hour

Administration technique
Shake the inhaler. Remove the mouthpiece cover.
Inhale and breathe out as completely as possible. Place the lips tightly around the mouthpiece.
Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.
Hand-breath co-ordination is very difficult in children under 6 years, older patients and patients with
severe dyspnoea. Use a spacer to facilitate administration and improve the efficacy of treatment.

WeContra-indications,
use a selection of our own adverse effects,
and third-party precautions
cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
May cause:
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, throat
which are used to headache,
irritation, display relevant content
cough, and advertising. If you choose "Accept all", you consent to the
vomiting;
use of allanticholinergic
cookies. You can accept and
effects: rejectof
dryness individual cookie
the mouth, types and revoke
constipation, your
dilation ofconsent for the
the pupils, futurevision,
blurred at any
time at "Settings".
urinary retention, tachycardia.
Administer with caution to older patients and patients with closed-angle glaucoma,
urethroprostatic disorders, urinary retention.
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Page 173/ 663

 Avoid or monitor combination with drugs known to have anticholinergic effects: tricyclic
antidepressants (e.g. amitriptyline), first generation H-1 antihistamines (e.g.
hydroxyzine, promethazine), biperiden, antispasmodics (e.g. atropine, hyoscine
butylbromide), antipsychotics (e.g. chlorpromazine, haloperidol), etc. (increased risk of adverse
effects).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
In severe asthma attack, preferably administer the treatment by nebulisation.
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).

Storage
– Below 25 °C

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Page 174/ 663

 IPRATROPIUM bromide nebuliser solution
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Bronchodilator, anticholinergic drug

Indications
Severe asthma attack, in combination with salbutamol

Forms and strengths

Solution for inhalation, in unit dose vial of 0.25 mg in 1 ml (0.25 mg/ml) and 0.5 mg in 2 ml (0.25
mg/ml), to be administered via a nebuliser

Dosage and duration

Child under 5 years: 0.25 mg (1 ml) per nebulisation every 20 minutes for the first hour
Child 5 years and over and adult: 0.5 mg (2 ml) per nebulisation every 20 minutes for the first hour

Contra-indications, adverse effects, precautions

May cause:
throat irritation, headache, cough, vomiting;
anticholinergic effects: dryness of the mouth, constipation, dilation of the pupils, blurred vision,
urinary retention, tachycardia.
Administer with caution to older patients and patients with closed-angle glaucoma, urethro-
prostatic disorders, urinary retention.
Avoid or monitor combination with drugs known to have anticholinergic effects: tricyclic
antidepressants (e.g. amitriptyline), first generation H-1 antihistamines (e.g.
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Page 175/ 663

 Volumes of nebuliser solution to be administered are insufficient to obtain efficient nebulisation in
most nebulisers: add ipratropium to salbutamol and then 0.9% sodium chloride to obtain a total
volume of 5 ml in the reservoir of the nebuliser. Stop the nebulisation when the reservoir is
empty (after around 10 to 15 minutes).

Storage
– Below 25 °C

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 ISONIAZID = H oral
Last updated: June 2021

Prescription under medical supervision

Therapeutic action
First line antituberculosis antibacterial (bactericidal activity)

Indications
Tuberculosis, in combination with other antituberculosis antibacterials
Latent tuberculosis, as monotherapy or in combination with rifampicin or rifapentine

Forms and strengths

100 mg and 300 mg tablets
50 mg and 100 mg dispersible tablets

Dosage
Tuberculosis, latent tuberculosis as monotherapy or in combination with daily rifampicin
Child under 30 kg: 10 mg/kg (7 to 15 mg/kg) once daily, on an empty stomach
Child 30 kg and over and adult: 5 mg/kg (4 to 6 mg/kg) once daily, on an empty stomach
Do not exceed 300 mg daily.

Latent tuberculosis in combination with weekly rifapentine

Child under 30 kg and over 2 years: 20 to 30 mg/kg once weekly, on an empty stomach
Child 30 kg and over and adult: 900 mg once weekly, on an empty stomach

Latent tuberculosis in combination with daily rifapentine

Child 13 years and over and adult: 300 mg once daily, on an empty stomach
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Latent tuberculosis in combination with daily rifapentine: 1 month

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Page 177/ 663

 Do not administer to patients with severe hepatic impairment.
May cause:
peripheral neuropathy, especially in malnourished, alcoholic, diabetic, HIV-infected patients;
pregnant and breast-feeding women and patients with renal impairment;
hepatotoxicity, especially in alcoholic patients or patients with chronic hepatic disease or
receiving rifampicin, or over 35 years;
hypersensitivity reactions, psychotic reactions, seizures and depression.
Monitor liver function in patients with known hepatic disease.
If signs of hepatotoxicity (e.g. jaundice) develop, isoniazid should be discontinued until symptoms
resolve.
Administer with caution and closely monitor patients taking phenytoin, carbamazepine,
benzodiazepines (risk of toxicity), warfarin (risk of bleeding).
Administer pyridoxine (vitamin B 6) in patients at risk of peripheral neuropathy (child: 5 to 10 mg once
daily; adult: 10 mg once daily).
Pregnancy: no contra-indication. Administer pyridoxine to the mother (10 mg once daily).
Breast-feeding: no contra-indication;. Administer pyridoxine to the mother (10 mg once daily)
and the infant (5 mg once daily).

Remarks
For patients sensitive to first-line antituberculosis treatment, isoniazid is given as part of a fixed
dose combination.
Also comes in fixed dose combination containing 300 mg of rifapentine/300 mg of isoniazid for the
treatment of latent tuberculosis in children over 14 years and adults.

Storage
– – Below 25 °C

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 ISOSORBIDE DINITRATE oral
Last updated: August 2021

Prescription under medical supervision

Therapeutic action
Vasodilator, antianginal

Indications
Prophylaxis and treatment of acute angina
Treatment of left-sided or global chronic heart failure in patients with intolerance to angiotensin-
converting enzyme (ACE) inhibitors
Adjunctive therapy in acute heart failure (acute pulmonary oedema)

Forms and strengths

5 mg sublingual tablet

Dosage
Short-term prophylaxis of acute angina
Adult: 5 to 10 mg sublingually taken 10 minutes before a precipitating event (physical exertion,
stress, etc.)

Long-term prophylaxis of acute angina and treatment of left-sided or global chronic heart failure
Adult: 5 to 40 mg orally 2 to 3 times daily
Gradually increase the dose until effective. Do not stop treatment abruptly.

Treatment of acute angina

Adult: 5 to 10 mg sublingually, to be repeated after 10 minutes if necessary
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Adult: 5 mg sublingually, to be repeated after 10 minutes if necessary. T he objective is to lower
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Duration
According to clinical response
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Page 179/ 663

 Contra-indications, adverse effects, precautions
Do not administer to patients with obstructive cardiomyopathy, hypotension, shock, severe
anaemia, intracranial hypertension or neurologic injury.
May cause:
orthostatic hypotension (especially in older patients), headache, nausea, flushing of the
face, haemolytic anaemia in patients with G6PD deficiency;
severe hypotension with risk of circulatory collapse in the event of overdose.
Avoid combination or use the lowest effective dose in patients taking another nitrate derivative, a
vasodilator, a diuretic or an antihypertensive drug (enhances hypotensive effects), and in older
patients.
Do not combine with sildenafil or other drugs used for erectile dysfunction (risk
of severe hypotension, syncope and acute coronary syndrome).
Pregnancy: not recommended (safety is not established)
Breast-feeding: not recommended (safety is not established)

Remarks
By sublingual route, antianginal effect appears within less than 10 minutes and persists for 1 to 2
hours.
Tolerance to nitrates develops with prolonged use and can be overcome by short periods of nitrate
withdrawal, and not by dose escalation.
Sustained-release formulations are used for the long-term management of acute angina and the
treatment of heart failure. T he time interval between each administration depends on the
preparations.

Storage
- - Below 25 °C

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Page 180/ 663

 ITRACONAZOLE oral
Prescription under medical supervision

Therapeutic action
Antifungal

Indications
Histoplasmosis and penicilliosis: treatment and secondary prophylaxis
Dermatophytosis of the scalp (Tinea capitis)

Forms and strengths

100 mg capsule
Also comes in 50 mg/5 ml oral solution.

Dosage and duration

Histoplasmosis (moderate symptoms)
Child: 5 mg/kg once daily for 6 to 12 weeks
Adult: 200 mg 3 times daily for 3 days then 200 mg 1 to 2 times daily for 6 to 12 weeks

Histoplasmosis (severe symptoms, disseminated form)

Same treatment for 12 weeks, preceded by one to 2 weeks of treatment with amphotericin B

Penicilliosis (moderate symptoms)

Adult: 200 mg 2 times daily for 8 weeks

Penicilliosis (severe symptoms)

Same treatment for 10 weeks, preceded by 2 weeks of treatment with amphotericin B
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Adult: 200 mg once daily as long as required
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Dermatophytosis
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Child: 3 to 5 mg/kg once daily for 4 weeks
Adult: 200 mg once daily for 2 to 4 weeks
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Contra-indications, adverse effects, precautions
Page 181/ 663
 Administer with caution and monitor use in patients > 60 years or with hepatic or renal impairment or
congestive heart failure.
May cause: gastrointestinal disturbances, headache, skin reactions sometimes severe,
anaphylactic reaction, hepatic disorders sometimes severe, paraesthesia, oedema, cardiac failure.
Stop treatment in the event of anaphylactic reaction, hepatic disorders or severe skin reaction.
In case of prolonged treatment, monitor liver function.
Do not combine with quinidine (risk of arrhythmia).
Avoid or monitor combination with amiodarone, calcium-channel blockers, benzodiazepines,
certain antiretrovirals (e.g. indinavir, ritonavir, saquinavir), corticosteroids (dexamethasone,
prednisolone), warfarin, carbamazepine, digoxin: increased blood concentration of these drugs.
Efficacy of itraconazole may be reduced when combined with: rifampicin, rifabutin, isoniazid,
efavirenz, phenytoin, phenobarbital.
Do not administer simultaneously with aluminium or magnesium hydroxide: administer 2 hours apart.
Pregnancy and breast-feeding: avoid; for histoplasmosis, amphotericin B alone for 4 to 6 weeks
is an alternative in pregnant women. Do not administer in the event of dermatophytosis of the scalp
(apply a topical treatment until it is possible to use itraconazole).

Remarks
Do not open the capsules; take with meals.

Storage
Below 25 °C

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Page 182/ 663

 IVERMECTIN oral
Prescription under medical supervision

Therapeutic action
Anthelminthic, scabicide

Indications
Onchocerciasis
Scabies

Forms and strengths

3 mg tablet

Dosage and duration

Onchocerciasis
Child over 15 kg and adult: 150 micrograms/kg single dose. A 2nd dose should be administered after
3 months if clinical signs persist. Repeat the treatment every 6 or 12 months to maintain the
parasite load below the threshold at which clinical signs appear.

Height 0 to < 90 cm 90 to < 120 120 to < 140 140 to < 160 ≥ 160 cm
Weight < 15 kg cm cm cm ≥ 65 kg
15 to < 25 kg 25 to < 45 kg 45 to < 65 kg

Do not
3 mg tablet 1 tab 2 tab 3 tab 4 tab
administer

Ordinary scabies
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Crusted scabies You can accept and reject individual cookie types and revoke your consent for the future at any
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Child over 15 kg and adult: 2 doses of 200 micrograms/kg one week apart, in combination with a
topical keratolytic and topical scabicide; additional doses may be necessary.
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Contra-indications, adverse effects, precautions
Page 183/ 663
 May cause:
increased itching;
moderate reactions in patients with onchocerciasis: ocular irritation, headache, arthralgia,
myalgia, lymphadenopathy, fever, oedema;
severe reactions in patients co-infected with Loa loa: marked functional impairment if Loa loa
microfilaraemia > 8,000 mf/ml; encephalopathy if Loa loa microfilaraemia > 30,000 mf/ml.
Administer with caution in regions where loiasis is endemic:
For symptomatic onchocerciasis:
Evaluate the severity of Loa loa microfilaraemia and manage accordingly: either treat as an out-
patient under supervision, or hospitalise, or choose an alternative treatment (doxycycline).
If it is not possible to perform a thick film examination: ivermectin may be administered if the
patient has no history of loiasis (migration of an adult worm under the conjunctiva or transient «
Calabar » swellings), nor history of severe adverse reactions following a previous treatment with
ivermectin. In other cases, it is wiser either to treat under supervision, or to choose an
alternative treatment (doxycycline), or decide not to treat, according to the severity of the
onchocerciasis and the previous history.
For ordinary scabies:
Review the patient’s history and if in doubt, topical scabicidal treatment is preferred.​​
Pregnancy: avoid (safety is not established)
Breast-feeding: no contra-indication

Remarks
Take tablets on an empty stomach. Tablets may be crushed for administration to small children.
Ivermectin is also used for the treatment of strongyloidiasis (200 micrograms/kg single dose) and
cutaneous larva migrans (200 micrograms/kg daily for 1 to 2 days).

Storage
- Below 25 °C

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Page 184/ 663

 LABETALOL oral
Last updated: March 2024

Prescription under medical supervision

Therapeutic action
Non cardioselective beta-blocker

Indications
Hypertension in pregnancy

Forms and strengths

100 mg and 200 mg tablets

Dosage
100 mg 2 times daily. Increase if necessary in 100 to 200 mg increments until an effective dose is
reached, usually 400 to 800 mg daily (max. 2400 mg daily). If higher doses are required, give in 3
divided doses.

Duration
According to clinical response. Do not stop treatment abruptly, decrease doses gradually.

Contra-indications, adverse effects, precautions

Do not administer to patients with asthma, chronic obstructive bronchopneumonia, heart failure,
severe hypotension, bradycardia < 50/minute, atrio-ventricular heart blocks, Raynaud's syndrome,
hepatic impairment.
May cause: bradycardia, hypotension, heart failure, bronchospasm, hypoglycaemia, gastrointestinal
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Administer with caution to patients with diabetes (risk of hypoglycaemia).
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Reduce
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display relevant impairment.
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In the event of anaphylactic shock, risk of resistance
use of all cookies. You can accept and reject individual to epinephrine.
cookie types and revoke your consent for the future at any
time Avoid or monitor combination with: mefloquine, digoxin, amiodarone, diltiazem, verapamil (risk of
at "Settings".
bradycardia); tricyclic antidepressants, antispychotics, other anti-hypertensive drugs (risk of
hypotension).
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Page 185/ 663

 Do not administer simultaneously with antacids (aluminium or magnesium hydroxide, etc.).
Administer 2 hours apart.
Monitor the neonate: risk of hypoglycaemia, bradycardia, respiratory distress occurring most often
during the first 24 hours and until 72 hours after the birth.
Breast-feeding: no contra-indication

Storage
– – Below 25 °C

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 LACTULOSE oral
Last updated: January 2024

Therapeutic action
Osmotic laxative

Indications
Prevention of constipation in patients taking opioid analgesics (e.g. codeine, morphine)

Forms and strengths

10 g/15 ml oral solution, to be administered using a measuring device (oral syringe, measuring
spoon, or cup with graduations)

Dosage and duration

Child under 1 year: 5 ml daily (3.3 g daily)
Child from 1 to 6 years: 5 to 10 ml daily (3.3 to 6.7 g daily)
Child from 7 to 14 years: 10 to 15 ml daily (6.7 to 10 g daily)
Child over 14 years and adult: 15 to 45 ml daily (10 to 30 g daily)

Start lactulose when analgesic treatment continues more than 48 hours.

Lactulose must be taken daily, until the end of the opioid treatment. Regular follow up
(frequency/consistency of stools) is essential in order to adjust dosage correctly.

Contra-indications, adverse effects, precautions

Do not administer to patients with Crohn’s disease, ulcerative colitis, intestinal obstruction,
undiagnosed abdominal pain.
May cause: abdominal discomfort, flatulence and diarrhoea.
In the event of diarrhoea, exclude a faecal impaction and intestinal obstruction; reduce the dose.
Pregnancy: no contra-indication
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Remarks
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It may take up to 48 hours, or even longer, before the treatment is effective. Lactulose is not
time at "Settings".
indicated in acute constipation where a rapid result is needed.
If necessary, lactulose may be given in combination with a stimulant laxative (e.g. bisacodyl, senna).
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T he treatment should be accompanied by dietary measures (fluids and fibre).
Page 187/ 663
 Storage
Below 25 °C. Do not store in a refrigerator (cristallisation).

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 LAMIVUDINE = 3TC oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretroviral, nucleoside reverse transcriptase inhibitor

Indications
HIV infection, in combination with other antiretrovirals

Forms and strengths

150 mg tablet
50 mg/5 ml oral solution

Dosage
T he daily dose is administered once daily or in 2 divided doses.
Child 1 month and over and adult:

Weight Daily dose 50 mg/5 ml oral sol. 150 mg tablet

3 to < 6 kg 60 mg 3 ml x 2 –

6 to < 10 kg 80 mg 4 ml x 2 –

10 to < 14 kg 120 mg 6 ml x 2 –

½ tab x 2
14 to < 20 kg 150 mg –
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1 tab x 2
≥ 25 kg 300 mg –
or 2 tab x 1
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Page 189/ 663

 Duration
Depending on the efficacy and tolerance of lamivudine.

Contra-indications, adverse effects, precautions

Administer with caution to patients with history of hepatic disorders.
May cause: gastrointestinal disturbances (diarrhoea, nausea, vomiting, etc.) and possibly:
haematological disorders, especially when combined with zidovudine (neutropenia, anaemia,
thrombocytopenia), myopathy, hepatic or pancreatic disorders.
Reduce dosage in patients with renal impairment.
Pregnancy: no contra-indication

Remarks
In neonates, the dosage of lamivudine 50 mg/5 ml (i.e. 10 mg/ml) solution is:
2 to < 3 kg: 0.5 ml 2 times daily (daily dose: 10 mg)
3 to < 4 kg: 0.8 ml 2 times daily (daily dose: 16 mg)
4 to < 5 kg: 1 ml 2 times daily (daily dose: 20 mg)
Lamivudine is also used for HIV post-exposure prophylaxis, in combination with other
antiretrovirals.
Also comes in fixed-dose combinations with other antiretrovirals. Preferably use these formulations
when available.

Storage
Below 25 °C
Once opened, oral solution keeps for 30 days maximum.

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 LEVETIRACETAM = LEV oral
Last updated: October 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of LEV, patients should be
kept under close surveillance.

Therapeutic action
Antiseizure (antiepileptic)

Indications
Epilepsy: generalised tonic-clonic seizures, focal (partial) seizures and absence seizures

Forms and strengths

250 mg, 500 mg, 750 mg and 1 g tablets
500 mg/5 ml oral solution, to be administered using a measuring device (oral syringe, measuring
spoon, or cup with graduations)

Dosage
Start with a low dose then increase gradually based on patient's response and tolerance.
Child 1 to 5 months: start with 7 mg/kg once daily; increase to 7 mg/kg 2 times daily after 2 weeks,
then by increments of 7 mg/kg 2 times daily every 2 weeks if necessary (max. 21 mg/kg 2 times
daily).
Child 6 months to 17 years (< 50 kg): start with 10 mg/kg once daily; increase to 10 mg/kg 2 times
daily after 2 weeks, then by increments of 10 mg/kg 2 times daily every 2 weeks if necessary (max.
30 mg/kg 2 times daily).
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Duration
As long as required. Do not stop treatment abruptly, even if changing treatment to another
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antiseizure medication.

Page 191/ 663

 Contra-indications, adverse effects, precautions
Administer with caution to patients with renal impairment (reduce dosage) or heart disorders.
May cause:
drowsiness (caution when driving/operating machinery), headache, asthenia, dizziness, mood
and behavioural disturbances, anxiety, depression, insomnia;
haematologic disorders, gastrointestinal disturbances, cough, nasopharyngitis;
rarely: QT prolongation, hypersensitivity reactions (including severe cutaneous reactions such as
Stevens-Johnson, Lyell and DRESS syndromes). In these cases stop treatment. Early
symptoms such as fever, rash, mouth ulcers and bleeding require immediate medical attention.
respiratory depression and coma in the event of overdose.
Avoid or monitor the combination with:
mefloquine (reduced effect of LEV);
drugs that prolong the QT interval (antimalarials, antipsychotics, fluconazole, fluoroquinolones,
hydroxyzine, macrolides, ondansetron, etc.);
drugs containing alcohol, benzodiazepines, opioid analgesics, antipsychotics, first-generation
antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc.
(increased sedation).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: use the lowest effective dose.
Administer folic acid high dose (5 mg daily) during the first trimester. Start as soon as possible,
including during the preconception period in case of planned pregnancy.
Plasma concentrations may decrease during pregnancy. Monitor clinical response; increase
dose if needed then resume the usual dose after delivery.
Breast-feeding: administer with caution (excreted in milk); reduce the dose if increased during
pregnancy and monitor the child (risk of drowsiness and poor feeding).

Remarks
LEV can be used with contraceptive implants and oral contraceptives.

Storage
– Below 25 °C

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Page 192/ 663

 LEVODOPA/CARBIDOPA oral
Last updated: April 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of levodopa/carbidopa,

patients should be kept under close surveillance.

Therapeutic action
Antiparkinson drug

Indications
Parkinson’s disease and extrapyramidal disorders except those induced by antipsychotics

Forms and strengths

100 mg levodopa + 10 mg carbidopa tablet
250 mg levodopa + 25 mg carbidopa tablet

Dosage
Doses are expressed as levodopa:
Adult:
Initial dose: 50 to 125 mg 3 times daily, immediately after meals. Increase by 50 to 125 mg every
day or every 2 days until the optimal dose for the individual patient is reached.
Maintenance dose usually: 250 to 500 mg 3 times daily, immediately after meals (max. 2 g daily)
Reduce dosage in older patients.

Duration
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Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not administer in case of severe psychosis, confusion, closed-angle glaucoma, recent
at "Settings".
myocardial infarction, malignant melanoma.
May cause:
Settings early in treatment, when dose is not adjusted : anorexia, vomiting, orthostatic hypotension,
Decline Accept
cardiac arrhythmia, agitation, insomnia or drowsiness, depression;
Page 193/ 663
 frequent delayed adverse effects, signs of excessive dosage, mainly:
dyskinesia, tremor;
mental disorders more frequent in older patients: confusional state or depression with or
without suicidal tendencies;
later in treatment : fluctuation of the effect during the day (in this event, daily dosage may be
divided into smaller doses and taken more frequently); or reduction of the effect (progression of
the disease).
Administer with caution in mental disorders, cardiac disease, gastroduodenal ulcer.
Do not administer simultaneously with MAOI antidepressants, antipsychotics, reserpine.
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: CONT RA-INDICAT ED

Remarks
Tablet must be swallowed whole. Do not chew or dissolve.

Storage
– Below 25 °C

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Settings Decline Accept

Page 194/ 663

 LEVONORGESTREL oral
Prescription under medical supervision

Therapeutic action
Hormonal contraceptive, progestogen

Indications
Oral contraception

Forms and strengths

0.03 mg (30 micrograms) tablet

Dosage
One tablet daily to be taken at the same time each day, on a continuous basis, including during
menstruation.
Contraception may be started at any moment of the cycle if it is reasonably certain the woman is
not pregnant, including when switching from another form of contraception. Contraception will be
effective as of the 3rd tablet.
Use condoms for the first 2 days of the pack if the pill is started:
more than 5 days after the start of menstruation;
more than 28 days postpartum if not breastfeeding;
more than 7 days after an abortion.
If a pill is missed, it should be taken as soon as possible and usual treatment continued. T he missed
pill and next scheduled pill can be taken together.
If the missed pill is more than 3 hours overdue, the effectiveness of the contraceptive is reduced.
Use:
condoms for the following 2 days;
We use aemergency
selection of contraception
our own and third-party cookieshas
if the woman on the
hadpages of this website:
intercourse in the 5 Essential cookies, the
days preceding which are
missed
required pill.
in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Duration
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
If there are no adverse effects, as long as this method of contraception is desired.

Contra-indications,
Settings adverse effects, precautions Decline Accept

Page 195/ 663

 Do not administer to women with breast cancer, severe or recent liver disease, unexplained vaginal
bleeding, active thromboembolic disorders.
May cause: amenorrhoea, menstrual disturbances, nausea, weight gain, breast tenderness, mood
changes, acne, headache.
Enzyme-inducing drugs (rifampicin, rifabutine, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital,
phenytoin, carbamazepine, griseofulvin, etc.) reduce the effectiveness of the contraceptive.
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Remarks
Levonorgestrel is a possible alternative when oestroprogestogens are contra-indicated or poorly
tolerated. Its use requires taking pills at strictly the exact time daily, no more than 3 hours late.

Storage
- Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 196/ 663

 LEVONORGESTREL for emergency
contraception
Therapeutic action
Hormonal contraceptive, progestogen

Indications
Emergency contraception after unprotected or inadequately protected intercourse (e.g. forgotten
pill or condom breaking)

Forms and strengths

1.5 mg tablet

Dosage and duration

One 1.5 mg tablet, whatever the day of the cycle, as soon as possible after unprotected or
inadequately protected intercourse and preferably within the first 72 hours as effectiveness
decreases with time. It is however recommended to administer the treatment up to 120 hours (5
days) after unprotected intercourse.

Contra-indications, adverse effects, precautions

May cause: disturbance of next menstrual cycle, metrorrhagia, nausea, headache, dizziness.
Re-administer treatment immediately if vomiting occurs within 2 hours of taking treatment.
Double the dose (3 mg single dose) in women taking enzyme-inducing drugs (rifampicin,
rifabutin, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital, phenytoin, carbamazepine,
griseofulvin, etc.): can reduce the effectiveness of the contraceptive.
Pregnancy: in the event of treatment failure (i.e. pregnancy develops) or if used during an
undiagnosed pregnancy, there is no known harm for the foetus.
We use a selection of ournoown
Breast-feeding: and third-party cookies on the pages of this website: Essential cookies, which are
contra-indication
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Emergency contraception is intended to prevent pregnancy; it cannot terminate an ongoing
time at "Settings".
pregnancy.
If hormonal contraception is started or resumed immediately after taking levonorgestrel as
Settings
emergency contraception, use condoms during the first 7 days. Decline Accept

Page 197/ 663

 T here is a risk of treatment failure; carry out a pregnancy test if signs or symptoms of pregnancy
(no menstruation, etc.) appear one month after taking levonorgestrel as emergency contraception.

Storage
- Below 25 °C​

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

Settings Decline Accept

Page 198/ 663

 LOPERAMIDE oral
Last updated: January 2024

Prescription under medical supervision

Therapeutic action
Opioid antidiarrhoeal

Indications
Symptomatic treatment of persistent diarrhoea in adults with HIV infection, in combination with
rehydration

Forms and strengths

2 mg capsule or tablet

Dosage
Adult: 4 mg (2 capsules), then 2 mg (1 capsule) after each loose stool, without exceeding 16 mg
daily (8 capsules daily).

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Do not exceed indicated doses.
Do not administer to children.
Do not administer to patients with bloody diarrhoea, ulcerative colitis, diarrhoea due to antibiotics.
May cause: constipation, allergic skin reactions, drowsiness, dizziness.
We use a selection
In the event ofof overdosage,
our own and third-party
treat withcookies on the pages of this website: Essential cookies, which are
naloxone.
required in order to use the website;
Pregnancy: no contra-indication functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Breast-feeding: no contra-indication
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

Rehydration is essential and must be adapted to the severity of diarrhoea.

Loperamide is not included in the WHO list of essential medicines.
Settings Decline Accept

Page 199/ 663

 Storage
– Below 25 °C

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 200/ 663

 LOPINAVIR/RITONAVIR = LPV/r oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretrovirals, HIV protease inhibitors

Indications
HIV infection, in combination with other antiretrovirals

Forms and strengths

40 mg lopinavir/10 mg ritonavir sachet of granules
100 mg lopinavir/25 mg ritonavir film coated tablet

Dosage
T he daily dose is administered in 2 divided doses.
Child 2 weeks and over:

Daily dose
Weight 40/10 mg granules 100/25 mg tablet
LPV/r

3 to < 6 kg 160/40 mg 2 sachets x 2 –

6 to < 10 kg 240/60 mg 3 sachets x 2 –

10 to < 14 kg 320/80 mg 4 sachets x 2 –

We14usetoa selection
< 20 kg of our own and third-party
400/100 mg cookies on the5pages of this
sachets x 2website: Essential cookies,
2 tab xwhich
2 are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
20 to < 25 kg 400/100 mg – 2 tab x 2
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time25atto
"Settings".
< 35 kg 600/150 mg – 3 tab x 2

≥ 35 kg 800/200 mg – 4 tab x 2
Settings Decline Accept

Page 201/ 663

 In children 10 to < 14 kg who can swallow the tablets whole, administer two 100/25 mg tablets
in the morning and one 100/25 mg tablet in the evening (daily dose: 300/75 mg).
In children on nevirapine or efavirenz: increase the dose of LPV/r according to manufacturer's
instructions.

Adult:
400/100 mg (4 tablets) 2 times daily (daily dose: 800/200 mg)
In adult on nevirapine or efavirenz: 500/125 mg (5 tablets) 2 times daily (daily dose: 1000/250
mg)

Duration
Depending on the efficacy and tolerance of lopinavir and ritonavir.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe hepatic impairment or hypokalaemia.
Do not combine with rifampicin, replace with rifabutin. If rifabutin is not available and LPV/r is
essential, adjust the dose:
child: increase the dose of RT V to obtain a one-to-one (1:1) LPV/r ratio;
adult: double the dose (800/200 mg 2 times daily).
Administer with caution and monitor use in patients with haemophilia (increased bleeding) or mild to
moderate hepatic impairment.
May cause:
gastrointestinal disturbances (mainly diarrhoea), skin rash, fatigue, headache,
insomnia, paraesthesia, muscle pain hyperglycaemia, conduction disorders, hyperlipidaemia,
lipodystrophy;
hepatic and pancreatic disorders; in this event, stop treatment immediately.
Administer with caution and monitor combination with drugs that prolong the QT interval
(amiodarone, co-artemether, mefloquine, quinine, haloperidol, etc.).
LPV/r reduces the efficacy of implants and oral contraceptives: use injectable
medroxyprogesterone or an intrauterine device.
Pregnancy: no contra-indication

Remarks
Do not cut, crush or chew tablets.
We use a selection
Pour granulesofinto
our aown andamount
small third-party cookiesmilk,
of breast on the pagesorofsoft
water this website:
foods andEssential cookies,
administer which are
immediately
required in order to use the website; functional cookies, which provide better easy of use when using the website;
(within 2 hours of preparation max.).
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Storage
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
– – Below 25 °C

Settings Decline Accept

Page 202/ 663

 LORATADINE oral
Last updated: February 2024

Prescription under medical supervision

Therapeutic action
H1 antihistamine

Indications
Symptomatic treatment of minor allergic reactions (urticaria, allergic conjunctivitis, etc.)

Forms and strengths

5 mg/5 ml oral solution
10 mg tablet

Dosage
Child over 2 years and under 30 kg: 5 mg (5 ml) once daily
Child over 30 kg and adult: 10 mg (1 tab) once daily

Duration
As short as possible (a few days).

Contra-indications, adverse effects, precautions

Administer with caution and reduce the dose (administer every other day) in patients with
severe renal or hepatic impairment.
May cause: headache, dizziness, drowsiness (caution when driving/operating machinery),
nervousness, insomnia, increased appetite, rash.
We use a selection
Monitor of our own
combination and third-party cookies on the pages of this website: Essential cookies, which are
with:
required central
in order nervous
to use thesystem
website;depressants
functional cookies,
(opioidwhich provideantipsychotics,
analgesics, better easy of usesedatives,
when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
antidepressants, etc.);
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of allerythromycin,
cookies. You canfluconazole, fluoxetine,
accept and reject amiodarone,
individual ritonavir,
cookie types cimetidine
and revoke (increased
your consent for theplasma
future at any
concentrations of loratadine).
time at "Settings".
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: avoid during the first trimester (uncertain risk of hypospadias)
Settings Decline Accept
Breast-feeding: no contra-indication

Page 203/ 663

 Remarks
Loratadine is less sedating than promethazine.

Storage
– Below 25 °C

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

Settings Decline Accept

Page 204/ 663

 MEBENDAZOLE oral
Prescription under medical supervision

Therapeutic action
Anthelminthic

Indications
Ascariasis (Ascaris lumbricoides), trichuriasis (Trichuris trichiura), hookworm infections
(Ancylostoma duodenale, Necator americanus), enterobiasis (Enterobius vermicularis),
trichinellosis (Trichinella sp)

Forms and strengths

100 mg tablet

Dosage and duration

Ascariasis, trichuriasis, hookworm infections
Child over 6 months and adult: 100 mg 2 times daily for 3 days
Child over 6 months but under 10 kg: 50 mg 2 times daily for 3 days

Enterobiasis
Child over 6 months and adult: 100 mg single dose
Child over 6 months but under 10 kg: 50 mg single dose

A second dose may be given after 2 to 4 weeks.

Trichinellosis
Child over 2 years: 2.5 mg/kg 2 times daily for 10 to 15 days
We use a selection
Adult: 200 mgof2our owndaily
times and third-party
for 10 to 15cookies
days on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Do not administer to children under 6 months.
time at "Settings".
May cause: gastrointestinal disturbances, headache, dizziness.
Pregnancy: avoid during the first trimester
Settings
Breast-feeding: no contra-indication Decline Accept

Page 205/ 663

 Remarks
Use albendazole in preference to mebendazole: albendazole is easier to use and is preferred in
mixed infections as it has a broader spectrum of activity.
Tablets are to be chewed or crushed: follow manufacturer's instructions.
Take tablets between meals.

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 206/ 663

 MEDROXYPROGESTERONE acetate oral
Last updated: October 2021

Prescription under medical supervision

Therapeutic action
Progestogen

Indications
Abnormal uterine bleeding (especially functional uterine bleeding unrelated to pregnancy)

Forms and strengths

10 mg tablet

Dosage and duration

Persistent abnormal uterine bleeding despite tranexamic acid therapy or heavy bleeding when
tranexamic acid is contra-indicated
Adolescent and adult: 20 mg 3 times daily for 7 days

Long-term treatment of functional uterine bleeding

Adult: 10 mg once daily (up to 30 mg once daily if necessary). Continue treatment according to
clinical response.

Contra-indications, adverse effects, precautions

Do not administer to patients with breast cancer, severe hypertension (≥ 160/100), active
thromboembolic disorders, uncontrolled or complicated diabetes, severe or recent hepatic
disease.
May cause: menstrual irregularities, amenorrhoea, menometrorrhagia, breast tenderness, headache,
weight gain, acne, mood change, abdominal pain, gastrointestinal disturbances.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order toCONTRA-INDICATED
Pregnancy: use the website; functional cookies, which provide better easy of use when using the website;
Breast-feeding:
performance no contra-indication
cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Remarks
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Unlike injectable medroxyprogesterone, the oral form has no contraceptive effect.

Storage
Settings Decline Accept

Page 207/ 663

 – Below 25 °C

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 208/ 663

 METFORMIN oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Biguanide antidiabetic

Indications
First-line treatment of type 2 diabetes, when diet and lifestyle measures alone are insufficient, as
monotherapy or in combination with another antidiabetic

Forms and strengths

500 mg and 1 g tablets

Dosage and duration

Adult:
Week 1: 500 mg once daily in the morning
Week 2: 500 mg 2 times daily (morning and evening)
Increase if necessary in increments of 500 mg per week, according to blood glucose levels and as
long as the drug is well tolerated, without exceeding 2 g daily (1 g morning and evening).

Contra-indications, adverse effects, precautions

Do not administer to patients with: ketoacidosis; cardiac, respiratory, hepatic or severe renal
impairment.
May cause:
often: dose-related gastrointestinal disturbances (nausea, vomiting, diarrhoea, abdominal pain),
We use aloss of appetite,
selection metallic
of our own taste in mouth;
and third-party cookies on the pages of this website: Essential cookies, which are
required rarely:
in orderlactic
to useacidosis (in the
the website; event of
functional acutewhich
cookies, alcohol intoxication,
provide dehydration,
better easy of use whentaking drugs
using the that
website;
performance
altercookies, which weetc.);
renal function, use to generate aggregated
decreased absorption data
of on website
vitamin use(risk
B 12 andof
statistics; and marketing
macrocytic anaemia).
cookies, which are used to display relevant content and advertising.
Reduce dose (max. 1 g daily) in case of moderate renal impairment. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Monitor combination with:
time at "Settings".
diuretics, angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs (risk
of lactic acidosis due to altered renal function);
Settings drugs increasing blood glucose levels: corticosteroids, hydrochlorothiazide, salbutamol,
Decline Accept
chlorpromazine.
Page 209/ 663
 Stop metformin before surgery or the injection of iodinated contrast agents. Resume treatment 48
hours later after checking renal function.
Pregnancy: insulin is the drug of choice for type 2 diabetes in pregnant women (improved
glycaemic control; reduced risk of foetal anomalies and neonatal complications). Nevertheless,
metformin is not contra-indicated.
Breast-feeding: no contra-indication

Remarks
To reduce gastrointestinal intolerance, gradually increase the dose and take tablets with meals.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Settings Decline Accept

Page 210/ 663

 METHYLDOPA oral
Prescription under medical supervision

Therapeutic action
Centrally acting antihypertensive

Indications
Hypertension in pregnancy

Forms and strengths

250 mg tablet

Dosage
Initially 250 mg 2 to 3 times daily for 2 days, then increase gradually if necessary by 250 mg every 2
to 3 days, until the optimal dose is reached, usually 1.5 g daily. Do not exceed 3 g daily.

Duration
According to clinical response. Do not stop treatment abruptly; reduce doses gradually.

Contra-indications, adverse effects, precautions

Do not administer to patients with active liver disease, history of drug-induced hepatitis, severe
depression.
Administer with caution to patients with hepatic impairment, and reduce doses in patients with renal
impairment.
May cause:
orthostatic hypotension, drowsiness, headache, gastrointestinal disturbances, dry mouth;
We use ararely:
selection of our own and hepatic,
haematological, third-party cookies
mental on the pages
disorders; of this
allergic website: Essential cookies, which are
reactions.
required
Stop treatment in the event of haemolytic anaemia or jaundice. easy of use when using the website;
in order to use the website; functional cookies, which provide better
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
In the event of unexplained fever during treatment, check blood count and transaminases for
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofpossible hepatitis
all cookies. due
You can to methyldopa.
accept and reject individual cookie types and revoke your consent for the future at any
time Monitor combination with lithium (risk of lithium overdose), antidepressants (enhanced hypotensive
at "Settings".
effect), CNS depressants (increased sedation).
Pregnancy: no contra-indication
Settings Decline Accept
Breast-feeding: no contra-indication

Page 211/ 663

 Storage
Below 25 °C

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 212/ 663

 METOCLOPRAMIDE oral
Last updated: February 2024

Prescription under medical supervision

Do not exceed the recommended dose and duration of treatment (risk of serious
neurological adverse effects).

Therapeutic action
Antiemetic (dopamine antagonist)

Indications
Symptomatic treatment of nausea and vomiting in adults

Forms and strengths

10 mg tablet

Dosage
Adult under 60 kg: 5 mg 3 times daily
Adult over 60 kg: 10 mg 3 times daily
T he interval between each dose should be at least 6 hours (even in the event of vomiting).

Duration
Max. 5 days

Contra-indications, adverse effects, precautions

We use
Doa not
selection of our to
administer own and third-party
children < 18 yearscookies
and on
to the pages with
patients of this website: Essential
gastrointestinal cookies, which are
haemorrhage,
required in order to use the website; functional cookies, which provide better easy of use when using the website;
obstruction or perforation.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Reduce
cookies, whichthe
aredose bydisplay
used to half in relevant
patientscontent
with severe renal impairment.
and advertising. If you choose "Accept all", you consent to the
use ofAdminister
all cookies.with
Youcaution
can acceptandand
monitor use in patients
reject individual cookie>types
60 years and patients
and revoke with epilepsy
your consent or at any
for the future
time Parkinson's
at "Settings". disease.
May cause: drowsiness (caution when driving/operating machinery), dizziness, confusion,
extrapyramidal symptoms, seizures (especially in patients with epilepsy), allergic reactions;
Settings Decline Accept

Page 213/ 663

 neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular disorders),
exceptional but requiring immediate treatment discontinuation.
Do not combine with levodopa (antagonism).
Avoid combination with CNS depressants (opioid analgesics, antipsychotics, sedatives,
antidepressants, antihistamines, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 214/ 663

 METRONIDAZOLE oral
Prescription under medical supervision

Therapeutic action
Antiprotozoal, antibacterial (group of nitroimidazoles)

Indications
Amoebiasis, giardiasis, trichomoniasis
Bacterial vaginitis, infections due to anaerobic bacteria (e.g. Clostridium sp, Bacteroides sp, etc.)

Forms and strengths

250 mg and 500 mg tablets
200 mg/5 ml oral suspension

Dosage and duration

Amoebiasis
Child: 15 mg/kg 3 times daily
Adult: 500 mg 3 times daily
T he treatment lasts 5 days in intestinal amoebiasis and 5 to 10 days in hepatic amoebiasis.

Giardiasis
Child: 30 mg/kg once daily for 3 days
Adult: 2 g once daily for 3 days

Trichomoniasis and bacterial vaginitis

Adult: 2 g single dose

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Adult: 500 mg 3 times daily
time at "Settings".
According to indication, metronidazole may be used in combination with other anti bacterials;
treatment duration depends on indication.
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Page 215/ 663

 Contra-indications, adverse effects, precautions
Do not administer to patients with hypersensitivity to metronidazole or
another nitroimidazole (tinidazole, secnidazole, etc.).
May cause: gastrointestinal disturbances; rarely: allergic reactions, brownish urine, headache,
dizziness. Risk of antabuse reaction when combined with alcohol.
Administer with caution in patients taking oral anticoagulants (risk of haemorrhage), lithium,
phenytoin, ergometrine (increased plasma concentrations of these drugs).
Reduce total daily dose to one third and give once daily to patients with severe hepatic impairment.
Pregnancy: no contra-indication; divide into smaller doses, avoid prolonged use.
Breast-feeding: significantly excreted in milk (risk of gastrointestinal disturbances in breastfed
infants); divide into smaller doses, avoid prolonged use.

Storage
– Below 25 °C
For the oral suspension: follow manufacturer’s instructions.

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Page 216/ 663

 MICONAZOLE oral gel
Prescription under medical supervision

Therapeutic action
Antifungal

Indications
Mild oropharyngeal candidiasis

Forms and strengths

2% oral gel (24 mg/ml) together with, depending on the manufacturer:
a 2.5 ml measuring spoon with 1.25 ml and 2.5 ml graduation
or
a 5 ml measuring spoon with 2.5 ml and 5 ml graduation

Dosage
Child from 6 months to 2 years: 1.25 ml 4 times daily
Child over 2 years and adult: 2.5 ml 4 times daily

T he oral gel should be kept in the mouth 2 to 3 minutes and then swallowed, or in young children,
applied to the tongue and inside of each cheek.

Duration
7 days; 14 days of treatment may be necessary.

Contra-indications, adverse effects, precautions

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not combine with antivitamin K agents (risk of haemorrhage), glibenclamide (increased
hypoglycaemic effect), phenytoin (increased plasma concentration of phenytoin).
May cause: nausea, taste disturbances.
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Pregnancy: no contra-indication

Page 217/ 663

 Breast-feeding: no contra-indication

Remarks
Use the measuring spoon provided and check the graduation.
Administer between meals (preferably after meals).
In patients with dentures, clean dentures with oral gel when removed.
In the event of moderate or severe oropharyngeal candidiasis, use oral fluconazole.
Miconazole oral gel is not included in the WHO list of essential medicines.

Storage
– Below 25 °C

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Page 218/ 663

 MIFEPRISTONE oral
Prescription under medical supervision

Therapeutic action
Antiprogestogen

Indications
Termination of intra-uterine pregnancy up to 22 weeks after the last menstrual period, in
combination with misoprostol

Forms and strengths

200 mg tablet

Dosage and duration

200 mg single dose, followed by the administration of misoprostol 1 to 2 days later

Contra-indications, adverse effects, precautions

Do not administer to patients with chronic adrenal failure or severe uncontrolled asthma.
May cause: gastrointestinal disturbances, vaginal bleeding, uterine contractions, headache.
Breast-feeding: no contra-indication for a single dose; to be avoided if multiple doses

Remarks
Do not use mifepristone in ectopic or molar pregnancy.

Storage
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Page 219/ 663

 MISOPROSTOL oral
Last updated: December 2024

Prescription under medical supervision

Therapeutic action
Oxytocic drug, prostaglandin analogue

Indications
Incomplete abortion
Termination of intra-uterine pregnancy, preferably in combination with mifepristone
Induction of labour
Treatment of post-partum haemorrhage due to uterine atony, when injectable oxytocics are not
available or ineffective
Cervical dilation before aspiration or curettage

Forms and strengths

25 micrograms and 200 micrograms tablets

Dosage and duration

Incomplete abortion
Up to 13 weeks since the last menstrual period: 400 micrograms single dose sublingually or 600
micrograms single dose orally
From 13 to 22 weeks since the last menstrual period: 400 micrograms sublingually every 3 hours

Termination of pregnancy
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ndof use when
vaginally. If expulsion has not occurred within 24 hours administer a 2 dose of 800 micrograms. using the website;
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From 13 to 22 weeks since the last menstrual period: 400 micrograms single dose sublingually or
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Induction of labour
25 micrograms orally every 2 hours, or if not possible, vaginally every 6 hours, until labour starts
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(max. 200 micrograms per 24 hours)

Page 220/ 663

 Treatment of post-partum haemorrhage
800 micrograms single dose sublingually

Cervical dilation before aspiration or curettage

400 micrograms single dose sublingually 1 to 3 hours before the procedure or vaginally 3 hours
before the procedure

Contra-indications, adverse effects, precautions

For induction of labour if the foetus is viable:
Do not administer in the event of previous caesarean section.
Administer with caution in case of grand multiparity or overdistention of the uterus (risk of
uterine rupture).
Monitor the intensity and frequency of contractions as well as foetal heart rate after
administration of misoprostol.
Do not administer simultaneously with oxytocin. At least 4 hours must have elapsed since the
last administration of misoprostol before oxytocin can be given.
For incomplete abortion or termination of pregnancy after 13 weeks since the last menstrual
period: reduce the dose by half in the event of 2 or more previous caesarean sections.
May cause: dose-dependent diarrhoea, vomiting, uterine hypertony, headache, fever, chills, foetal
heart rhythm disorders, foetal distress.
Breast-feeding: no contra-indication

Remarks
Do not use misoprostol in ectopic or molar pregnancy.
Rectal route is used for the treatment of post-partum haemorrhage when the sublingual route
cannot be used.
Also comes is 25 micrograms vaginal tablet for induction of labour (every 6 hours until labour
starts). T hese tablets are intended to be used by vaginal route only.

Storage
– – Below 25 °C

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Page 221/ 663

 MORPHINE immediate-release (MIR) oral
Last updated: October 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of morphine, patients should
be kept under close surveillance.

Therapeutic action
Centrally acting opioid analgesic

Indications
Severe pain

Forms and strengths

10 mg immediate-release tablet
10 mg/5 ml oral solution, for pediatric use

Dosage
T here is no standard dose. T he optimal dose is that which provides efficient pain relief to the patient.
It is adjusted in relation to the regular assessment of pain intensity and the incidence of adverse
effects.

Day 1:
Start with a scheduled treatment (scheduled doses):
Child over 6 months: 0.15 mg/kg every 4 hours
We use aAdult: 10 mg
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T he rescue doses administered are the same as the scheduled doses. use and statistics; and marketing
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T hen, adjust scheduled treatment every 24 hours according to the total dose given the day before
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time (i.e. total scheduled doses + total rescue doses).
at "Settings".
For example, Day 1, for a dose of 60 mg, i.e. 10 mg every 4 hours:

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Page 222/ 663

 In this example, the scheduled treatment on Day 2 is 90 mg, i.e. 60 mg (total scheduled doses on
Day 1) + 30 mg (total rescue doses on Day 1), i.e. 15 mg every 4 hours.
Scheduled doses must be administered at regular time intervals and not on demand, even at night,
unless the patient is abnormally drowsy (in this event, delay the administration).
Reduce the dose by half in elderly patients and patients with renal or hepatic impairment.

Duration
Once the pain is controlled, change to sustained-release morphine.

Contra-indications, adverse effects, precautions

See sustained-release oral morphine (MSR).

Remarks
Administer an appropriate laxative (e.g. lactulose) if analgesic treatment continues more than 48
hours.
T he morphine dose in tablets is not suitable for young children. Use oral solution instead. If this is
not available, use injectable morphine by the oral route: dilute an ampoule of 10 mg/ml (1 ml) with 9
ml of water to obtain a solution containing 1 mg/ml.
Morphine is on the list of narcotics: follow national regulations.

Storage:
– Below 25 °C

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Page 223/ 663

 MORPHINE sustained-release (MSR) oral
Last updated: October 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of morphine, patients should
be kept under close surveillance.

Therapeutic action
Centrally acting opioid analgesic

Indications
Severe and persistent pain, especially cancer pain

Forms and strengths

10 mg, 30 mg and 60 mg sustained-release capsules or tablets

Dosage
Usually, the effective daily dose is determined during the initial treatment with immediate-release
morphine (MIR). When changing from MIR to MSR, the daily dose remains the same.
For example, if the effective dose of MIR is 20 mg every 4 hours (120 mg daily), the dose of MSR is
60 mg every 12 hours (120 mg daily).
If treatment is initiated directly with MSR:
Child over 6 months: initially 0.5 mg/kg every 12 hours
Adult: initially 30 mg every 12 hours
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rescue doses.

Duration
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Page 224/ 663

 According to clinical response. Do not stop long-term treatment abruptly. Decrease doses
progressively to avoid withdrawal symptoms.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe respiratory impairment or decompensated hepatic
impairment.
Do not initiate treatment with the sustained-release formulation in elderly patients or those with
renal or hepatic impairment. Begin treatment with the immediate release formulation (MIR).
May cause:
dose-related sedation and respiratory depression, nausea, vomiting, constipation, urinary
retention, confusion, raised intracranial pressure, pruritus;
in the event of overdose: excessive sedation, respiratory depression, coma.
Management of respiratory depression includes assisted ventilation and/or administration of
naloxone. Monitor patient closely for several hours.
Administer with caution to patients with respiratory impairment, head injury, raised intracranial
pressure, uncontrolled epilepsy or urethroprostatic disorders.
Do not combine with opioid analgesics with mixed agonist-antagonist activity such as
buprenorphine, nalbuphine, pentazocine (competitive action).
Increased risk of sedation and respiratory depression, when combined with alcohol and drugs
acting on the central nervous system: benzodiazepines (diazepam, etc.), neuroleptics
(chlorpromazine, haloperidol, etc.), antihistamines (chlorphenamine, promethazine), phenobarbital,
etc.
Pregnancy and breast-feeding: no contra-indication. T he child may develop withdrawal
symptoms, respiratory depression and drowsiness when the mother receives morphine at the end
of the 3rd trimester and during breast-feeding. In these situations, administer with caution, for a
short period, at the lowest effective dose, and monitor the child.

Remarks
Administer an appropriate laxative (e.g. lactulose) if analgesic treatment continues more than 48
hours.
Do not crush or chew capsules. T hey can be opened and emptied into food.
Morphine is on the list of narcotics: follow national regulations.

Storage:
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Page 225/ 663

 MULTIVITAMINS - VITAMIN B COMPLEX oral
Therapeutic action
Vitamin supplementation

Indications
Few indications: this drug has no effect in case of real vitamin deficiency. Nevertheless, vitamin
supplementation helps to prevent some deficiencies in people at risk (e.g. pregnant women).

Forms and strengths

Tablet. Composition varies in quality and quantity, with manufacturers.

Examples of composition per tablet:

Multivitamins B complex Daily needs (adult)

Vitamin A 2500 IU / 2500 IU

Vitamin B 1 1 mg 1 mg 0.9 to 1.3 mg
Vitamin B 2 0.5 mg 1 mg 1.5 to 1.8 mg
Vitamin B 3 (= PP) 7.5 mg 15 mg 15 to 20 mg
Vitamin C 15 mg / 10 mg
Vitamin D 3 300 IU / 100 to 200 IU

Dosage
Child under 5 years: 1 tablet daily
Child over 5 years: 2 tablets daily
Adult: 3 tablets daily

Duration
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Depending ofsituation
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Contra-indications, adverse effects, precautions
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Pregnancy: no contra-indication
time at "Settings".
Breast-feeding: no contra-indication

Remarks
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Page 226/ 663

 Specific vitamin deficiency states require appropriate doses of vitamins.
Multivitamins are not included in the WHO list of essential medicines.

Storage
– Keep in a cool place (8 °C to 15 °C)

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 NEVIRAPINE = NVP oral
Last updated: January 2025

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of NVP, patients should be
kept under close surveillance.

Therapeutic action
Antiretroviral, HIV-1 non nucleoside reverse transcriptase inhibitor

Indications
Prevention of mother-to-child transmission (PMT CT ) of HIV in neonates, alone or in
combination with other antiretrovirals

Forms and strengths

50 mg/5 ml oral suspension
50 mg scored dispersible tablet

Dosage
Full term neonate:
Follow national recommendations. For information (WHO simplified age-based dosage):
From birth to 6 weeks of age (from 0 to 42 days): 15 mg (1.5 ml) oral suspension or 25 mg (1/2
tab) dispersible tablet once daily. From birth to 4 weeks of age, preferably use the oral
suspension.
T hen, when indicated,
After 6 weeks and up to 12 weeks of age (from 43 to 84 days): 20 mg (2 ml) oral suspension or
We use a25 mg (1/2
selection oftab) dispersible
our own tablet once
and third-party daily
cookies on the pages of this website: Essential cookies, which are
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Preterm or to use the website;
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Duration
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Depending on the risk of acquiring HIV infection (for information):
High risk: 6 weeks (NVP combined with zidovudine). For breastfed children, treatment is extended
for an additional 6 weeks (NVP alone or combined with zidovudine).
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Low risk (NVP alone): 4 to 6 weeks for non-breastfed children; 6 weeks for breastfed children.

Page 228/ 663

 Contra-indications, adverse effects, precautions
Do not administer to neonates:
with severe hepatic impairment;
born to mothers with resistance to NVP or HIV-2 mono-infection.
May cause:
rash and hepatic disorders, especially in the first 6 weeks of treatment; gastrointestinal
disturbances;
less frequently, hypersensitivity reactions (including severe cutaneous reactions such as
Stevens-Johnson, Lyell and DRESS syndromes) and life-threatening hepatotoxicity.
Any isolated rash requires immediate medical attention and surveillance.
Stop NVP immediately and permanently in the event of:
severe rash or rash associated with signs and symptoms of hypersensitivity
reaction (e.g. fever, mouth ulcer, cutaneous blister, conjunctivitis, facial oedema);
signs and symptoms of hepatic disorders (e.g. anorexia, nausea, general malaise, dark urine,
pale stools, hepatomegaly, jaundice).
NVP is a hepatic enzyme inducer. It may interact with many drugs and concomitant use requires
monitoring (e.g. azole derivates, phenobarbital, phenytoin, carbamazepine, clarithromycin).
Avoid combination with rifampicin (decreased NVP plasma concentrations).

Remarks
Shake the oral suspension well before use. T he 50 mg tablet should be dispersed in 10 ml of water
immediately before administration.
NVP is also used for the treatment of HIV-1 infection in children and adults, in combination with
other antiretrovirals. Check national recommendations.
Also comes in fixed-dose combinations with other antiretrovirals. For PMT CT, NVP is sometimes
given as a fixed-dose combination of zidovudine/lamivudine/nevirapine.

Storage
– Below 25 °C
Once opened, oral suspension keeps for 2 months maximum.

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Page 229/ 663

 NICLOSAMIDE oral
Therapeutic action
Anthelminthic (taenicide)

Indications
Taeniasis: beef tapeworm (Taenia saginata), pork tapeworm (Taenia solium), dwarf tapeworm
(Hymenolepis nana) and fish tapeworm (Diphyllobothrium latum)

Forms and strengths

500 mg chewable tablet

Dosage and duration

T. saginata, T. solium and D. latum
Child under 2 years: 500 mg single dose
Child from 2 to 6 years: 1 g single dose
Child over 6 years and adult: 2 g single dose

H. nana
Child under 2 years: 500 mg on D1, then 250 mg once daily for 6 days
Child from 2 to 6 years: 1 g on D1, then 500 mg once daily for 6 days
Child over 6 years and adult: 2 g on D1, then 1 g once daily for 6 days

Contra-indications, adverse effects, precautions

May cause: gastrointestinal disturbances.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

WeRemarks
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In the
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niclosamide is a taenicide not a taenifuge, do not expect the patient to expel the worm, portions
are voided in a partially digested form.
Niclosamide is not active against the larval form of T. solium (cysticercosis).
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Page 230/ 663

 Storage
– Below 25 °C

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Page 231/ 663

 NICOTINAMIDE = VITAMIN PP = VITAMIN B3
oral
Therapeutic action
Vitamin

Indications
Treatment of pellagra

Forms and strengths

100 mg tablet

Dosage and duration

Child and adult: 100 mg 3 times daily, with a diet rich in protein, until the patient is fully cured

Contra-indications, adverse effects, precautions

Pregnancy and breast-feeding: avoid, except if clearly needed (safety is not established)

Remarks
Nicotinamide is also called niacinamide.
Vitamin PP deficiency is common when diet is almost entirely based on sorghum, millet or maize.
Vitamin PP deficiency often occurs in association with other vitamin B-complex deficiency
(thiamine, pyridoxine), especially in alcoholic patients.
Vitamin PP is usually one of the components of multivitamin preparations and B-complex (7.5 mg
to 15 mg per tablet).
Nicotinic acid has a similar action to nicotinamide, but is no longer used because of its adverse
effects,
We use especially
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of our own action.
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Page 232/ 663

 NIFEDIPINE oral
Last updated: February 2024

Prescription under medical supervision

Immediate-release forms of nifedipine should not be used in either long-term

treatment of hypertension or treatment of hypertensive crisis (risk of excessive fall in blood
pressure and cerebral or myocardial ischaemia in patients with coronary artery disease).

Therapeutic action
Uterine relaxant

Indications
T hreatened premature labour

Forms and strengths

10 mg immediate-release soft capsule or tablet

Dosage and duration

10 mg by oral route, to be repeated every 15 minutes if uterine contractions persist (max. 4 doses
or 40 mg), then 20 mg by oral route every 6 hours
T he total duration of treatment is 48 hours.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe cardiac disease (recent myocardial infarction, unstable
angina).
Do not administer if systolic blood pressure is below 90 mmHg.
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ischaemic reject
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pain occurscookie types pain
or existing and revoke yourafter
increases consent for thetreatment.
starting future at any
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at "Settings".
not combine with magnesium sulphate, salbutamol IV, and other calcium channel blockers.
Monitor combination with cimetidine (enhances hypotensive effects), phenytoin (risk of
phenytoin overdose), rifampicin (efficacy of nifedipine diminished), itraconazole (increased
Settings Decline risk of
Accept
oedema), beta-blockers (increased adverse cardiac effects).

Page 233/ 663

 Pregnancy: CONTRA-INDICATED during the first trimester. Never administer sublingually (risk of
foetal death from placental hypoperfusion).
Breast-feeding: avoid

Remarks
Nifedipine is a calcium channel blocker that is also used in the management of hypertension at
doses of 10 to 40 mg 2 times daily or 20 to 90 mg once daily, depending on the sustained-
release form used.

Storage
– Below 25 °C

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Page 234/ 663

 NITROFURANTOIN oral
Prescription under medical supervision

Therapeutic action
Antibacterial (group of nitrofuranes)

Indications
Uncomplicated cystitis, without fever or lower back pain, when no other antibiotic can be used

Forms and strengths

100 mg tablet

Dosage and duration

Adult: 100 mg 3 times daily for 5 to 7 days

Contra-indications, adverse effects, precautions

Do not administer to patients with renal impairment, G6PD deficiency or allergy to nitrofurantoin.
May cause:
nausea, vomiting, headache, dizziness, brownish urine;
haemolytic anaemia in patients with G6PD deficiency, pulmonary and hepatic disorders, allergic
reactions.
Do not administer simultaneously with antacids (aluminium or magnesium hydroxide, etc.).
Administer doses at least 2 hours apart.
Pregnancy: CONT RA-INDICAT ED during the last month of pregnancy (risk of haemolysis in the
newborn)
Breast-feeding: avoid during the first month

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Take during meals.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofDo
allnot use nitrofurantoin
cookies. You can accepttoandprevent cystitis. cookie types and revoke your consent for the future at any
reject individual
time Also comes in modified release capsules to be administered 2 times daily.
at "Settings".

Storage
Settings Decline Accept
– – Below 25 °C
Page 235/ 663
 NITROGLYCERIN oral
See GLYCERYL T RINIT RAT E oral

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Page 236/ 663

 NYSTATIN oral
Therapeutic action
Antifungal

Indications
Mild oropharyngeal candidiasis

Forms and strengths

100 000 IU/ml oral suspension, bottle with calibrated dropper

Dosage and duration

Child and adult: 100 000 IU 4 times daily (1 ml of the oral suspension 4 times daily) for 7 days

T he oral suspension should be retained in the mouth for a few minutes before swallowing, or, in young
children, applied to the tongue and the inside of the cheeks.

Contra-indications, adverse effects, precautions

Take between meals (e.g. at least 30 minutes before eating).
Shake oral suspension well before using.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Nystatin also comes in:
100 000 IU lozenge for the treatment of oropharyngeal candidiasis;
100 000 IU and 500 000 IU film coated tablets for the treatment of oesophageal candidiasis.
For the treatment of moderate to severe oropharyngeal candidiasis and oesophageal candidiasis,
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oral fluconazole is the first-line treatment.
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Storage
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Below
time 25 °C
at "Settings".

Settings Decline Accept

Page 237/ 663

 OLANZAPINE oral
Last updated: February 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of olanzapine, patients should
be kept under close surveillance.

Therapeutic action
Atypical antipsychotic

Indications
Acute and chronic psychosis and acute manic episode, in the event of intolerance or treatment
failure with other antipsychotics (preferably use haloperidol for these indications)

Forms and strengths

2.5 mg, 5 mg and 10 mg tablets

Dosage
Adult: 10 mg once daily. Increase up to 15 mg daily if necessary (max. 20 mg daily).
Reduce the dose by half in older patients (max. 10 mg daily).

Duration
Acute psychosis: at least 3 months
Chronic psychosis: at least one year
Manic episode: 8 weeks after remission of symptoms

WeDiscontinue treatment
use a selection gradually
of our own (over 4 weeks).
and third-party If signs
cookies on of relapse
the pages occur, increase
of this website: Essentialthe dosewhich
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decrease
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in order gradually.
to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do
at "Settings".
not administer to patients with cardiac disorders (heart failure, recent myocardial infarction,
conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease,
history of neuroleptic malignant syndrome and closed-angle glaucoma.
Settings Decline Accept

Page 238/ 663

 Administer with caution and carefully monitor use in older patients and patients with hypokalaemia,
hypotension, prostate disorders, renal or hepatic impairment, history of seizures.
May cause: orthostatic hypotension, drowsiness (caution when driving/operating machinery),
extrapyramidal symptoms, hyperprolactinaemia, weight gain, hyperlipidaemia,
hyperglycaemia, anticholinergic effects (constipation, dry
mouth), headache, insomnia, dizziness, sexual dysfunction; neuroleptic malignant syndrome
(unexplained hyperthermia with neuromuscular disorders), rare but requiring immediate treatment
discontinuation.
In case of extrapyramidal symptoms, try reducing the dose of olanzapine or, if the extrapyramidal
symptoms are severe, add biperiden or trihexyphenidyl.
Avoid or monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.);
ciprofloxacin (increased plasma concentrations of olanzapine);
carbamazepine, rifampicin, phenobarbital, phenytoin, ritonavir (decreased plasma
concentrations of olanzapine);
antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone,
chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, use the lowest
effective dose. Observe the neonate the first few days (risk of agitation, tremors,
hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under
treatment in the 3rd trimester. If treatment starts during pregnancy, preferably use haloperidol.
Breast-feeding: if absolutely necessary, do not exceed 10 mg daily.

Storage
– Below 25 °C

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Page 239/ 663

 OMEPRAZOLE oral
Prescription under medical supervision

Therapeutic action
Antiulcer and gastric antisecretory agent (proton pump inhibitor)

Indications
Gastro-oesophageal reflux
Gastric and duodenal ulcers in adult

Forms and strengths

10 mg dispersible gastro-resistant tablet
20 mg gastro-resistant capsule

Dosage
Gastro-oesophageal reflux
Child under 5 kg: 0.7 to 1.4 mg/kg (max. 2.8 mg/kg daily) once daily in the morning
Child 5 to 10 kg: 5 mg once daily in the morning
Child 10 to 20 kg: 10 mg once daily in the morning
Child over 20 kg and adult: 20 mg once daily in the morning

Age Weight 1 mg/ml sol. (a) 10 mg tablet (b) 20 mg capsule

< 2 months < 5 kg 3 ml – –

2 months to < 1 year 5 to < 10 kg 5 ml – –

We1use
to a<selection
6 years of our own and
10 tothird-party
< 20 kg cookies on the
– pages of this website:
1 tabEssential cookies, which
– are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
≥ 6 years and adult ≥ 20 kg – – 1 cap
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
a In a syringe, dissolve one 10 mg dispersible t ablet in 10 ml of wat er t o obt ain a solut ion of 1 mg/ml.
b Dissolve 1 dispersible t ablet in half a glass of wat er.
Settings Decline Accept
Gastric and duodenal ulcers
Page 240/ 663
 Adult: 20 mg once daily in the morning
In severe or recurrent cases, dose can be increased if necessary to 40 mg once daily.

Duration
Gastro-oesophageal reflux: 3 days (short-term relief of symptoms) or 4 to 8 weeks (long-term
treatment)
Gastric and duodenal ulcers: 7 to 10 days or up to 8 weeks (severe or recurrent cases)

Contra-indications, adverse effects, precautions

Do not exceed 0.7 mg/kg daily (max. 20 mg daily) in patients with severe hepatic impairment.
May cause: headache, diarrhoea, constipation, nausea, vomiting, abdominal pain, dizziness, skin
rash, fatigue.
Monitor combination with:
atazanavir, itraconazole (decreased efficacy of these drugs);
diazepam, phenytoin, digoxin, raltegravir (increased toxicity of these drugs).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Do not open capsules.
Omeprazole is also used in combination with 2 antibacterial drugs for cure of Helicobacter pylori
infection, at a dosage of 20 mg 2 times daily for 7 days.

Storage
– Below 25 °C
Once dissolved, dispersible tablets should be administered within 30 minutes.

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Page 241/ 663

 ORAL REHYDRATION SALTS = ORS
Last updated: October 2024

Indications
Prevention and treatment of dehydration from acute diarrhoea, cholera, etc.

Forms and strengths

Sachet of powder to be diluted in 1 litre of clean water.
WHO formulation:

Dosage
Prevention of dehydration (WHO - Treatment plan A)
Child under 24 months: 50 to 100 ml after each loose stool (approximately 500 ml daily)
Child from 2 to 10 years: 100 to 200 ml after each loose stool (approximately 1000 ml daily)
Child over 10 years and adult: 200 to 400 ml after each loose stool (approximately 2000 ml daily)

Treatment of moderate dehydration (WHO - Treatment plan B)

Child and adult:
Over the first four hours:

Age under 4 to 11 12 to 23 2 to 4 5 to 14 15 years

4 months months years years and over
months

WeWeight
use a selectionunder
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5 to 7.9 kg cookies on the
8 to 10.9 kg pages
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this website:
kg 16 Essential cookies,
to 29.9 kg which
30 kg andare
over
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

After four hours:

Settings
If there are no signs of dehydration: follow Treatment plan A. Decline Accept
If there are signs of moderate dehydration: repeat Treatment plan B.
Page 242/ 663
 If there are signs of severe dehydration: start IV therapy (Treatment plan C).

Treatment of severe dehydration (WHO - Treatment plan C)

In combination with IV therapy and only to a conscious patient:
Child and adult: 5 ml/kg per hour
After 3 hours (6 hours in infants), reassess and choose the appropriate plan A, B or C.

Duration
As long as diarrhoea and signs of dehydration persist.

Contra-indications, adverse effects, precautions

If the eyelids become puffy during the treatment: stop ORS, give plain water then, resume ORS
according to Treatment plan A when the puffiness is gone.
If case of vomiting, stop ORS for 10 min and then resume at a slower rate (very small, frequent,
amounts); do not stop rehydration.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
A special ORS-formula, ReSoMal, is used under medical supervision, for severely malnourished
children only. However, in malnourished children with cholera, standard ORS- formula is used instead
of ReSoMal.
Comes in flavoured and unflavoured ORS sachets.

Storage
– Below 25 °C
Do not use the powder if it has turned into a yellow-brownish sticky substance.
Once prepared, the solution must be used within 24 hours.

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Page 243/ 663

 PARACETAMOL = ACETAMINOPHEN oral
Last updated: October 2024

Do not exceed indicated doses, especially in children and older patients. Paracetamol
intoxications are severe (hepatic cytolysis).

Therapeutic action
Analgesic, antipyretic

Indications
Mild pain
Fever

Forms and strengths

100 mg and 500 mg tablets
100 mg dispersible tablet
120 mg/5 ml oral suspension

Dosage
Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily)
Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily)
Adult: 1 g 3 or 4 times daily (max. 4 g daily)

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Page 244/ 663

 Age Weight 120 mg/5 ml susp. 100 mg tablet 500 mg tablet

< 1 month < 4 kg 1.5 ml x 3 − −

1 to < 3 months 4 to < 6 kg 2.5 ml x 3 ½ tab x 3 −

3 months to < 1 year 6 to < 10 kg 4 ml x 3 1 tab x 3 −

1 to < 3 years 10 to < 15 kg 6 ml x 3 1½ tab x 3 −

3 to < 5 years 15 to < 20 kg 8 ml x 3 2 tab x 3 −

5 to < 9 years 20 to < 30 kg 12 ml x 3 3 tab x 3 −

9 to < 14 years 30 to < 50 kg – – 1 tab x 3

≥ 14 years and adult ≥ 50 kg – – 2 tab x 3

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Administer with caution to patients with hepatic impairment.
Reduce the dose in:
children with severe acute malnutrition: 10 mg/kg up to 3 times maximum per 24 hours
patients with dengue with warning sign(s):
Child: 10 mg/kg 3 to 4 times daily
Adult: 500 mg 3 to 4 times daily
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

WeRemarks
use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
For mildcookies,
performance pain, paracetamol
which we useistoused alone
generate or in combination
aggregated with an
data on website useNSAID.
and statistics; and marketing
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cookies, moderate pain,
are used to paracetamol is content
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combination
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and codeine or consent
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paracetamol reject
usedindividual cookie types
in combination andNSAID
with an revoke and
yourmorphine.
consent for the future at any
time Paracetamol
at "Settings". is particularly recommended for patients allergic to aspirin, patients with a history of
gastric problems and for pregnant and breast-feeding women and children.
Paracetamol has no anti-inflammatory properties.
Settings Decline Accept
N-acetylcysteine IV is the antidote for paracetamol poisoning.

Page 245/ 663

 Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 246/ 663

 PAROXETINE oral
Last updated: March 2024

Prescription under medical supervision

Therapeutic action
Antidepressant, selective serotonin re-uptake inhibitor (SSRI)

Indications
Major depression
Generalised anxiety
Severe post-traumatic stress disorder

Forms and strengths

20 mg scored tablet

Dosage
Major depression
Adult: 10 mg once daily for 3 days, then 20 mg once daily. In case of insufficient response after 3
weeks, increase up to 40 mg daily max.

Generalised anxiety, severe post-traumatic stress disorder

Adult: 10 to 20 mg once daily

Duration
Major depression: at least 9 months.
Discontinue treatment gradually (e.g. half dose once daily for 2 weeks then on alternate days for 2
weeks). If signs of relapse or withdrawal occur, increase the dose then decrease it more gradually.
Generalised
We use a selection anxiety, severe
of our own post-traumatic
and third-party cookiesstress
on the disorder: 2 towebsite:
pages of this 3 months after cookies,
Essential symptoms resolve.
which are
required in order to use the website; functional cookies, which
Discontinue treatment gradually (over at least 2 weeks). provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications, adverse effects, precautions
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Administer
at "Settings".with caution and monitor use in patients with epilepsy, diabetes, hepatic or renal
impairment (start at a lower dose); history of gastrointestinal bleeding, bipolar disorders, suicidal
ideation (in young adults) or closed-angle glaucoma.
Settings Decline Accept
May cause:
Page 247/ 663
 gastrointestinal disturbances, drowsiness (caution when driving or operating machinery), fatigue,
headache, dizziness, seizures, sexual dysfunction, blurred vision, hyponatraemia especially in
older patients;
mental disorders: anxiety, insomnia, agitation, aggressive behaviour, suicidal ideation in young
adults;
frequent withdrawal symptoms if discontinued abruptly: dizziness, paraesthesia, nightmares,
anxiety, tremors and headaches.
Avoid combination with:
aspirin, NSAIDs and warfarin (risk of bleeding);
serotonergic drugs: other SSRI, tricyclic antidepressants, ondansetron, tramadol, etc. (risk of
serotonin syndrome).
Monitor combination with: risperidone (increased plasma concentration), drugs which lower the
seizure threshold (antipsychotics, mefloquine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy and breast-feeding: re-evaluate whether the treatment is still necessary; if it is
continued, maintain paroxetine at effective dose. Observe the neonate (risk of agitation, tremors,
hypotony, respiratory difficulties, sleeping disorders, etc.) if the mother was under treatment in the
3rd trimester of pregnancy. If treatment starts during pregnancy or breast-feeding, preferably use
sertraline.

Remarks
It is necessary to wait at least 2 to 3 weeks before assessing the antidepressant effect. T his must
be explained to the patient.

Storage
– – Below 25 °C

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Page 248/ 663

 PHENOBARBITAL = PB oral
Last updated: October 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of PB, patients should be
kept under close surveillance.

Therapeutic action
Antiseizure (antiepileptic), sedative

Indications
Epilepsy: generalised tonic-clonic seizures and focal (partial) seizures

Forms and strengths

60 mg tablet

Dosage
Start with a low dose then increase gradually based on patient's response and tolerance.
Child 1 month to 11 years: start with 2 to 3 mg/kg once daily at bedtime or 1 to 1.5 mg/kg 2 times
daily for 2 weeks; increase the daily dose by increments of 1 to 2 mg/kg every week, up to 2 to
6 mg/kg once daily if necessary.
Child 12 years and over and adult: start with 1 mg/kg (max. 60 mg) once daily at bedtime for 2
weeks; increase the daily dose by increments of 15 to 30 mg every week, up to 3 mg/kg once daily
if needed (max. 180 mg daily).

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Duration
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, whichasare
As long used to display
required. Do notrelevant content and
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changing "Accept all",
another you consent to the
antiseizure
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
medication.
time at "Settings".

Contra-indications, adverse effects, precautions

Settings Decline Accept

Page 249/ 663

 Do not administer to patients with severe impairment of respiratory, renal or hepatic function (risk
of accumulation).
Administer with caution in children, older patients and patients with mild to moderate
impairment of respiratory, renal or hepatic function.
May cause:
drowsiness (caution when driving/operating machinery), dizziness, headache, behavioural
disturbances;
respiratory depression, hypotension;
vitamin D deficiency (consider supplementation), osteoporosis, haematologic disorders,
gastrointestinal disturbances;
rarely: hypersensitivity reactions (including severe cutaneous reactions such as Stevens-
Johnson, Lyell and DRESS syndromes). In these cases, stop treatment. Early symptoms such as
fever, rash, mouth ulcers and bleeding require immediate medical attention.
Avoid or monitor the combination with:
mefloquine (reduced effect of PB);
drugs containing alcohol, benzodiazepines, opioid analgesics, antipsychotics, first-generation
antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc.
(increased sedation).
Use with extreme caution with benzodiazepines and opioid analgesics (increased risk of respiratory
depression).
PB may reduce the effect of many drugs:
diazepam, midazolam, antimicrobials, some antiretrovirals, corticosteroids, tricyclic
antidepressants, itraconazole, direct-acting antivirals for chronic hepatitis C, warfarin,
etc. Adjust dosage if necessary.
implants and oral contraceptives: use injectable medroxyprogesterone or an intrauterine device.
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: avoid (risk of facial and cardiac malformations, hypospadias, small for gestational
age).
In case of pregnancy during treatment, prefer a safer drug (levetiracetam). If PB is the only
option, provide counselling about the risks to the child; use the lowest effective dose.
Administer folic acid high dose (5 mg daily) during the first trimester. Start as soon as possible,
including during the preconception period in case of planned pregnancy.
PB plasma concentrations may decrease during pregnancy. Monitor clinical response; increase
dose if needed then resume the usual dose after delivery. Monitor the child for a few days (risk
of accumulation and drowsiness or withdrawal symptoms).
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Breast-feeding: administer with caution (excreted in milk); reduce the dose if increased during
required in order to use the website; functional cookies, which provide better easy of use when using the website;
pregnancy
performance and monitor
cookies, which wethe
usechild (risk ofaggregated
to generate drowsiness,
datalethargy anduse
on website poor
andfeeding).
statistics; and marketing
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Remarks
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
PB is subject to international controls: follow national regulations.
PB is not recommended for absence seizures (risk of worsening symptoms).
Settings Decline
Plasma concentrations are stable after 2 to 3 weeks. Caution: risk of accumulation. Accept
Also comes in 15 mg and 30 mg tablets.
Page 250/ 663
 Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 251/ 663

 PHENOXYMETHYLPENICILLIN = PENICILLIN
V oral
Last updated: January 2024

Prescription under medical supervision

Therapeutic action
Penicillin antibacterial

Indications
Streptococcal pharyngitis, scarlet fever
Alternative to first-line antibiotic treatment of diphtheria
Completion treatment following parenteral therapy with penicillin

Forms and strengths

250 mg tablet (400 000 IU)
Powder for oral suspension, 125 mg/5 ml (200 000 IU/5 ml): ,
to be reconstituted with filtered water
to be administered using a measuring device (oral syringe, measuring spoon, or cup with
graduations)

Dosage
Streptococcal pharyngitis, scarlet fever

125 mg/5 ml 250 mg

Age Weight Daily dose
oral susp. tablet

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< 1 year < 10 kg 125 mg x 2 5 ml x 2 −
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1 to <which
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are used to display relevant < 21 kgand advertising.
250 mg Ifx 2you choose10"Accept
ml x 2 all", you consent
− to the
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< 12 years 21 to < 39 kg 500 mg x 2 20 ml x 2 2 tab x 2

≥ 12 years and adult

Settings ≥ 39 kg 1gx2 − 4 tabAccept
Decline x2

Page 252/ 663

 Diphtheria
Child under 40 kg: 10 to 15 mg/kg (max. 500 mg) 4 times daily
Child 40 kg and over and adult: 500 mg 4 times daily

Duration
Streptococcal pharyngitis, scarlet fever: 10 days
Diphtheria: 14 days

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to penicillin.
Administer with caution to patients with allergy to cephalosporin (cross-sensitivity may occur) or
severe renal impairment (reduce dose).
May cause: diarrhea, nausea; allergic reactions sometimes severe.
Do not combine with methotrexate.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Take between meals.
Phenoxymethylpenicillin is also used in children for the prevention of pneumococcal infections in
sickle cell disease and recurrence of acute rheumatic fever.

Storage
– – Below 25 °C
For the oral suspension (powder or reconstituted suspension): follow manufacturer’s instructions.

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Page 253/ 663

 PHENYTOIN = PHT oral
Last updated: October 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of PHT, patients should be
kept under close surveillance.
Be cautious when increasing doses (narrow margin between therapeutic and toxic
dose and nonlinear pharmacokinetics).

Therapeutic action
Antiseizure (antiepileptic)

Indications
Epilepsy: generalised tonic-clonic seizures and focal (partial) seizures

Forms and strengths

100 mg tablet

Dosage
Start with a low dose then increase gradually based on patient's response and tolerance.
Child 1 month to 11 years: start with 1.5 to 2.5 mg/kg 2 times daily; increase the daily dose by
increments of 5 mg/kg every 3 to 4 weeks, up to 2.5 to 5 mg/kg 2 times daily if necessary (max. 7.5
mg/kg 2 times daily or 300 mg daily).
Child 12 years and over: start with 75 to 150 mg 2 times daily; increase the daily dose by increments
of 25 mg every 3 to 4 weeks, up to 150 to 200 mg 2 times daily if necessary (max. 300 mg 2 times
daily).
Adult:
We use start with
a selection 150
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performance cookies, which we use to generate aggregated data on website
daily if necessary (max. 400 mg once daily or 300 mg 2 times daily). use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Duration
time at "Settings".
As long as required. Do not stop treatment abruptly, even if changing treatment to another
antiseizure medication.
Settings Decline Accept

Page 254/ 663

 Contra-indications, adverse effects, precautions
Administer with caution to patients with hepatic impairment (reduce dosage), heart
failure, atrioventricular block, cardiac rhythm disorders, hypotension.
May cause:
drowsiness (caution when driving/operating machinery), dizziness, headache, behavioural
disturbances, insomnia;
gastrointestinal disturbances (nausea, vomiting), vitamin D deficiency (consider
supplementation), osteoporosis, hepatotoxicity and gingival hypertrophy;
rarely: haematologic disorders (thrombocytopenia, agranulocytosis, anaemia), hypersensitivity
reactions (including severe cutaneous reactions such as Stevens-Johnson, Lyell and DRESS
syndromes). In these cases, stop treatment. Early symptoms such as fever, rash, mouth ulcers
and bleeding require immediate medical attention.
If possible, perform at least FBC and liver enzymes, at baseline then regularly during treatment.
Avoid or monitor the combination with:
rifampicin, mefloquine (reduced effect of PHT );
sulfonamides, chloramphenicol, fluconazole, isoniazid, fluoxetine, omeprazole (increased PHT
toxicity);
drugs containing alcohol, benzodiazepines, opioid analgesics, antipsychotics, first-generation
antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc.
(increased sedation).
PHT may reduce the effect of many drugs:
diazepam, midazolam, digoxin, corticosteroids, antimicrobials, some antiretrovirals,
itraconazole, warfarin, etc. Adjust dosage if necessary.
implants and oral contraceptives: use injectable medroxyprogesterone or an intrauterine device.
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: avoid (risk of cardiac malformations)
In case of pregnancy during treatment, prefer a safer drug (levetiracetam). If PHT is the only
option, provide counselling about the risks to the child; use the lowest effective dose.
Administer folic acid high dose (5 mg daily) during the first trimester. Start as soon as possible,
including during the preconception period in case of planned pregnancy.
PHT plasma concentrations may decrease during pregnancy. Monitor clinical
response; increase dose if needed then resume the usual dose after delivery. Monitor the child
for a few days (risk of accumulation and drowsiness or withdrawal symptoms).
Breast-feeding: administer with caution (excreted in milk); reduce the dose if increased during
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pregnancy.
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
PHT is not recommended for myoclonic and absence seizures (risk of worsening symptoms).
time at "Settings".
Also comes in 30 mg/5 ml oral solution.

Storage
Settings Decline Accept

Page 255/ 663

 – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

Settings Decline Accept

Page 256/ 663

 POTASSIUM CHLORIDE immediate-release
oral
Last updated: February 2024

Prescription under medical supervision

For long-term use (i.e. in combination with potassium-depleting diuretics), use only
sustained-release formulations.

Therapeutic action
Potassium supplement, when immediate effect is required

Indications
Treatment of moderate hypokalaemia

Forms and strengths

7.5% potassium chloride syrup (1 mmol of K+/ml), to be administered using a measuring device (oral
syringe, mesuring spoon, or cup with graduations)

Dosage
Child under 45 kg: 2 mmol/kg (2 ml/kg) daily (see table below)
Child 45 kg and over and adult: 30 mmol (30 ml) 3 times daily

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Settings Decline Accept

Page 257/ 663

 Age Weight 7.5% syrup

< 2 months < 5 kg 4 ml x 2

2 months to < 1 year 5 to < 10 kg 6 ml x 2

1 to < 3 years 10 to < 15 kg 12 ml x 2

3 to < 5 years 15 to < 20 kg 20 ml x 2

5 to < 7 years 20 to < 25 kg 25 ml x 2

7 to < 9 years 25 to < 30 kg 20 ml x 3

9 to < 13 years 30 to < 45 kg 25 ml x 3

≥ 13 years and adult ≥ 45 kg 30 ml x 3

Duration
According to clinical response. Treatment of 1 to 2 days is typically sufficient when the patient is
fully able to drink oral rehydration solution and can eat.

Contra-indications, adverse effects, precautions

Reduce dosage in older patients and patients with renal impairment (risk of hyperkalaemia).
Do not combine with spironolactone and angiotensin-converting-enzyme inhibitors (e.g. enalapril).
May cause: gastrointestinal ulcerations, diarrhoea, nausea and vomiting, rarely hyperkalaemia.
Administer with caution to patients with gastrointestinal ulcer (risk of gastrointestinal ulcerations).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
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Take with or at the end meals in order to reduce the risk of gastrointestinal ulcerations.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Hypokalaemia
performance cookies,iswhich
defined as atoserum
we use potassium
generate concentration
aggregated below
data on website 3.5statistics;
use and mmol/litre.
and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Storage
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Below 25 °C

Settings Decline Accept

Page 258/ 663

 POTASSIUM CHLORIDE sustained-release
oral
Prescription under medical supervision

Therapeutic action
Potassium supplement

Indications
Hypokalaemia induced by :
thiazide diuretics (e.g. hydrochlorothiazide)
loop diuretics (e.g. furosemide)

Forms and strengths

600 mg potassium chloride sustained-release tablet (8 mmol of K+)

Dosage
Adult: 15 to 25 mmol daily = 1 tablet 2 to 3 times daily
Do not exceed indicated doses if potassium serum levels cannot be measured.

Duration
According to clinical response and duration of diuretic treatment

Contra-indications, adverse effects, precautions

Administer with caution and reduce dosage in elderly patients and in patients with renal impairment
(risk of hyperkalaemia).
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Do in
required notorder
combine
to use with spironolactone
the website; functionaland angiotensin-converting-enzyme
cookies, inhibitors
which provide better easy of use (e.g.the
when using enalapril).
website;
May cause: hyperkalaemia, gastroduodenal ulcerations, diarrhoea, nausea and vomiting.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are no
Pregnancy: used to display relevant content and advertising. If you choose "Accept all", you consent to the
contra-indication
use ofBreast-feeding:
all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
no contra-indication
time at "Settings".
Remarks
Settings Decline Accept
Take with or at the end meals in order to reduce the risk of gastrointestinal ulcerations.

Page 259/ 663

 Hypokalaemia is defined as a serum potassium concentration below 3.5 mmol/litre.
If tablets are not available, a lack of potassium may be corrected by a diet rich in dates, bananas,
mangos, oranges, tomatoes, etc.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

Settings Decline Accept

Page 260/ 663

 PRAZIQUANTEL oral
Prescription under medical supervision

Therapeutic action
Anthelminthic

Indications
Urinary (S. haematobium) and intestinal (S. mansoni, S. japonicum, S. mekongi, S. intercalatum)
schistosomiasis
Taeniasis (T. saginata, T. solium, D. latum, H. nana)
Pulmonary (P. westermani), hepatobiliary (O. felineus, O. viverrini, C. sinensis) and intestinal (F.
buski, H. heterophyes, M. yokogawai) flukes

Forms and strengths

600 mg breakable tablet

Dosage and duration

Child 4 years and over and adult:

Schistosomiasis
S. haematobium, S. mansoni, S. intercalatum: 40 mg/kg single dose or 2 doses of 20 mg/kg
administered 4 hours apart
S. japonicum, S. mekongi: 2 doses of 30 mg/kg or 3 doses of 20 mg/kg administered 4 hours apart

Taeniase
T. saginata, T. solium, D. latum: 5 to 10 mg/kg single dose
H. nana: 15 to 25 mg/kg single dose
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
Fluke infections
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
lung and hepatobiliary: 25 mg/kg 3 times daily for 2 days
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofintestinal: 25You
all cookies. mg/kg
can 3accept
timesand
daily, 1 day
reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Contra-indications, adverse effects, precautions
Do not administer to patients with ocular cysticercosis.
Settings Decline Accept
May cause:
Page 261/ 663
 drowsiness, headache, gastrointestinal disturbances, dizziness; rarely: allergic reactions;
neurological disorders (headache, seizures) in patients with undiagnosed neuro cysticercosis.
Pregnancy: no contra-indication for the treatment of schistosomiasis and taeniasis. If immediate
treatment not considered essential for fluke infections, it should be delayed until after delivery.
Breast-feeding: no contra-indication

Remarks
Do not chew the tablets due to their bitter taste. Take during meals.
Praziquantel is not active against certain liver flukes (Fasciola hepatica and gigantica). For this
indication, use triclabendazole.

Storage
– Below 30 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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time at "Settings".

Settings Decline Accept

Page 262/ 663

 PREDNISOLONE and PREDNISONE oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Intermediate-acting steroidal anti-inflammatory drug (corticosteroid)

Indications
Symptomatic treatment of allergic and inflammatory diseases or reactions

Forms and strengths

5 mg tablet and 5 mg soluble tablet

Dosage and duration

Dosage varies according to indication, symptoms severity,
clinical response and patient's tolerance. In the event of treatment longer than 10 days, a high initial
dose should be reduced as quickly as possible to the lowest effective dose.
Child and adult: 0.5 to 2 mg/kg once daily in the morning or in 2 divided doses (max. 80 mg daily)
Duration varies according to indication. In the event of treatment longer than 3 weeks, decrease
doses gradually to avoid adrenal suppression.

Contra-indications, adverse effects, precautions

In case of systemic infection, only administer if patient is under antimicrobial treatment.
Do not administer to patients with active peptic ulcer (except if ulcer under treatment).
May cause (if prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth
retardation, increased susceptibility to infections, sodium and water retention (oedema and
hypertension), osteoporosis, hypokalaemia, digitalis toxicity due to potassium loss in patients
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
taking
required digitalis
in order glycosides.
to use the website; functional cookies, which provide better easy of use when using the website;
Pregnancy:
performance no which
cookies, contra-indication
we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content
Breast-feeding: no contra-indication; use and
the advertising. If you choose
lowest effective "Accept
dose; for all", you
treatment consent
longer thanto 7the
use ofdays
all cookies. You can
with doses accept
higher thanand
40reject individual
mg daily, cookie types
take tablets and revoke
just after your
a feed andconsent
wait 4 for the before
hours future atthe
any
time at "Settings".
next feed if possible.

Remarks
Settings Decline Accept

Page 263/ 663

 Take with food.
Prednisolone is also used for preventing inflammatory reaction triggered by certain antiparasitic
treatment (e.g. trichinellosis, african trypanosomiasis).
5 mg of prednisolone or prednisone has the same anti-inflammatory activity as 0.75 mg of
dexamethasone and 20 mg of hydrocortisone.

Storage
– Below 25 °C

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Page 264/ 663

 PROMETHAZINE oral
Last updated: February 2024

Prescription under medical supervision

Therapeutic action
Sedating H1 antihistamine

Indications
Insomnia
Agitation or aggressive behaviour in patients with acute or chronic psychosis, in combination with
haloperidol

Forms and strengths

25 mg tablet

Dosage and duration

Insomnia
Adult: 25 mg once daily at bedtime for 7 to 10 days max.
Agitation or aggressive behaviour in patients with acute or chronic psychosis, with haloperidol
Adult: 25 mg, to be repeated after 60 minutes if necessary

Contra-indications, adverse effects, precautions

Administer with caution and monitor use:
in older patients;
in patients with prostate disorders, closed-angle glaucoma, epilepsy, orthostatic hypotension,
severe renal or hepatic impairment;
We use ainselection
patientsoftaking central
our own nervous system
and third-party depressants
cookies on the pages of(opioid analgesics,
this website: antipsychotics,
Essential cookies, which are
required sedatives,
in order to use the website; functional cookies, which provide better easy of use
antidepressants, etc.) or drugs known to have an anticholinergic effectwhen using(atropine,
the website;
performance cookies, which
amitriptyline, we use to generate
chlorpromazine, etc.). aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
May cause:
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
drowsiness (caution when driving/operating machinery), dizziness, headache, confusional state,
time at "Settings".
hypotension, photosensitivity (protect skin from sun exposure);
anticholinergic effects (dry mouth, constipation, blurred vision, tachycardia, disorders of
Settings micturition); Decline Accept

Page 265/ 663

 rarely: seizures, extrapyramidal symptoms, neuroleptic malignant syndrome (unexplained
hyperthermia with neuromuscular disorders), allergic reactions.
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy and breast-feeding: avoid

Remarks
Promethazine is not included in the WHO list of essential medicines.

Storage
– – Below 25 °C

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Page 266/ 663

 PYRAZINAMIDE = Z oral
Last updated: June 2021

Prescription under medical supervision

Therapeutic action
First line antituberculosis antibacterial (sterilising and bactericidal activity)

Indications
Tuberculosis, in combination with other antituberculosis antibacterials

Forms and strengths

400 mg tablet
150 mg dispersible tablet

Dosage
Child under 30 kg: 35 mg/kg (30 to 40 mg/kg) once daily
Child 30 kg and over and adult: 25 mg/kg (20 to 30 mg/kg) once daily
Do not exceed 2 g daily.
Patient with renal impairment: 25 mg/kg 3 times weekly

Duration
According to protocol

Contra-indications, adverse effects, precautions

Do not administer to patients with hypersensitivity to pyrazinamide, severe hepatic impairment or
We use a selection
severe gout. of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
May cause: gout and arthralgias, hepatotoxicity, photosensitivity (limit sun exposure), rash,
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
gastrointestinal
cookies, which are useddisturbances, hypersensitivity
to display relevant reactions. If you choose "Accept all", you consent to the
content and advertising.
use ofMonitor liverYou
all cookies. function in patients
can accept withindividual
and reject known hepatic disease.
cookie types and revoke your consent for the future at any
time If
at signs of hepatotoxicity (e.g. jaundice) develop, pyrazinamide should be discontinued until
"Settings".
symptoms resolve.
Pregnancy: no contra-indication
Settings Decline Accept
Breast-feeding: no contra-indication

Page 267/ 663

 Remarks
For patients on first-line antituberculosis treatment, pyrazinamide is given as part of a fixed dose
combination.

Storage
– – Below 25 °C

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Page 268/ 663

 PYRIDOXINE = VITAMIN B6 oral
Therapeutic action
Vitamin

Indications
Prevention and treatment of isoniazid-induced peripheral neuropathy

Forms and strengths

25 mg tablet
Also comes in 10 mg and 50 mg tablets.

Dosage
Prevention of isoniazid neuropathy
Child under 5 kg: 5 mg once daily
Child over 5 kg and adult: 10 mg once daily

Treatment of isoniazid neuropathy

Child: 50 mg once daily
Adult: 50 mg 3 times daily

Duration
Prevention: as long as treatment with isoniazid continues.
Treatment: according to clinical response (in general, ≤ 3 weeks) then, preventive dose, as long as
treatment with isoniazid continues.

Contra-indications, adverse effects, precautions

No contra-indication.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
May cause: peripheral neuropathy in the event of prolonged use with doses ≥ 200 mg daily.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Pregnancy:
performance no which
cookies, contra-indication
we use to generate aggregated data on website use and statistics; and marketing
Breast-feeding:
cookies, which are usedno contra-indication
to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

In children receiving isoniazid prophylaxis or treatment for tuberculosis: concomitant administration

Settings
of pyridoxine at preventive dosage is recommended for children under 5 years andDecline
all childrenAccept
infected with HIV.
Page 269/ 663
 Pyridoxine is also used for the prevention and treatment of cycloserin-induced neuropathy (150 to
200 mg daily in adults, in divided doses).

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 270/ 663

 PYRIMETHAMINE oral
Prescription under medical supervision

Therapeutic action
Antiprotozoal

Indications
Treatment and secondary prophylaxis of toxoplasmosis in immunodeficient patients, in
combination with sulfadiazine or clindamycin
Primary prophylaxis of toxoplasmosis in immunodeficient patients, in combination with dapsone
(only if co-trimoxazole cannot be used)
Second-line treatment of isosporiasis in immunodeficient patients (only if co-trimoxazole cannot
be used)

Forms and strengths

25 mg tablet

Dosage and duration

Treatment of toxoplasmosis
Adult: 2 doses of 100 mg on D1, then 75 to 100 mg once daily for at least 6 weeks

Secondary prophylaxis of toxoplasmosis

Adult: 25 to 50 mg once daily, as long as necessary

Primary prophylaxis of toxoplasmosis

Adult: 50 to 75 mg once weekly, as long as necessary

We use a selection
Treatment of our own and third-party cookies on the pages of this website: Essential cookies, which are
of isosporiasis
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Adult: 50 to 75 mg once daily for 10 days
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Contra-indications,
use adverse
of all cookies. You can accept effects,
and reject precautions
individual cookie types and revoke your consent for the future at any
time at "Settings".
Do not administer to patients with severe renal or hepatic impairment.
May cause: gastrointestinal disturbances, seizures, leucopenia, thrombocytopenia, megaloblastic
Settings
anaemia due to folic acid deficiency. Decline Accept
Administer calcium folinate to prevent folic acid deficiency.
Page 271/ 663
 Avoid if possible combination with other folate antagonists: co-trimoxazole, methotrexate
(increased risk of folic acid deficiency).
Monitor combination with zidovudine (increased risk of zidovudine-associated haematotoxicity).
Pregnancy: CONT RA-INDICAT ED during the first trimester
Breast-feeding: no contra-indication; however avoid concomitant administration of other folate
antagonists.

Remarks
T he combination of sulfadoxine/pyrimethamine is used for the treatment of uncomplicated
falciparum malaria.

Storage
Below 25 °C

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Page 272/ 663

 QUININE oral
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria, when artemisinin-based combinations cannot be
used
Completion treatment following parenteral therapy with quinine for severe falciparum malaria, when
artemisinin-based combinations cannot be used

Forms and strengths

300 mg quinine sulfate tablet

Dosage and duration

Dosage is expressed in terms of salt. Except for quinine bisulfate, the dosage is the same for all
quinine salts (sulfate, hydrochloride, dihydrochloride):
Child and adult < 50 kg: 10 mg/kg 3 times daily at 8-hour intervals for 7 days
Adult ≥ 50 kg: 600 mg 3 times daily at 8-hour intervals for 7 days

Age Weight 300 mg tablet

5 months to < 2 years 7 to < 12 kg ¼ tab x 3

2 to < 8 years 12 to < 25 kg ½ tab x 3

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11 to < 14 years 35 to < 50 kg 1½ tab x 3
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Contra-indications, adverse effects, precautions
Page 273/ 663
 May cause: headache, skin rash; visual, auditory and gastrointestinal disturbances.
Do not exceed indicated doses: risk of toxicity in the event of overdose.
Avoid combination with drugs that prolong QT interval: amiodarone, other
antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron,
etc.
If the patient vomits within 30 minutes after administration, re-administer the full dose. If the patient
vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
Pregnancy: no contra-indication; it is recommended to administer quinine in combination with
clindamycin if possible.
Breast-feeding: no contra-indication

Remarks
10 mg of quinine sulfate or hydrochloride or dihydrochloride = 8 mg of quinine base; 14 mg of
quinine bisulfate = 8 mg of quinine base.

Storage
– Below 25 °C

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Page 274/ 663

 ReSoMal (REhydration SOlution for
MALnutrition) oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Oral rehydration salts with high potassium and low sodium contents

Indications
Prevention and treatment of dehydration, in children suffering from complicated acute malnutrition
only

Forms and strengths

Sachet containing 84 g of powder, to be diluted in 2 litres of clean, boiled and cooled water

Composition for one litre:

Dosage and duration

Prevention of dehydration
Child: 5 ml/kg after each loose stool as long as diarrhoea persists
Child under 5 kg: 25 ml
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Child 10 to 19 kg: 100 ml
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time at "Settings".
Treatment of some dehydration
Child: 20 ml/kg/hour for 2 hours orally or by nasogastric tube. If improvement (diarrhoea and signs of
dehydration regress), reduce to 10 ml/kg/hour until there are no signs of dehydration and/or target
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weight is reached, then change to prevention of dehydration as above.

Page 275/ 663

 Treatment of severe dehydration
Only if there is no circulatory impairment and rehydration by oral route or nasogastric tube is tolerated:
Child: 20 ml/kg/hour for 1 hour orally or by nasogastric tube. If improvement (diarrhoea and signs of
dehydration regress), continue with 20 ml/kg/hour for 2 hours, then reduce to 10 ml/kg/hour, as for
some dehydration.

Contra-indications, adverse effects, precautions

Do not administer to patients with cholera or uncomplicated acute malnutrition: use standard ORS
instead.
Closely monitor rate of administration.
May cause:
fluid overload (increased respiratory and heart rates and new onset or worsening of oedema). In
this event, stop ReSoMal for one hour then reassess the child’s condition;
heart failure when administered too rapidly.

Remarks
ReSoMal can also be administered in adults suffering from complicated acute malnutrition,
including in pregnant or breastfeeding women.

Storage
– – Below 25 °C
Do not use the powder if it has turned sticky.
Once prepared, the solution should be used within 24 hours.

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Page 276/ 663

 RETINOL = VITAMIN A oral
Therapeutic action
Vitamin

Indications
Prevention of vitamin A deficiency
Treatment of vitamin A deficiency (xerophthalmia)

Forms and strengths

200 000 IU capsule, i.e. about 8 drops (1 drop = 25 000 IU)

Dosage and duration

Prevention of vitamin A deficiency
Child under 6 months: 50 000 IU single dose
Child from 6 to 12 months: one dose of 100 000 IU every 4 to 6 months
Child over 1 year: one dose of 200 000 IU every 4 to 6 months

Treatment of vitamin A deficiency

Child under 6 months: 50 000 IU once daily on D1, D2 and D8 (or D15)
Child from 6 to 12 months: 100 000 IU once daily on D1, D2 and D8 (or D15)
Child over 1 year and adult: 200 000 IU once daily on D1, D2 and D8 (or D15)

200 000 IU capsule

Age
Prevention Treatment

< 6 months 2 drops 2 drops

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months to < of our own and third-party cookies on the4pages
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1 to <which
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Page 277/ 663

 Contra-indications, adverse effects, precautions
Do not exceed indicated doses.
Overdosage may cause: gastrointestinal disturbances, headache, raised intracranial pressure
(bulging fontanelle in infants); foetal abnormalities.
Pregnancy:
Prevention: after delivery only, 200 000 IU single dose
Treatment: dosage depends on severity of eye lesions:
Night blindness and Bitot's spots: 10 000 IU once daily or 25 000 IU once weekly for at least 4
weeks
Corneal lesion: 200 000 IU once daily on D1, D2 and D8 (or D15)
Breast-feeding: no contra-indication at recommended doses

Remarks
Do not swallow the capsule. Cut open the end of the capsule and squeeze the dose directly into
the mouth.
Administer routinely 2 doses (on D1 and D2) to children suffering from measles to prevent the
complications of measles.

Storage
– Below 25 °C

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Page 278/ 663

 RIFAMPICIN = R oral
Last updated: June 2021

Prescription under medical supervision

Therapeutic action
Antibacterial, first line antituberculosis antibacterial (sterilising and bactericidal activity), antileprotic
antibacterial (bactericidal activity)

Indications
Tuberculosis, in combination with other antituberculosis antibacterials
Paucibacillary and multibacillary leprosy, in combination with dapsone and clofazimine
Brucellosis, in combination with another antibacterial
Latent tuberculosis, as monotherapy or in combination with isoniazid

Forms and strengths

150 mg tablet and 300 mg capsule

Dosage
Tuberculosis, latent tuberculosis, as monotherapy or in combination with isoniazid
Child under 30 kg: 15 mg/kg once daily, on an empty stomach
Child 30 kg and over and adult: 10 mg/kg once daily, on an empty stomach

Do not exceed 600 mg daily.

Paucibacillary and multibacillary leprosy

Child under 10 years: 10 mg/kg once monthly, on an empty stomach
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years: third-party
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Child 15 years and over and adult: 600 mg once monthly, on an empty better easy stomach
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Brucellosis
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Child: 15 to 20 mg/kg once daily, on an empty stomach (max. 600 mg daily)
at "Settings".
Adult: 600 to 900 mg once daily, on an empty stomach

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In patients with hepatic impairment: do not exceed 8 mg/kg/day when treatment is administered daily.

Page 279/ 663

 Duration
Tuberculosis: according to protocol
Latent tuberculosis as monotherapy: 4 months
Latent tuberculosis in combination with isoniazid: 3 months
Paucibacillary leprosy: 6 months
Multibacillary leprosy: 12 months
Brucellosis: 6 weeks

Contra-indications, adverse effects, precautions

Do not administer to patients with jaundice, hypersensitivity to rifamycins or history of severe
haematological disorders (thrombocytopenia, purpura) during a previous treatment with rifamycins.
Avoid or administer with caution to patients with hepatic disorders.
May cause:
harmless orange-red discoloration of body secretions (urine, tears, saliva, sputum, sweat, etc.);
gastrointestinal disturbances (can be taken with a small amount of food to increase
gastrointestinal tolerance); headache, drowsiness, hepatotoxicity;
influenza-like symptoms;
thrombocytopenia, hypersensitivity reactions.
If signs of hepatotoxicity (e.g. jaundice) develop, rifampicin should be discontinued until symptoms
resolve.
Rifampicin reduces the effect of many drugs (antimicrobials, some antiretrovirals, some hormones,
antidiabetics, corticosteroids, phenytoin, direct-acting antivirals for chronic hepatitis C, warfarin,
etc.):
in patients taking nevirapine, lopinavir/ritonavir, atazanavir/ritonavir, use rifabutin in place of
rifampicin;
in women using contraception, use injectable medroxyprogesterone or an intrauterine device;
in the event of concomitant fluconazole administration, administer each drug 12 hours apart
(rifampicin in the morning, fluconazole in the evening);
for the other drugs, adjust dosage if necessary.
Pregnancy: no contra-indication. Risk of maternal and neonatal bleeding disorders when the
mother receives rifampicin in late pregnancy: administer phytomenadione (vitamin K) to the mother
and the neonate to reduce the risk.
Breast-feeding: no contra-indication
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Forwhich
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are sensitive to first-line
used to display relevantantituberculosis treatment,
content and advertising. rifampicin
If you is givenall",
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partconsent
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Storage
Settings
– – Below 25 °C Decline Accept

Page 280/ 663

 RIFAPENTINE = P oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Antituberculosis antibacterial (bactericidal activity)

Indications
Latent tuberculosis, in combination with isoniazid

Forms and strengths

150 mg and 300 mg tablets

Dosage and duration

Weekly regimen for 3 months, in combination with isoniazid
Child 2 years and over and adult:

Weight Weekly dosage 150 mg tablet 300 mg tablet

10 to 14 kg 300 mg 2 tab once weekly 1 tab once weekly

14.1 to 25 kg 450 mg 3 tab once weekly _

25.1 to 32 kg 600 mg 4 tab once weekly 2 tab once weekly

32.1 to 49 kg 750 mg 5 tab once weekly _

We≥use50akgselection of our own and third-party

900 mg cookies on6 the
tabpages
onceofweekly
this website: Essential
3 tabcookies, which are
once weekly
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Daily regimen for 1 month, in combination with isoniazid
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Child 13 years and over and adult: 600 mg once daily
at "Settings".

Contra-indications, adverse effects, precautions

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Page 281/ 663

 Do not administer to patients with jaundice, hypersensitivity to rifamycins or history of
severe haematological disorders (thrombocytopenia, purpura) during a previous treatment
with rifamycins.
Do not administer the weekly regimen to children under 2 years or the daily regimen to children
under 13 years.
Avoid or administer with caution to patients with hepatic disorders.
May cause:
harmless orange-red discoloration of body secretions (urine, tears, saliva, sputum, sweat, etc.);
gastrointestinal disturbances; rarely, hepatotoxicity;
headache, influenza-like symptoms;
haematological disorders, cutaneous reactions (rash, pruritus) and hypersensitivity
reactions (approximately 4% of patients).
If signs of hepatotoxicity develop (e.g. jaundice), rifapentine should be discontinued until symptoms
resolve.
Rifapentine reduces the effect of many drugs (antimicrobials, anticonvulsants, some antiretrovirals,
some hormones, antidiabetics, corticosteroids, direct-acting antivirals for chronic hepatitis C,
warfarin, etc.):
do not administer in patients on protease inhibitors or nevirapine;
in women using contraceptive, use medroxyprogesterone or an intrauterine device;
in the event of concomitant fluconazole administration, administer each drug 12 hours apart
(rifapentine in the morning, fluconazole in the evening);
for the other drugs, adjust dosage if necessary.
Pregnancy and breast-feeding: not recommended (safety not established)

Remarks
Tablets can be crushed and mixed into a spoon with a small amount of food.
Also comes in fixed dose combination containing 300 mg of rifapentine/300 mg of isoniazid. Prefer
this formulation for weekly regimens to reduce the pill burden (3 tablets once weekly). T his
formulation is only recommended for children over 14 years and adults.
Rifapentine and rifampicin are not interchangeable in regimens for latent tuberculosis.

Storage
– – Below 25 °C

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Page 282/ 663

 RISPERIDONE oral
Last updated: February 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of risperidone, patients should
be kept under close surveillance.

Therapeutic action
Atypical antipsychotic

Indications
Acute and chronic psychosis and acute manic episode, in the event of intolerance or treatment
failure with other antipsychotics (preferably use haloperidol for these indications)

Forms and strengths

1 mg and 2 mg tablets

Dosage
Acute or chronic psychosis
Adult: 1 mg 2 times daily. Gradually increase up to 3 mg 2 times daily if necessary (max. 10 mg daily).

Acute manic episode

Adult: 2 mg once daily. Increase in increments of 1 mg per week if necessary (max. 6 mg daily).

Reduce the dose by half (initial dose and increments) in older patients and in patients with hepatic or
renal impairment (max. 4 mg daily).

WeDuration
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
Acute psychosis: at least 3 months
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Chronic
cookies, whichpsychosis:
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display one yearcontent and advertising. If you choose "Accept all", you consent to the
use ofManic episode:
all cookies. You8can
weeks after
accept and remission of symptoms
reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Discontinue treatment gradually (over 4 weeks). If signs of relapse occur, increase the dose then
decrease it more gradually.
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Contra-indications, adverse effects, precautions
Page 283/ 663
 Do not administer to patients with cardiac disorders (heart failure, recent myocardial infarction,
conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease
and history of neuroleptic malignant syndrome.
Administer with caution and carefully monitor use in older patients, patients with hypokalaemia,
hypotension, renal or hepatic impairment, history of seizures.
May cause: drowsiness (caution when driving/operating machinery), insomnia,
headache, extrapyramidal symptoms, agitation, anxiety, orthostatic hypotension, weight gain,
hyperprolactinaemia, sexual dysfunction; neuroleptic malignant syndrome (unexplained hyperthermia
with neuromuscular disorders), rare but requiring immediate treatment discontinuation.
In case of extrapyramidal symptoms, try reducing the dose of risperidone or, if the extrapyramidal
symptoms are severe, add biperiden or trihexyphenidyl.
Avoid or monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.);
fluoxetine, paroxetine, sertraline, verapamil (increased plasma concentrations of risperidone);
carbamazepine, rifampicin, phenobarbital, phenytoin (decreased plasma concentrations of
risperidone);
antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone,
chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, use the lowest
effective dose. Observe the neonate the first few days (risk of agitation, tremors,
hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under
treatment in the 3rd trimester. If treatment starts during pregnancy, preferably use haloperidol.
Breast-feeding: if absolutely necessary, do not exceed 6 mg daily.

Storage
– Below 25 °C

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Page 284/ 663

 RITONAVIR = RTV oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretroviral, HIV protease inhibitor

Indications
Booster for protease inhibitors (atazanavir, darunavir, lopinavir, etc.) in HIV infection. Ritonavir
should not be used alone.

Forms and strengths

25 mg and 100 mg tablets

Dosage
Dosage depends on the administration schedule of the boosted protease inhibitor. T he daily dose is
administered once daily or in 2 divided doses.
Child 14 to < 25 kg:
50 mg (two 25 mg tablets) 2 times daily, or
100 mg (four 25 mg tablets or one 100 mg tablet) once daily
Child ≥ 25 kg and adult: 100 mg (one 100 mg tablet) once or 2 times daily

Duration
Depending on the efficacy and tolerance of the boosted protease inhibitor and ritonavir.

Contra-indications, adverse effects, precautions

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Do not administer to patients with severe hepatic impairment.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Administer
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use monitor useaggregated
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data onhaemophilia (increased
website use and statistics;bleeding) or mild to
and marketing
moderate
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which are used toimpairment.
display relevant content and advertising. If you choose "Accept all", you consent to the
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he cookies.
adverseYou can accept
effects and reject
of ritonavir as aindividual
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are also and revoke
dependent onyour consent forprotease
the boosted the future at any
time inhibitor.
at "Settings".
May cause:
Settings gastrointestinal disturbances, fatigue, headache, dizziness, paraesthesia, joint Decline
and muscle pain,
Accept
taste disturbances, hyperglycaemia, hyperlipidaemia, lipodystrophy, conduction disorders;
Page 285/ 663
 pancreatitis, hepatic disorders, skin rash sometimes severe; in this event, stop treatment
immediately.
Ritonavir reduces the efficacy of implants and oral contraceptives.: use injectable
medroxyprogesterone or an intrauterine device. Only when combined with atazanavir, an oral
contraceptive containing at least 30 micrograms of ethinylestradiol per tablet may also be used.
Pregnancy: no contra-indication

Remarks
Take with meals.
Tablets are not recommended in children < 14 kg.
Also comes in fixed-dose combinations with other protease inhibitors (atazanavir, darunavir,
lopinavir, etc.). Preferably use these formulations when available.

Storage
– – Below 25 °C

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Page 286/ 663

 SALBUTAMOL metered dose inhaler
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Short-acting beta-2 agonist bronchodilator

Indications
Symptomatic treatment of asthma attack

Forms and strengths

Solution or suspension for inhalation in pressurised metered dose inhaler, delivering 100 micrograms
of salbutamol/puff

Dosage and duration

Asthma attack
Child and adult: 2 to 10 puffs (200 to 1000 micrograms) every 20 minutes for the first hour
T hen:
If the attack is completely resolved: 2 to 4 puffs (200 to 400 micrograms) every 4 to 6 hours for 24
to 48 hours
If the attack is not completely resolved: 2 to 10 puffs (200 to 1000 micrograms) every 1 to 4 hours
until symptoms subside then 2 to 4 puffs (200 to 400 micrograms) every 4 to 6 hours for 24 to 48
hours

Chronic asthma (when symptomatic only)

Child and adult: 2 to 4 puffs (200 to 400 micrograms) up to 4 times daily if necessary

Administration technique
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Shake in order to use the
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cover.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofInhale deeplyYou
all cookies. while
canactivating
accept andthe inhaler.
reject Hold cookie
individual breathtypes
10 seconds before
and revoke your exhaling.
consent for the future at any
time Hand-breath
at "Settings". co-ordination is very difficult in children under 6 years, older patients and patients with
severe dyspnoea. Use a spacer to facilitate administration and improve the efficacy of treatment.

Contra-indications,
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Page 287/ 663

 May cause: headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
In severe asthma attack, preferably administer salbutamol by nebulisation, in combination with
ipratropium. Use salbutamol metered dose inhaler only if nebuliser solution is not available.
Salbutamol is also used for other conditions associated with bronchoconstriction (e.g. chronic
obstructive pulmonary disease, some severe respiratory infections).
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).

Storage
– Below 25 °C

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 SALBUTAMOL nebuliser solution
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Short-acting beta-2 agonist bronchodilator

Indications
Symptomatic treatment of severe asthma attack, in combination with ipratropium

Forms and strengths

Solution for inhalation, in unit dose vial of 5 mg in 2.5 ml (2 mg/ml), to be administered via a
nebuliser

Dosage and duration

Child under 5 years: 2.5 mg (1.25 ml) per nebulisation every 20 minutes for the first hour
Child 5 to 11 years: 2.5 to 5 mg (1.25 to 2.5 ml) per nebulisation every 20 minutes for the first hour
Child 12 years and over and adult: 5 mg (2.5 ml) per nebulisation every 20 minutes for the first hour
T hen:
If symptoms do not improve, continue treatment every 20 minutes.
If symptoms improve, reduce gradually the frequency of nebulisations then change to salbutamol
metered dose inhaler.

Contra-indications, adverse effects, precautions

May cause: headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
Never use nebuliser solution by the parenteral route.
Pregnancy: no contra-indication
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Breast-feeding:
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Nebulised salbutamol should be reserved for severe asthma attacks. Otherwise, salbutamol should
at "Settings".
be delivered via a metered-dose inhaler with a spacer: administration is easier and faster, the
treatment is as effective, or even more effective, than with a nebuliser and causes fewer adverse
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Page 289/ 663

 Volumes of nebuliser solution to be administered are insufficient to obtain efficient nebulisation in
most nebulisers: dilute salbutamol solution with 0.9% sodium chloride to obtain a total volume of 4
ml in the reservoir of the nebuliser. Stop the nebulisation when the reservoir is empty (after around
10 to 15 minutes).

Storage
– Below 25 °C

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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 290/ 663

 SALMETEROL metered dose inhaler
Last updated: June 2023

Prescription under medical supervision

Therapeutic action
Long-acting beta-2 agonist bronchodilator

Indications
Long term treatment of moderate and severe persistent asthma (maintenance treatment), in
combination with an inhaled corticosteroid (beclometasone)

Forms and strengths

Solution or suspension for inhalation in pressurised metered dose inhaler, delivering 25 micrograms
of salmeterol/puff

Dosage
Start at the step most appropriate to initial severity. Always try to administer the lowest effective
dose.
Child 6 to 11 years: 2 puffs (50 micrograms) 2 times daily (max. 4 puffs or 100 micrograms daily)
Child 12 years and over and adult: 2 to 4 puffs (50 to 100 micrograms) 2 times daily (max. 8 puffs or
200 micrograms daily)

Duration
Treatment should be given as long as required. Re-evaluate after 2 to 3 months if doses are
adequate or need to be increased or decreased.

Administration technique
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required
Shake in order to use the
the inhaler. website;the
Remove functional cookies,
mouthpiece which provide better easy of use when using the website;
cover.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofInhale deeplyYou
all cookies. while
canactivating
accept andthe inhaler.
reject Hold cookie
individual breathtypes
10 seconds before
and revoke your exhaling.
consent for the future at any
time If
at hand-breath
"Settings". co-ordination is difficult, use a spacer to facilitate administration and improve the
efficacy of treatment.

Contra-indications, adverse effects, precautions

Settings Decline Accept

Page 291/ 663

 May cause: headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Salmeterol must always be used with an inhaled corticosteroid. It should not be used for
symptomatic relief of acute asthma.
Relief of symptoms may require several days or weeks of continuous therapy.
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 292/ 663

 SERTRALINE oral
Last updated: March 2024

Prescription under medical supervision

Therapeutic action
Antidepressant, selective serotonin re-uptake inhibitor (SSRI)

Indications
Major depression, if fluoxetine or paroxetine poorly tolerated or contra-indicated
Severe post-traumatic stress disorder

Forms and strengths

50 mg and 100 mg tablets

Dosage
Major depression
Adult: 25 mg once daily for 3 days, then 50 mg once daily. In case of insufficient response after 3
weeks, increase up to 100 mg daily max.
Severe post-traumatic stress disorder
Adult: 50 mg once daily

Duration
Major depression: at least 9 months. Discontinue treatment gradually (e.g. half dose once daily for
2 weeks and then on alternate days for 2 weeks). If signs of relapse or withdrawal occur, increase
the dose and decrease it more gradually.
Severe post-traumatic stress disorder: 2 to 3 months after symptoms resolve. Discontinue
treatment
We use gradually
a selection (over
of our own andatthird-party
least 2 weeks).
cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Contra-indications,
performance cookies, which adverse effects,
we use to generate precautions
aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofDo
allnot
cookies. You can
administer toaccept and with
patients rejectsevere
individual cookie
hepatic types and revoke
impairment. Reduceyour
theconsent
dose by forhalf
the future at any
in patients
time with
at "Settings".
mild to moderate hepatic impairment.
Administer with caution and monitor use in patients with epilepsy, diabetes; history
of gastrointestinal bleeding, bipolar disorders, suicidal ideation (in young adults), orDecline
Settings closed-angle
Accept
glaucoma.
Page 293/ 663
 May cause:
gastrointestinal disturbances, drowsiness (caution when driving or operating machinery), fatigue,
headache, dizziness, seizures, sexual dysfunction, blurred vision, hyponatraemia especially in
older patients;
mental disorders: anxiety, insomnia, agitation, aggressive behaviour, suicidal ideation in young
adults;
withdrawal symptoms very frequent if discontinued abruptly: dizziness, paraesthesia,
nightmares, anxiety, tremors and headaches.
Avoid combination with:
aspirin, NSAIDs and warfarin (risk of bleeding);
serotonergic drugs: other SSRI, tricyclic antidepressants, ondansetron, tramadol, etc. (risk of
serotonin syndrome).
Monitor combination with: risperidone (increased plasma concentration), drugs which lower the
seizure threshold (antipsychotics, mefloquine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy and breast-feeding: no contra-indication; re-evaluate whether the treatment is still
necessary; if it is continued, maintain sertraline at effective dose. Observe the neonate (risk of
agitation, tremors, hypotony, respiratory difficulties, sleeping disorders, etc.) if the mother was
under treatment in the 3rd trimester.

Remarks
It is necessary to wait at least 2 to 3 weeks before assessing the antidepressant effect. T his must
be explained to the patient.

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 294/ 663

 SODIUM VALPROATE oral
See VALPROIC acid oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 295/ 663

 SOFOSBUVIR/DACLATASVIR = SOF/DCV oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Combination of two direct-acting antivirals: a NS5B polymerase inhibitor (sofosbuvir) and a NS5A
inhibitor (daclatasvir)

Indications
Treatment of chronic hepatitis C

Forms and strengths

400 mg sofosbuvir/60 mg daclatasvir co-formulated tablet

Dosage and duration

Genotypes 1, 2, 4, 5, 6 without cirrhosis or with compensated cirrhosis and genotype 3 without
cirrhosis
Adult: one 400 mg/60 mg tablet once daily for 12 weeks

Genotype 3 with compensated cirrhosis or genotypes 1, 2, 3, 4, 5, 6 with decompensated

cirrhosis
Adult: one 400 mg/60 mg tablet once daily for 24 weeks

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to sofosbuvir or daclatasvir.
May cause: fatigue, headache, insomnia, dizziness, gastrointestinal disturbances, arthralgia.
Administer with caution to patients co-infected with hepatitis B virus (risk of HBV reactivation).
We use
Doa not
selection of our
combine owncarbamazepine,
with: and third-party cookies on the pages
phenobarbital, of this website:
phenytoin, Essential
rifampicin, cookies,
rifabutin, which are
rifapentine,
required in order to use the website; functional cookies, which provide better easy
oral or injectable dexamethasone (decreased sofosbuvir and/or daclatasvir plasma of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
concentrations); amiodarone (risk of severe bradycardia and heart block).
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofAdminister
all cookies.with
Youcaution andand
can accept monitor combination
reject individual with:
cookie types and revoke your consent for the future at any
efavirenz, etravirine, nevirapine (decreased daclatasvir plasma concentrations);
time at "Settings".
clarithromycin, erythromycin, itraconazole, atazanavir/ritonavir (increased daclatasvir plasma
concentrations);
Settings Decline Accept
digoxin (increased digoxin plasma concentrations).

Page 296/ 663

 Closely monitor blood glucose levels in patients with diabetes (risk of hypoglycaemia); adjust the
antidiabetic treatment if necessary.
Provide effective contraception in women of childbearing age.
Pregnancy and breast-feeding: CONT RA-INDICAT ED (safety not established)

Remarks
Tablets have a bitter taste, they should be swallowed whole (not crushed or chewed), with meals.
If the patient vomits within 2 hours after administration: take the same dose.
If the patient misses a dose, the dose should be taken as soon as possible if remembered within 18
hours of the usual time. After 18 hours or more, the dose should be skipped, and the next dose
taken at the usual time.
Also comes in single drug formulations (sofosbuvir 200 mg tablet and daclatasvir 60 mg tablet) for
paediatric use.

Storage
– Below 30 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 297/ 663

 SOFOSBUVIR/VELPATASVIR = SOF/VEL oral
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Combination of two direct-acting antivirals: a NS5B polymerase inhibitor (sofosbuvir) and a NS5A
inhibitor (velpatasvir)

Indications
Treatment of chronic hepatitis C

Forms and strengths

400 mg sofosbuvir/100 mg velpatasvir co-formulated tablet

Dosage and duration

Genotypes 1, 2, 3, 4, 5, 6 with no cirrhosis or compensated cirrhosis
Adult: one 400 mg/100 mg tablet once daily for 12 weeks

Genotypes 1, 2, 3, 4, 5, 6 with decompensated cirrhosis

Adult: one 400 mg/100 mg tablet once daily for 24 weeks

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to sofosbuvir or velpatasvir.
May cause: fatigue, headache, insomnia, nausea, rash.
Administer with caution to patients co-infected with hepatitis B virus (risk of HBV reactivation).
Do not combine with: carbamazepine, phenobarbital, phenytoin, rifampicin, rifabutin, rifapentine,
efavirenz, nevirapine, etravirine (decreased sofosbuvir and/or velpatasvir plasma concentrations);
We use a selection (risk
amiodarone of ourofown and third-party
severe bradycardia cookies on theblock)
and heart pages of this website: Essential cookies, which are
required in order to use the website; functional cookies,
Administer with caution and monitor combination with: which provide betteratorvastatin,
tenofovir, easy of use when using(increased
digoxin the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
plasma concentration of these drugs)
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofDo
allnot administer
cookies. You can simultaneously with:
accept and reject individual cookie types and revoke your consent for the future at any
omeprazole: take sofosbuvir/velpatasvir 4 hours before omeprazole, with food;
time at "Settings".
antacids (aluminium/magnesium hydroxide, etc.), calcium carbonate: take 4 hours apart.
Closely monitor blood glucose levels in patients with diabetes (risk of hypoglycemia); adjust the
Settings Decline Accept
antidiabetic treatment if necessary.

Page 298/ 663

 Pregnancy and breast-feeding: CONT RA-INDICAT ED (safety not established)

Remarks
Tablets have a bitter taste, they should be swallowed whole (not crushed or chewed), with meals.
If the patient vomits within 3 hours after administration: take the same dose.
If the patient misses a dose, the dose should be taken as soon as possible if remembered within 18
hours of the usual time. After 18 hours or more, the dose should be skipped, and the next dose
taken at the usual time.
Also comes in 200 mg sofosbuvir/50 mg velpatasvir co-formulated tablet for paediatric use.

Storage
– Below 30 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 299/ 663

 SPIRONOLACTONE oral
Prescription under medical supervision

Therapeutic action
Potassium-sparing diuretic, antagonist of aldosterone

Indications
Oedema associated with heart failure, hepatic cirrhosis and nephrotic syndrome

Forms and strengths

25 mg tablet

Dosage
Adjunctive therapy in heart failure
Adult: 25 mg once daily

Ascites in hepatic cirrhosis

Adult: 100 to 400 mg daily.
When weight is stable, administer the lowest possible maintenance dose, in order to prevent
adverse effects.

Oedema in nephrotic syndrome

Adult: 100 to 200 mg daily

T he daily dose can be administered in 2 to 3 divided doses or once daily.

Duration
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
According
required in order to clinical
to use response;
the website; avoid prolonged
functional use. provide better easy of use when using the website;
cookies, which
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not administer to patients with severe renal impairment, anuria, hyperkalaemia > 5 mmol/litre,
at "Settings".
hyponatraemia.
Do not combine with potassium salts, potassium-sparing diuretics; lithium (risk of lithium toxicity).
Settings Decline Accept

Page 300/ 663

 Avoid or closely monitor combination with angiotensin-converting enzyme inhibitors (risk of severe,
potentially fatal hyperkalaemia), digoxin (risk of digoxin toxicity) and reduce dosages.
May cause:
hyperkalaemia (especially in elderly or diabetics patients, patients with renal impairment or
patients taking NSAIDs), hyponatraemia; metabolic acidosis (in patients with decompensated
cirrhosis);
gynecomastia, metrorrhagia, impotence, amenorrhoea, gastrointestinal disturbances,
headache, skin rash, drowsiness.
Administer with caution in patients with hepatic or renal impairment or diabetes.
Monitor regularly plasma-potassium levels.
Pregnancy: avoid, use only if clearly needed (risk of feminisation of foetus); spironolactone is not
indicated in the treatment of pregnancy-related oedema.
Breast-feeding: no contra-indication

Remarks
In children with oedema, the daily dose is 1 to 3 mg/kg once daily or 0.5 to 1.5 mg/kg 2 times daily.
Spironolactone is also used for the diagnosis and treatment of primary hyperaldosteronism.

Storage:
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 301/ 663

 SULFADIAZINE oral
Prescription under medical supervision

Therapeutic action
Sulfonamide antibacterial

Indications
Treatment and secondary prophylaxis of toxoplasmosis in immunodeficient patients, in
combination with pyrimethamine

Forms and strengths

500 mg tablet

Dosage and duration

Treatment of toxoplasmosis
Adult: 2 g 2 to 3 times daily for 6 weeks minimum

Secondary prophylaxis of toxoplasmosis

Adult: 1 to 1.5 g 2 times daily, as long as necessary

Contra-indications, adverse effects, precautions

Do not administer to sulfonamide-allergic patients; patients with severe renal or hepatic
impairment.
May cause:
gastrointestinal disturbances, renal disorders (crystalluria, etc.), photosensitivity, megaloblastic
anaemia due to folic acid deficiency; haemolytic anaemia in patients with G6PD deficiency;
allergic reactions (fever, rash, etc.) sometimes severe (Lyell's and Stevens-Johnson syndromes,
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required haematological
in order to use thedisorders, etc.). In these
website; functional cases,
cookies, whichstop treatment
provide immediately.
better easy of use when using the website;
Adversecookies,
performance effectswhich
occurwemore frequently
use to in patientsdata
generate aggregated withonHIV infection.
website use and statistics; and marketing
cookies, which are used to display
Monitor blood count if possible. relevant content and advertising. If you choose "Accept all", you consent to the
use ofReduce
all cookies. You can
the dose by accept
half inand reject with
patients individual
renal cookie types and revoke your consent for the future at any
impairment.
time at "Settings".
Do not combine with methotrexate and phenytoin.
Administer calcium folinate systematically to prevent folic acid deficiency.
Drink a lot of liquid during treatment.
Settings Decline Accept

Page 302/ 663

 Pregnancy: no contra-indication. However, avoid using during the last month of pregnancy (risk of
jaundice and haemolytic anaemia in the newborn infant).
Breast-feeding: avoid if preterm infant, jaundice, low-birth weight, infant under one month of age. If
sulfadiazine is used, observe the infant for signs of jaundice.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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time at "Settings".

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Page 303/ 663

 SULFADOXINE/PYRIMETHAMINE = SP oral
Last updated: October 2024

Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Intermittent preventive treatment of malaria in pregnancy (IPT p-SP), as of the second trimester, in
areas with moderate to high malaria transmission in Africa

Forms and strengths

Sulfadoxine 500 mg/pyrimethamine 25 mg tablet
Sulfadoxine 500 mg/pyrimethamine 25 mg dispersible tablet

Dosage and duration

3 tablets single dose for each treatment, starting as early as possible in the second trimester
Each treatment should be given at least one month apart and at least 3 doses should be given
during pregnancy.

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to sulfonamides.
Do not administer to HIV-infected women taking co-trimoxazole prophylaxis.
May cause: gastrointestinal disturbances, skin reactions, sometimes severe (toxic epidermal
necrolysis and Stevens-Johnson syndrome); anaemia, leukopenia, agranulocytosis,
thrombocytopenia, haemolytic anaemia in patients with G6PD deficiency.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Do in
required notorder
use to
in use
combination
the website;with co-trimoxazole.
functional cookies, which provide better easy of use when using the website;
Do not cookies,
performance give folicwhich
acidweon use
thetosame day aggregated
generate SP is administered, or within
data on website 2 weeks
use and thereafter.
statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept
Pregnancy: CONT RA-INDICAT ED during the first trimester (risk of neural tube defects) all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

Also comes as co-packaged dispersible tablets for seasonal malaria chemoprevention in children:
Settings Decline Accept
amodiaquine 153 mg + sulfadoxine/pyrimethamine 500 mg/25 mg and amodiaquine 76.5 mg +

Page 304/ 663

 sulfadoxine/pyrimethamine 250 mg/12.5mg.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 305/ 663

 SULFAMETHOXAZOLE
(SMX)/TRIMETHOPRIM (TMP) oral
See CO-T RIMOXAZOLE oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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time at "Settings".

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Page 306/ 663

 TENOFOVIR DISOPROXIL FUMARATE = TDF
oral
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antiretroviral, HIV nucleotide reverse transcriptase inhibitor

Indications
HIV infection with or without chronic hepatitis B coinfection, in combination with other
antiretrovirals
Chronic hepatitis B without HIV coinfection, in monotherapy

Forms and strengths

300 mg tablet, equivalent to 245 mg of tenofovir disoproxil

Dosage
Child 35 kg and over and adult: 300 mg once daily

Duration
Depending on the efficacy and tolerance of tenofovir.

Contra-indications, adverse effects, precautions

Administer with caution and monitor use in patients with renal impairment, osteoporosis. In the
event of deterioration of renal function, switch to another antiretroviral.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Avoid
required combination
in order to use the(or monitor
website; renal function
functional cookies,inwhich
the event of better
provide combination) with
easy of use nephrotoxic
when drugs:
using the website;
aminoglycosides
performance (e.g.we
cookies, which gentamicin, streptomycin),
use to generate aggregated amphotericin
data on websiteB,use
pentamidine,
and statistics;NSAIDs, etc.
and marketing
cookies,
Maywhich are used to display relevant content and advertising. If you choose "Accept all", you consent to the
cause:
use of allgastrointestinal
cookies. You candisturbances
accept and reject individual
(nausea, cookiediarrhoea,
vomiting, types and revoke your consent
etc.), dizziness, for theskin
fatigue, future at any
rash;
time at "Settings".
renal impairment, bone loss (osteoporosis, fractures), pancreatitis.
Pregnancy: no contra-indication
Settings Decline Accept
Remarks
Page 307/ 663
 Tenofovir is also used for HIV pre-exposure and post-exposure prophylaxis, in combination with
other antiretrovirals.
Also comes in fixed-dose combinations containing tenofovir and other antiretrovirals for the
treatment of HIV infection. Preferably use these formulations when available.

Storage
– – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 308/ 663

 THIAMINE = VITAMIN B1 oral
Therapeutic action
Vitamin

Indications
Vitamin B 1 deficiencies: beriberi, alcoholic neuritis

Forms and strengths

50 mg tablet
Also comes in 10 mg and 25 mg tablets.

Dosage and duration

Infantile beriberi
10 mg once daily, until complete recovery (3 to 4 weeks)

Acute beriberi
50 mg 3 times daily for a few days, until symptoms improve, then 10 mg once daily until complete
recovery (several weeks)

Mild chronic deficiency

10 to 25 mg once daily

Contra-indications, adverse effects, precautions

No contra-indication, or adverse effects with oral thiamine.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

WeRemarks
use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
In the treatment
performance of severe
cookies, which we usecases, the use
to generate of injectable
aggregated data onthiamine
website is
usejustified to correct
and statistics; the disorder
and marketing
as rapidly
cookies, as used
which are possible, but isrelevant
to display no longer justified
content when symptoms
and advertising. have improved.
If you choose "Accept all", you consent to the
use ofVitamin
all cookies. You can accept
B 1 deficiency oftenand reject in
occurs individual cookie
association types
with andvitamin
other revoke B-complex
your consent deficiencies,
for the future at any
time especially
at "Settings".
in alcoholic patients.
T hiamine is also called aneurine.
Settings Decline Accept
Storage
Page 309/ 663
 – In airtight non-metallic container

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 310/ 663

 TINIDAZOLE oral
Prescription under medical supervision

Therapeutic action
Antiprotozoal, antibacterial (group of nitroimidazoles)

Indications
Amoebiasis, giardiasis, trichomoniasis
Bacterial vaginitis, infections due to anaerobic bacteria (e.g. Clostridium sp, Bacteroides sp)

Forms and strengths

500 mg tablet

Dosage and duration

Amoebiasis
Child: 50 mg/kg once daily (max. 2 g daily)
Adult: 2 g once daily

T he treatment lasts 3 days in intestinal amoebiasis; 5 days in hepatic amoebiasis.

Giardiasis, trichomoniasis and bacterial vaginitis

Child: 50 mg/kg single dose (max. 2 g)
Adult: 2 g single dose

In the event of trichomoniasis, also treat sexual partner.

Infections due to anaerobic bacteria

We use a selection
Child over 12ofyears
our own
andand third-party
adult: 2 g on D1cookies
thenon
1 gthe pages
once of this
daily website:
or 500 mg 2Essential cookies, which are
times daily
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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According to indication, tinidazole may be used in combination with other antibacterials; treatment
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
duration
use depends
of all cookies. oncan
You indication.
accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Contra-indications, adverse effects, precautions
Do not administer to patients with allergy to tinidazole or another nitroimidazole (metronidazole,
Settings Decline Accept
secnidazole, etc.).
Page 311/ 663
 May cause: gastrointestinal disturbances; rarely: allergic reactions, brownish urine, headache,
dizziness. Risk of antabuse reaction when combined with alcohol.
Administer with caution in patients taking oral anticoagulants (risk of haemorrhage), lithium,
phenytoin (increased plasma concentrations of these drugs).
Pregnancy: no contra-indication; divide into smaller doses, avoid prolonged use.
Breast-feeding: significantly excreted in milk (risk of gastrointestinal disturbances in breastfed
infants); divide into smaller doses, avoid prolonged use.

Storage
– Below 25 °C

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Page 312/ 663

 TRAMADOL oral
Last updated: October 2024

Prescription under medical supervision

Use for short term treatment (risk of dependence and tolerance).

Due to the numerous and potentially severe adverse effects of tramadol, patients
should be kept under close surveillance.

Therapeutic action
Opioid analgesic

Indications
Moderate pain, alone or in combination with a non-opioid analgesic

Forms and strengths

50 mg capsule
100 mg/ml oral solution (1 drop = 2.5 mg)

Dosage
Child over 12 years and adult: 50 to 100 mg every 4 to 6 hours (max. 400 mg daily)

Duration
According to clinical evolution; as short as possible.
In the event of prolonged treatment, do not stop abruptly, reduce doses progressively.

Contra-indications, adverse effects, precautions

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Do innotorder to use the
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the eventfunctional cookies,
of severe which depression
respiratory provide better easy
and toof use when
patients using
that riskthe website;
seizures
performance cookies,head
(e.g. epilepsy, which we use
injury, to generate aggregated data on website use and statistics; and marketing
meningitis).
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
May cause:
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
dizziness, nausea, vomiting, drowsiness, dry mouth, sweating;
time at "Settings".
rarely: allergic reactions, seizures, confusion; withdrawal symptoms; respiratory depression in
the event of overdosage.
Settings
Do not combine with opioid analgesics, including codeine. Decline Accept

Page 313/ 663

 Avoid combination with carbamazepine, fluoxetine, chlorpromazine, promethazine, clomipramine,
haloperidol, digoxin.
Reduce doses by half and administer every 12 hours in elderly patients and in patients with severe
renal or hepatic impairment (risk of accumulation).
Pregnancy: no contra-indication. T he neonate may develop withdrawal symptoms, respiratory
depression and drowsiness in the event of prolonged administration of large doses at the end of
the 3rd trimester. In this event, closely monitor the neonate.
Breast-feeding: use with caution, for a short period (2-3 days), at the lowest effective dose.
Monitor the mother and the child: in the event of excessive drowsiness, stop treatment.

Remarks
Tramadol is approximately 10 times less potent than morphine.
In some countries, tramadol is on the list of narcotics: follow national regulations.
Tramadol is not included in the WHO list of essential medicines.

Storage:
– – Below 25 °C

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Page 314/ 663

 TRANEXAMIC acid oral
Last updated: October 2021

Prescription under medical supervision

Therapeutic action
Antifibrinolytic

Indications
Abnormal uterine bleeding (especially functional uterine bleeding unrelated to pregnancy)

Forms and strengths

500 mg tablet

Dosage and duration

Adolescent and adult: 1 g 3 times daily (max. 1 g 4 times daily) until bleeding stops (max. 5 days)

Contra-indications, adverse effects, precautions

Do not administer in patients with (or with history of) venous or arterial thromboembolic disorders,
severe renal impairment, history of seizures.
Reduce dosage in patients with mild to moderate renal impairment (risk of accumulation).
May cause: gastrointestinal disturbances, seizures with high doses, visual disturbances, allergic
reactions.
Avoid combination with drugs that increase the risk of thromboembolism. Concomitant use of
oestrogens (e.g. ethinylestradiol/levonorgestrel) should be carefully considered on a case-by-case
basis.
Pregnancy: this drug is not indicated in the event of bleeding during pregnancy.
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Breast-feeding:
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time T
athe treatment may be administered at each bleeding episode. In situations of repeated bleeding, it
"Settings".
may be helpful to combine tranexamic acid with a non-steroidal anti-inflammatory drug and/or a
long-term treatment with a levonorgestrel intrauterine device or ethinylestradiol/levonorgestrel or
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oral or injectable medroxyprogesterone.

Page 315/ 663

 Storage
Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 316/ 663

 TRICLABENDAZOLE oral
Prescription under medical supervision

Therapeutic action
Anthelminthic

Indications
Fascioliasis (Fasciola hepatica and Fasciola gigantica infections)
Paragonimiasis

Forms and strengths

250 mg tablet

Dosage and duration

Fascioliasis
Child and adult: 10 mg/kg single dose

Paragonimiasis
Child and adult: 10 mg/kg 2 times daily

Contra-indications, adverse effects, precautions

Do not administer to patients with hypersensitivity to triclabendazole or other benzimidazoles
(albendazole, flubendazole, mebendazole, tiabendazole).
May cause: abdominal pain, mild fever, headache, dizziness.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

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Remarks
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Take tablets after meals.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofDue to its efficacy,
all cookies. You cangood
accepttolerance, and ease cookie
and reject individual of administration, triclabendazole
types and revoke your consent is
forthe
thedrug
futureofat any
time choice for fascioliasis.
at "Settings".
Bithionol may be used as an alternative to triclabendazole in the treatment of fascioliasis: 30
mg/kg daily for 5 days.
Settings Decline Accept
Unlike infections with other flukes, fascioliasis does not respond to praziquantel.

Page 317/ 663

 Storage
– Below 25 °C

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Page 318/ 663

 TRIHEXYPHENIDYL oral
Prescription under medical supervision

Therapeutic action
Anticholinergic antiparkinson drug

Indications
Second-line treatment of extrapyramidal reactions induced by antipsychotics

Forms and strengths

2 mg tablet

Dosage
Adult: 2 mg once daily, then increase if necessary up to 2 mg 2 or 3 times daily (max. 12 mg daily)
Administer the lowest effective dose in elderly patients and do not exceed 10 mg daily.

Duration
As long as antipsychotic treatment lasts.

Contra-indications, adverse effects, precautions

Do not administer to patients with closed-angle glaucoma, prostate disorders, gastrointestinal
obstruction or atony.
Administer with caution and carefully monitor use in elderly patients (risk of mental confusion,
hallucinations).
May cause: anticholinergic effects (dry mouth, constipation, blurred vision, tachycardia, disorders
of micturition), confusion, hallucinations, memory loss.
We use a selection
Avoid of ourcombination
or monitor own and third-party cookies
with other on the pagesdrugs
anticholinergic of this(atropine,
website: Essential cookies, which are
amitriptyline,
required in order to use the website; functional
chlorpromazine, promethazine, etc.). cookies, which provide better easy of use when using the website;
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Pregnancy: re-evaluate whether the antipsychotic treatment is still necessary; if treatment is
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofcontinued,
all cookies.administer trihexyphenidyl
You can accept at the lowest
and reject individual cookieeffective
types anddose;
revokeobserve the neonate
your consent if theat any
for the future
rd
time mother was under treatment in the 3 trimester (risk of anticholinergic effects, e.g. tremors,
at "Settings".
abdominal distension).
Breast-feeding: if treatment is necessary, administer at the lowest effective dose and observe the
Settings Decline Accept
child (risk of anticholinergic effects, e.g. tachycardia, constipation, thickening of bronchial

Page 319/ 663

 secretions).

Remarks
Take with meals.
Also comes in 2 mg extended-release capsule, administered once daily.
Trihexyphenidyl is also used in treatment of Parkinson’s disease.

Storage
– – Below 25 °C

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Page 320/ 663

 TRINITRIN oral
See GLYCERYL T RINIT RAT E oral

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Page 321/ 663

 ULIPRISTAL oral
Therapeutic action
Hormonal contraceptive, progesterone receptor modulator with agonist/antagonist effects

Indications
Emergency contraception after unprotected or inadequately protected intercourse (e.g. forgotten
pill or condom breaking)

Forms and strengths

30 mg tablet

Dosage and duration

One 30 mg tablet, whatever the day of the cycle, as soon as possible after unprotected or
inadequately protected intercourse and preferably within the first 120 hours (5 days)

Contra-indications, adverse effects, precautions

May cause: headache, nausea, vomiting, abdominal pain, dysmenorrhea, disturbance of next
menstrual cycle.
Re-administer treatment immediately if vomiting occurs within 3 hours of taking treatment.
Use with caution in patients taking drugs that might decrease ulipristal effectiveness:
omeprazole and antacids containing aluminium or magnesium hydroxide;
enzyme-inducing drugs: rifampicin, rifabutine, efavirenz, nevirapine, lopinavir, ritonavir,
phenobarbital, phenytoin, carbamazepine, griseofulvin, etc.
Avoid combination with hormonal contraceptives: decreased effectiveness of ulipristal and of the
hormonal contraceptive if taken immediately after the administration of ulipristal.
Pregnancy: in the event of treatment failure (i.e. pregnancy develops) or if used during an
undiagnosed pregnancy, there is no known harm for the foetus.
Breast-feeding:
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contra-indication
and third-party cookies on the pages of this website: Essential cookies, which are
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Remarks cookies, which we use to generate aggregated data on website use and statistics; and marketing
performance
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofEmergency
all cookies.contraception
You can accept and reject individual
is intended cookie
to prevent types anditrevoke
pregnancy; cannotyour consent an
terminate for ongoing
the future at any
time pregnancy.
at "Settings".
If an oral contraceptive pill is missed, use preferably levonorgestrel or a copper intrauterine device
as emergency contraception (fewer drug interactions).
Settings Decline Accept

Page 322/ 663

 Start or resume hormonal contraception the 6th day after the administration of ulipristal. Use
condoms for:
the first 7 days of taking an oral oestroprogestogen pill or an injection of medroxyprogesterone
or the insertion of an implant;
the first 2 days of taking an oral progestogen only pill.
T here is a risk of treatment failure; carry out a pregnancy test if signs or symptoms of pregnancy
(no menstruation, etc.) appear one month after taking ulipristal.

Storage
– Below 25 °C

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Page 323/ 663

 VALPROIC acid = VPA = SODIUM VALPROATE
oral
Last updated: October 2024

Prescription under medical supervision

VPA must not be used in pregnancy or in women and girls of childbearing age. T he risk
of foetal harm is higher than with other antiseizure medications.
Due to the numerous and potentially severe adverse effects of VPA, patients should be
kept under close surveillance.

Therapeutic action
Antiseizure (antiepileptic), mood stabilizer

Indications
Epilepsy: generalised tonic-clonic seizures, focal (partial) seizures and absence seizures
Prevention of recurrence of bipolar disorder

Forms and strengths

200 mg and 500 mg enteric-coated tablets
200 mg/5 ml oral solution, to be administered using a measuring device (oral syringe, measuring
spoon, or cup with graduations).

Dosage
Start with a low dose then increase gradually based on patient's response and tolerance.
Epilepsy
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Child
required in2order
to 11to years:
use thestart withfunctional
website; 10 to 15cookies,
mg/kg once
whichdaily or 5better
provide to 7.5 mg/kg
easy 2 times
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which wedose
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increments of 5 to
aggregated 10on
data mg/kg every
website use week, up to 12.5
and statistics; to 15 mg/kg 2
and marketing
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times daily if necessary (max. 600 mg 2 times daily). advertising. If you choose "Accept all", you consent to the
use ofChild
all cookies.
12 years You canover
and accept
andand reject
adult: individual
start cookie
with 500 types
to 600 mgand revoke
once your
daily; consentthe
increase for the future
daily doseatby
any
time at "Settings".
increments of 200 mg every 3 days, up to 500 mg to 1 g 2 times daily if necessary (max. 2.5 g daily).
Prevention of recurrence of bipolar disorder
Adult: start with 200 mg 2 times daily; increase the daily dose until the optimal individual
Settings doseAccept
Decline is
reached, usually around 500 mg 2 times daily (max. 1g 2 times daily).
Page 324/ 663
 Duration
As long as required. Do not stop treatment abruptly, even if changing treatment to another
medication.

Contra-indications, adverse effects, precautions

Do not administer:
to women and girls of childbearing age. If the treatment is necessary and if there is no
alternative, a negative blood pregnancy test and effective contraception are required;
to children under 2 years (increased risk of hepatotoxicity);
to patients with pancreatitis, hepatic disease or history of hepatic disease.
Reduce dosage in patients with renal impairment.
May cause:
drowsiness (caution when driving/operating machinery), extrapyramidal symptoms, behavioural
disturbances, confusional state, insomnia;
weight gain, menstrual irregularities, gastrointestinal disturbances, vitamin D deficiency (consider
supplementation), osteoporosis, thrombocytopenia;
rarely: pancreatitis, hepatic disorders (e.g. elevated liver enzymes), prolonged bleeding time,
hypersensitivity reactions (including severe cutaneous reactions such as Stevens-Johnson, Lyell
and DRESS syndromes), hyperammonemic encephalopathy. In these cases, stop treatment.
Early symptoms such as fever, rash, mouth ulcers and bleeding require immediate medical
attention.
respiratory depression and coma in the event of overdose.
If possible, perform at least FBC, liver enzymes and serum sodium levels, at baseline then regularly
during treatment; check prothrombin time before surgical procedures.
Avoid or monitor the combination with:
mefloquine, carbapenems, tricyclic antidepressants, rifampicin, protease inhibitors,
other antiseizure medications (reduced effect of VPA);
acetylsalicylic acid, erythromycin, isoniazid (increased VPA toxicity);
drugs containing alcohol, benzodiazepines, opioid analgesics, antipsychotics, first-generation
antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc.
(increased sedation).
Avoid alcohol during treatment (increased risk of adverse effects).
Pregnancy: do not use (risk of neural tube defects; urogenital, limb and facial malformations;
neurodevelopmental
We use disorders).
a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required In
in case
order of pregnancy
to use during
the website; treatment,
functional change
cookies, whichtoprovide
a saferbetter
drug easy
(levetiracetam).
of use when usingIf VPA
theiswebsite;
the only
performance cookies,
option, which
provide we use to about
counselling generate
theaggregated datachild;
risks to the on website uselowest
use the and statistics;
effectiveanddose
marketing
cookies, and
which are used to display relevant content and advertising. If you choose
divide doses over the day to minimize peaks in plasma concentrations. "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Administer folic acid high dose (5 mg daily) during the first trimester. Start as soon as possible,
time at "Settings".
including during the preconception period in case of planned pregnancy.
Breast-feeding: administer with caution (excreted in milk); monitor the child (risk of hepatotoxicity
Settings
and bleeding). Decline Accept

Page 325/ 663

 Remarks
Take with meals.
VPA can be used with contraceptive implants and oral contraceptives, although estrogens may
decrease VPA plasma concentrations.

Storage
– – Below 25 °C

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Page 326/ 663

 VITAMIN A oral
See RET INOL oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 327/ 663

 VITAMIN B1 oral
See T HIAMINE oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 328/ 663

 VITAMIN B3 oral
See NICOT INAMIDE oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 329/ 663

 VITAMIN B6 oral
See PYRIDOXINE oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 330/ 663

 VITAMIN B9 oral
See FOLIC acid oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 331/ 663

 VITAMIN C oral
See ASCORBIC acid oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 332/ 663

 VITAMIN D2 oral
See ERGOCALCIFEROL oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 333/ 663

 VITAMIN D3 oral
See COLECALCIFEROL oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 334/ 663

 VITAMIN PP oral
See NICOT INAMIDE oral

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 335/ 663

 ZIDOVUDINE = AZT = ZDV oral
Last updated: January 2025

Prescription under medical supervision

Therapeutic action
Antiretroviral, nucleoside reverse transcriptase inhibitor

Indications
HIV infection, in combination with other antiretrovirals
Prevention of mother-to-child transmission (PMT CT ) of HIV in neonates, alone or in
combination with other antiretrovirals

Forms and strengths

Single formulations:
300 mg tablet
50 mg/5 ml oral solution
Fixed-dose combinations with lamivudine (3T C):
300 mg zidovudine/150 mg lamivudine breakable and dispersible tablet
60 mg zidovudine/30 mg lamivudine breakable and dispersible tablet

Dosage
HIV infection, in combination with other antiretrovirals
T he daily dose is administered in 2 divided doses.
Child 1 month and over and adult:

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Page 336/ 663

 50 mg/5
300 mg tablet 60 mg AZT /30 mg
Daily ml oral
Weight or 300 mg AZT/150 mg 3TC
dose sol.
3TC tablet tablet
(10 mg/ml)

3 to < 6 kg 120 mg 6 ml x 2 – 1 tab x 2

6 to < 10 kg 180 mg 9 ml x 2 – 1 ½ tab x 2

10 to < 14 kg 240 mg 12 ml x 2 – 2 tab x 2

14 to < 20 kg 300 mg 15 ml x 2 – 2 ½ tab x 2

20 to < 25 kg 360 mg 18 ml x 2 – 3 tab x 2

≥ 25 kg 600 mg – 1 tab x 2 –

PMTCT of HIV in neonates

Full term neonate:
Follow national recommendations. For information (WHO simplified age-based dosage):
From birth to 6 weeks of age (from 0 to 42 days): 15 mg (1.5 ml) oral suspension 2 times daily
T hen, if indicated:
After 6 weeks and up to 12 weeks of age (from 43 to 84 days): 60 mg (6 ml) oral suspension 2
times daily
Preterm or low-birth weight neonate: seek specialist advice.

Duration
HIV infection: depending on the efficacy and tolerance of AZT.
PMT CT: depending on the risk of acquiring HIV infection (for information):
High risk: 6 weeks (AZT combined with nevirapine). For breastfed children,
this combined treatment may be extended for an additional 6 weeks.
Low risk: 4 to 6 weeks (AZT alone), only for non-breastfed children.
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required adverse
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functional precautions
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Do which
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are used totodisplay
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patients with hepatic impairment or coinfection with hepatitis B or hepatitis C virus;
neonates with hyperbilirubinaemia or raised transaminases.
Reduce dosage in patients with severe renal or hepatic impairment.
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May cause:

Page 337/ 663

 rash, gastrointestinal disturbances, myopathy;
haematologic disorders (monitor FBC), hepatic disorders (e.g. anorexia, nausea, general
malaise, dark urine, pale stools, hepatomegaly, jaundice) and lactic acidosis.
Stop AZT in the event of:
severe anaemia or neutropenia. AZT may be resumed following recovery with reduced
dosage and close surveillance.
signs and symptoms of lactic acidosis (e.g. rapid or difficult breathing, anorexia, nausea, fatigue,
weakness, myalgias). If lactic acidosis is confirmed, stop AZT permanently.
Avoid combination with ribavirin (increased risk of anaemia).
Use with caution and monitor combination with co-trimoxazole, dapsone, pyrimethamine (increased
risk of haematotoxicity), fluconazole (increased AZT plasma concentrations).
Pregnancy: no contra-indication

Remarks
AZT is also used for the treatment of HIV infection in neonates, in combination with other
antiretrovirals. Check national recommendations.
Also comes in fixed-dose combinations with other antiretrovirals. For PMT CT, zidovudine is
sometimes given as a fixed-dose combination of zidovudine/lamivudine/nevirapine.

Storage
– Below 25 °C

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Page 338/ 663

 ZINC SULFATE oral
Therapeutic action
Micronutrient

Indications
Adjunct to oral rehydration therapy in the event of acute and/or persistent diarrhoea in children
under 5 years

Forms and strengths

20 mg scored and dispersible tablet, packed in a blister

Dosage and duration

Child under 6 months: 10 mg (½ tablet) once daily for 10 days
Child from 6 months to 5 years: 20 mg (1 tablet) once daily for 10 days

Place the half-tablet or full tablet in a teaspoon, add a bit of water to dissolve it, and give the entire
spoonful to the child.

Contra-indications, adverse effects, precautions

No contra-indication.
If the child vomits within 30 minutes after swallowing the tablet, re-administer the dose.
Do not give simultaneously with ferrous salts, administer at least 2 hours apart.

Remarks
Zinc sulfate is given as an adjunct to oral rehydration therapy in order to reduce the duration and
severity of diarrhoea, as well as to prevent further occurrences in the 2 to 3 months after
treatment. Zinc sulfate must never replace oral rehydration therapy which is essential (nor can it
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replace antibiotic therapy that may, in specific cases, be necessary).
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Storage
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– Below 25 °C
Tablets are packed in a blister. Leave tablets in blister until use. Once a tablet is removed from the
blister, it must be dissolved and administered immediately.
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Page 339/ 663

 Injectable drugs
ACETAMINOPHEN injectable

ADRENALINE injectable

ALBUT EROL injectable

AMOXICILLIN/CLAVULANIC ACID = CO-AMOXICLAV injectable

AMPHOT ERICIN B conventional injectable

AMPHOT ERICIN B liposomal injectable

AMPICILLIN injectable

ART ESUNAT E injectable

ART ESUNAT E (with arginine and sodium bicarbonate solvent) injectable

AT ROPINE injectable

AZIT HROMYCIN injectable

BENZAT HINE BENZYLPENICILLIN injectable

BENZYLPENICILLIN = PENICILLIN G injectable

BENZYLPENICILLIN PROCAINE = PENICILLIN G PROCAINE injectable

BUT YLSCOPOLAMINE injectable

CALCIUM GLUCONAT E injectable

CEFOTAXIME injectable

CEFT RIAXONE injectable

CHLORAMPHENICOL injectable

CLINDAMYCIN injectable

CLOXACILLIN injectable
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CO-AMOXICLAV
required injectable
in order to use the website; functional cookies, which provide better easy of use when using the website;
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DEXAMET
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DIAZEPAM injectable
time at "Settings".
DICLOFENAC injectable

DIGOXIN injectable
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Page 340/ 663

 EFLORNIT HINE injectable

EPINEPHRINE = EPN = ADRENALINE injectable

ET ONOGEST REL subdermal implant

FLUCONAZOLE injectable

FUROSEMIDE injectable

GENTAMICIN injectable

GLUCOSE 50% = DEXT ROSE 50% injectable

HALOPERIDOL injectable

HALOPERIDOL decanoate injectable

HEPARIN sodium injectable

HYDRALAZINE injectable

HYDROCORT ISONE injectable

HYOSCINE BUT YLBROMIDE = BUT YLSCOPOLAMINE injectable

INSULIN injectable

INSULIN, INT ERMEDIAT E-ACT ING injectable

INSULIN, LONG-ACT ING injectable

INSULIN, SHORT-ACT ING injectable

INSULIN, BIPHASIC injectable

ISOSORBIDE DINIT RAT E injectable

KETAMINE injectable

LABETALOL injectable

LEVET IRACETAM = LEV injectable

LEVONORGEST REL subdermal implant

WeLIDOCAINE = LIGNOCAINE
use a selection injectable
of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
MAGNESIUM
performance SULFAT
cookies, whichE=weMgSO4 injectable
use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
MEDROXYPROGEST ERONE acetate injectable
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings". injectable
MELARSOPROL

MET HYLERGOMET RINE injectable

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MET OCLOPRAMIDE injectable
Page 341/ 663
 MET RONIDAZOLE injectable

MIDAZOLAM injectable

MORPHINE injectable

NALOXONE injectable

NOREPINEPHRINE tartrate = NEP = NORADRENALINE tartrate injectable

OMEPRAZOLE injectable

ONDANSET RON injectable

OXYT OCIN injectable

PARACETAMOL = ACETAMINOPHEN injectable

PENICILLIN G injectable

PENTAMIDINE injectable

PHENOBARBITAL = PB injectable

PHENYT OIN = PHT injectable

PHYT OMENADIONE = VITAMIN K1 injectable

POTASSIUM CHLORIDE 15% = KCl 15% injectable

PROMET HAZINE injectable

PROTAMINE injectable

SODIUM BICARBONAT E 8.4% injectable

ST REPT OMYCIN injectable

SURAMIN injectable

T HIAMINE = VITAMIN B1 injectable

T RAMADOL injectable

T RANEXAMIC acid injectable

WeVALPROIC acid of
use a selection = VPA = SODIUM
our own VALPROAT
and third-party E on
cookies injectable
the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
VITAMIN B1
performance injectable
cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
VITAMIN K1 injectable
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time at "Settings".

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Page 342/ 663

 ACETAMINOPHEN injectable
See PARACETAMOL injectable

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 343/ 663

 ADRENALINE injectable
See EPINEPHRINE = EPN injectable

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 344/ 663

 ALBUTEROL injectable
See SALBUTAMOL injectable

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 345/ 663

 AMOXICILLIN/CLAVULANIC ACID = CO-
AMOXICLAV injectable
Last updated: November 2024

Prescription under medical supervision

Therapeutic action
Penicillin antibacterial, combined with a beta-lactamase inhibitor. T he addition of clavulanic acid to
amoxicillin extends its spectrum of activity to cover beta-lactamase producing Gram-positive and
Gram-negative organisms, including some Gram-negative anaerobes.

Indications
Erysipelas and cellulitis
Necrotizing infections of the skin and soft tissues (necrotizing fasciitis, gas gangrene, etc.), in
combination with clindamycin
Severe postpartum upper genital tract infection, in combination with gentamicin

Forms and strengths, route of administration

Powder for injection, in 1 g amoxicillin/200 mg clavulanic acid vial, to be dissolved in 20 ml water for
injection or 0.9% sodium chloride, for slow IV injection (3 minutes) or IV infusion (30 minutes).
DO NOT DILUT E IN GLUCOSE.

Dosage
Doses expressed in amoxicillin:

Erysipelas, cellulitis
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Child under 3 months: 30 mg/kg every 12 hours
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Child 3 months
performance cookies, and
which over: 20 to
we use 30 mg/kg
to generate every 8 hours
aggregated data on(max. 3 guse
website daily)
and statistics; and marketing
Adult:
cookies, 1 g are
which every
used8 to
hours
display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Necrotizing infections
Child under 3 months: 50 mg/kg every 12 hours
Child 3 months and over and < 40 kg: 50 mg/kg every 8 hours (max. 6 g daily)
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Child 40 kg and over and adult: 2 g every 8 hours
Page 346/ 663
 Upper genital tract infection
Adult: 1 g every 8 hours

For administration by IV infusion, dilute each dose of amoxicillin/clavulanic acid in 5 ml/kg of 0.9%
sodium chloride in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride in children 20
kg and over and in adults.

Duration
Erysipelas, cellulitis: 7 to 10 days
Necrotizing infections: 14 days
Upper genital tract infection: depending on clinical response
Change to oral treatment as soon as possible.

Contra-indications, adverse effects, precautions

Do not administer to penicillin-allergic patients, patients with history of hepatic disorders during a
previous treatment with co-amoxiclav, patients with infectious mononucleosis.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur),
patients with hepatic impairment or severe renal impairment (reduce dosage and give every 12 or 24
hours).
May cause: diarrhoea; hepatic disorders (avoid treatments longer than 14 days); allergic reactions
sometimes severe.
Do not combine with methotrexate (increased methotrexate toxicity).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Do not mix with other drugs in the same syringe or infusion bag.

Storage
Below 25 °C
Once reconstituted, the solution must be used immediately; discard any unused open vial.

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Page 347/ 663

 AMPHOTERICIN B conventional injectable
Last updated: March 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of conventional amphotericin
B, patients should be kept under close surveillance.

Therapeutic action
Antifungal

Indications
Cryptococcal meningitis (induction phase), in combination with flucytosine or fluconazole
Severe histoplasmosis or penicilliosis

Forms and strengths, route of administration

Powder for injection, in 50 mg vial, to be dissolved in 10 ml of water for injection, to obtain a
concentrated solution containing 5 mg/ml. T he concentrated solution must be diluted in 500 ml of
5% glucose to obtain a solution containing 0.1 mg/ml, for slow IV infusion.

Dosage
Child and adult: 0.7 to 1 mg/kg once daily over 4 to 6 hours depending on tolerance

Duration
Cryptococcal meningitis: one week if in combination with flucytosine; 2 weeks if in combination with
fluconazole
Histoplasmosis: 1 to 2 weeks
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Penicilliosis: 2 weeks
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Administer
at "Settings".with caution to patients with renal impairment.
May cause:
intolerance reactions during administration: fever, chills, headache, nausea, vomiting,
Settings hypotension; local reaction: pain and thrombophlebitis at injection site; allergic reactions;
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Page 348/ 663

 muscle or joint pain, cardiovascular disorders (arrhythmias, heart failure, hypertension, cardiac
arrest), neurologic (seizures, blurred vision, dizziness), haematological or hepatic disorders;
disturbances in renal function (reduced glomerular filtration, hypokalaemia, hypomagnesiemia).
Avoid combination with: drugs causing hypokalaemia (furosemide, corticosteroids), nephrotoxic
drugs (amikacin, ciclosporine, tenofovir); digoxin, zidovudine.
To prevent renal toxicity, administer 500 ml to 1 litre of 0.9% NaCl or Ringer lactate prior to each
amphotericin B infusion.
In adults, as soon as the patient can swallow, give supplements of potassium (2 tab of 8 mmol 2
times daily) and magnesium (500 mg 2 times daily) until the end of amphotericin treatment.
In the event of intolerance, stop infusion, give paracetamol or an antihistamine then, resume
administration reducing infusion rate by half.
Monitor serum creatinine levels, and if possible, serum potassium levels (1 to 2 times weekly)
throughout treatment.
If serum creatinine levels rise by over 50%, increase preventive hydration (1 litre every 8 hours) or
stop treatment. T hen, after improvement, resume amphotericin at the lowest effective dose or on
alternate days.
Use liposomal amphotericin B if serum creatinine levels increase again or if clearance is < 30
ml/minute or in patients with pre-existing severe renal failure.
Pregnancy: check for renal dysfunction in the neonate if administered during the last month of
pregnancy.
Breast-feeding: avoid, except if vital

Remarks
Only use 5% glucose for administration (incompatible with other infusion fluids). Do not use the
preparation if there is visible precipitation (the glucose solution is too acid).
Do not add other drugs in the infusion bottle or bag.
Protect infusion bottle from light during administration (wrap in dark paper).

Storage

Vial of powder: must be kept refrigerated (between 2 °C and 8 °C); in the absence of a refrigerator,
7 days maximum, below 25 °C.
Concentrated solution (5 mg/1 ml): may be kept refrigerated 24 hours (between 2 °C and 8 °C).
Solution for infusion (0.1 mg/ml): must be used immediately.
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Page 349/ 663

 AMPHOTERICIN B liposomal injectable
Last updated: March 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of liposomal amphotericin B,
patients should be kept under close surveillance.

Therapeutic action
Antifungal

Indications
Cryptococcal meningitis, when conventional amphotericin B is contra-indicated (severe pre-
existing renal impairment or amphotericin B induced renal impairment)
Mucocutaneous or visceral leishmaniasis
Severe histoplasmosis

Forms and strengths, route of administration

Powder for injection, in 50 mg vial, to be dissolved in 12 ml of water for injection, to obtain a
concentrated suspension containing 4 mg/ml
With a syringe, withdraw the required dose of concentrated suspension. Attach the filter provided
with the vial to the syringe; inject the contents of the syringe, through the filter, into the volume of
5% glucose (50 ml, 250 ml, 500 ml) needed to obtain a solution containing between 0.2 to 2 mg/ml,
for IV perfusion.

Dosage and duration

Cryptococcal meningitis, severe histoplasmosis
WeChild
useover 1 month
a selection andown
of our adult:
and3third-party
mg/kg once dailyon
cookies over
the 30 to 60
pages minutes
of this forEssential
website: 2 weekscookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 350/ 663

 Liposomal amphotericin B, 50 mg-vial in 12 ml G5%

Volume of Volume
Weight
Daily dose Nb suspension required
in mg of vials (4 mg/ml) to be for
withdrawn administration

4 kg 12 3 ml

5 kg 15 4 ml

6 kg 18 4.5 ml

7 kg 21 5 ml
1 50 ml
8 kg 24 6 ml

9 kg 27 7 ml

10 kg 30 7.5 ml

15 kg 45 11 ml

20 kg 60 15 ml

25 kg 75 2 19 ml 250 ml

30 kg 90 23 ml

35 kg 105 26 ml

40 kg 120 30 ml
3 500 ml
45 kg 135 34 ml
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
50 kg
performance cookies, which we use150to generate aggregated data on website use38
andmlstatistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use55
of all
kg cookies. You can accept 165
and reject individual cookie
4 types and revoke41your ml consent for the 500
future
mlat any
time at "Settings".

60 kg 180 45 ml
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65 kg 195 50 ml
Page 351/ 663
 70 kg 210 5 53 ml 500 ml

Mucocutaneous or visceral leishmaniasis

Follow the recommended protocol, which varies from one region to another (exact dose,
administration schedule, etc.). For information, the total dose in children over 1 month and adults is 15
to 30 mg/kg.

Contra-indications, adverse effects, precautions

May cause:
intolerance reactions during administration: fever, chills, headache, nausea, vomiting,
hypotension; local reaction: pain and thrombophlebitis at injection site; allergic reactions;
gastrointestinal disturbances, disturbances in renal function (raised creatinine or urea levels,
renal impairment), hypokalaemia, hypomagnesiemia, elevated liver enzymes; rarely,
haematological disorders (thrombocytopenia, anaemia).
Avoid combination with: drugs causing hypokalaemia (furosemide, corticosteroids), nephrotoxic
drugs (amikacin, ciclosporine, tenofovir); digoxin, zidovudine.
T he infusion may be administered over 2 hours if necessary to prevent or minimize adverse effects.
Monitor serum creatinine levels, and if possible, serum potassium levels (once to twice weekly)
throughout treatment; adapt adjunctive therapy (potassium and magnesium supplementation)
according to the results.
If renal function deteriorates, reduce the dose by half for a few days.
Pregnancy: check for renal dysfunction in the neonate if administered during the last month of
pregnancy.
Breast-feeding: avoid, except if vital

Remarks
Liposomal amphotericin B is better tolerated and less nephrotoxic than conventional amphotericin
B.
Do not add other drugs in the infusion bottle or bag; do not use the preparation if there is visible
precipitation.
Before each infusion, rinse the IV catheter with 5% glucose.

WeStorage
use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Vial of powder:
performance must be
cookies, which we kept
use torefrigerated (between
generate aggregated 2 °C
data on and 8 °C)
website useorand
below 25 °C.
statistics; and marketing
Solutions
cookies, (reconstituted
which are and
used to display for infusion):
relevant content be
andkept refrigerated
advertising. If you24 hours"Accept
choose (between all",2you
°C consent
and 8 °C).
to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 352/ 663

 AMPICILLIN injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Penicillin antibacterial

Indications
Severe bacterial infections: septicaemia, meningitis, pneumonia, pyelonephritis, postpartum upper
genital tract infection, severe cutaneous anthrax, etc., alone or in combination with other
antibacterials, depending on indication

Forms and strengths, route of administration

Powder for injection, in 500 mg and 1 g vials, to be dissolved in 5 ml of water for injection
Prefer administration by slow IV injection (3 to 5 minutes) or IV infusion (30 minutes) in 0.9% sodium
chloride or 5% glucose for high doses; use IM route only if correct IV administration is not possible.
In neonates, administer only by slow IV injection or IV infusion.

Dosage
Severe bacterial infections, in combination with other antibacterials
T he dose varies according to indication:
Neonate:
0 to 7 days (< 2 kg): 50 to 100 mg/kg every 12 hours
0 to 7 days (≥ 2 kg): 50 to 100 mg/kg every 8 hours
8 days to < 1 month: 50 to 100 mg/kg every 8 hours
Child 1 month and over: 50 to 100 mg/kg every 8 hours
Adult: 1 to 2 g every 6 to 8 hours (2 g every 4 hours in meningitis)
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Severeincutaneous
required order to useanthrax, in combination
the website; withwhich
functional cookies, clindamycin
provide better easy of use when using the website;
Child 1 month and over: 50 mg/kg (max. 3 g) every 6 hours
performance cookies, which we use to generate aggregated data on website or 65 mg/kg
use and(max. 4 g) and
statistics; every 8 hours
marketing
cookies, which
Adult: 3 g are used6 to
every display
hours or 4relevant
g everycontent
8 hoursand advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Foratadministration
time "Settings". by IV infusion, dilute each dose of ampicillin in 5 ml/kg of 0.9% sodium chloride or
5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose
in children 20 kg and over and in adults.
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Duration
Page 353/ 663
 According to indication and clinical response. Change to oral treatment as soon as possible with
amoxicillin or a combination of antibacterials, depending on indication.

Contra-indications, adverse effects, precautions

Do not administer to patients with infectious mononucleosis (risk of skin eruption) or to penicillin
allergic patients.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) or
patients with severe renal impairment (reduce dosage).
May cause: skin eruption, gastrointestinal disturbances, allergic reactions sometimes severe.
Do not combine with methotrexate (increased methotrexate toxicity).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Do not mix with another drug in the same syringe or infusion.
Injectable amoxicillin is used for the same indications.

Storage
– Below 25 °C
Once reconstituted, the solution must be used immediately.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 354/ 663

 ARTESUNATE injectable

Last updated: June 2025

Prescription under medical supervision

T his formulation requires a 2-step reconstitution/dilution of the injectable artesunate

powder. Do not confuse with injectable artesunate requiring a 1-step reconstitution (see
following page).

Therapeutic action
Antimalarial

Indications
Treatment of severe malaria
Initial treatment of uncomplicated malaria, when persistent vomiting precludes oral therapy

Forms and strengths, route of administration

Powder for injection (artesunate), 60 mg vial, plus
Solvent: 5% sodium bicarbonate, 1 ml ampoule, plus
Diluent: 0.9% sodium chloride, 5 ml ampoule
Preparation :
For reconstitution (Step-1): add the 1 ml ampoule of 5% sodium bicarbonate into the vial.
We use aShake
selection
theofvial
ourgently
own and third-party
until cookies
the powder on the pages
is dissolved andofthethissolution
website:isEssential
clear. cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
For dilution (Step-2):
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, whichForare
slow
usedIVto(3display
to 5 minutes): add 5 ml
relevant content ofadvertising.
and 0.9% sodium chloride
If you chooseinto the vial
"Accept all",to obtain
you 6 ml
consent to of
the
solution containing 10 mg of artesunate per ml
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
For slow IM: add 2 ml of 0.9% sodium chloride into the vial to obtain 3 ml of solution
containing 20 mg of artesunate per ml
NEVER ADMINIST ER BY IV INFUSION.
Settings Decline Accept

Page 355/ 663

 Dosage and duration
Child under 6 kg: seek specialist advice.
Child 6 kg to < 20 kg: 3 mg/kg/dose
Child 20 kg and over and adult: 2.4 mg/kg/dose
One dose on admission (H0) then 12 hours after admission (H12) then 24 hours after admission (H24)
then, once daily.

Administer for at least 24 hours (minimum 3 doses), then, if the patient can tolerate the oral route,
change to a full 3-day course of an artemisinin-based combination (ACT ). If not, continue parenteral
treatment with one dose daily until the patient can tolerate the oral route (do not exceed 7 days of
parenteral treatment). T he first dose of ACT should be taken 8 to 12 hours after the last injection of
artesunate.
For information (WHO weight-based dosage):

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 356/ 663

 Weight Dose Artesunate 10 mg/ml Artesunate 20 mg/ml
per solution for IV solution for IM
injection Dose per injection (ml) Dose per injection (ml)
(mg)

Child 6 to < 20 kg

6 to < 7 kg 20 mg 2 ml 1 ml

7 to < 11 kg 30 mg 3 ml 2 ml

11 to < 14 kg 40 mg 4 ml 2 ml

14 to < 17 kg 50 mg 5 ml 3 ml

17 to < 20 kg 60 mg 6 ml 3 ml

Child ≥ 20 kg and adult

20 to < 26 kg 60 mg 6 ml 3 ml

(a)
26 to < 30 kg 70 mg 7 ml 4 ml

30 to < 34 kg 80 mg 8 ml 4 ml

34 to < 38 kg 90 mg 9 ml 5 ml

38 to < 42 kg 100 mg 10 ml 5 ml

42 to < 46 kg 110 mg 11 ml 6 ml

46 to < 51 kg 120 mg 12 ml 6 ml

51 to < 55 kg (a) 130 mg 13 ml 7 ml

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
55 to < 59
performance kg which
cookies, 150
wemg 14 mldata on website use and statistics; 7and
use to generate aggregated mlmarketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
59 to < 63 kg 150 mg 15 ml 8 ml
time at "Settings".

63 to < 67 kg 160 mg 16 ml 8 ml
Settings Decline Accept
67 to < 71 kg 170 mg 17 ml 9 ml
Page 357/ 663
 71 to < 76 kg 180 mg 18 ml 9 ml

76 to < 80 kg (a) 190 mg 19 ml 10 ml

80 to < 84 kg 200 mg 20 ml 10 ml

84 to < 88 kg 210 mg 21 ml 11 ml

a For pat ient s over 26 kg, a 2n d vial must be prepared t o obt ain t he volume needed, a 3rd vial f or pat ient s
over 51 kg and a 4th vial f or pat ient s over 76 kg.

Contra-indications, adverse effects, precautions

May cause: gastrointestinal disturbances, dizziness, headache, fever, muscle and joint pain,
pruritus; rarely rash, delayed haemolytic anaemia (appearing 2 to 3 weeks after treatment,
especially in case of hyperparasitaemia and in young children).
Pregnancy and breast-feeding: no contra-indication

Remarks
T he solution should be clear, do not use if the solution is cloudy or if a precipitate is present.
Artesunate 60 mg 2-step formulation and artesunate 1-step formulation are bioequivalent and can
be used interchangeably during the course of a treatment. For preparation, use only the
solvent/diluent provided by the manufacturer for each formulation. However, to avoid confusion
and reduce the risk of preparation errors, it is recommended to use only one formulation per patient
per treatment course.

Storage
– Below
We use 30 °C
a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to
Once reconstituted, use the
thewebsite;
solutionfunctional cookies,
must be used which provide better easy of use when using the website;
immediately.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Page 358/ 663

 ARTESUNATE (with arginine and sodium
bicarbonate solvent) injectable
Last updated: June 2025

Prescription under medical supervision

T his formulation requires a 1-step reconstitution of the injectable artesunate powder. Do

not confuse with injectable artesunate requiring a 2-step reconstitution/dilution (see
artesunate).

Therapeutic action
Antimalarial

Indications
Treatment of severe malaria
Initial treatment of uncomplicated malaria, when persistent vomiting precludes oral therapy

Forms and strengths, route of administration

Powder for injection (artesunate), 60 mg vial, plus
Solvent: 2% arginine + 0.84% sodium bicarbonate (NaHCO3), 3 ml ampoule
For reconstitution:
Add the entire ampoule of solvent into the vial, to obtain 3 ml of solution containing 20 mg of
artesunate per ml.
Shake the vial gently until the powder is dissolved. Use when the solution is clear.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Administer
required in order by slow
to use theIVwebsite;
(3 to 5 functional
minutes) or slow IM
cookies, injection.
which provideNEVER ADMINIST
better easy ER BY
of use when IV the
using INFUSION.
website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Dosage
cookies, andareduration
which used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Child under 6 kg: seek specialist advice.
at "Settings".
Child from 6 to < 20 kg: 3 mg/kg/dose
Child 20 kg and over and adult: 2.4 mg/kg/dose
Settings Decline Accept

Page 359/ 663

 One dose on admission (H0) then 12 hours after admission (H12) then 24 hours after admission (H24)
then, once daily.

Administer for at least for 24 hours (minimum 3 doses), then, if the patient can tolerate the oral route,
change to a full 3-day course of an artemisinin-based combination (ACT ). If not, continue parenteral
treatment with one dose daily until the patient can tolerate the oral route (do not exceed 7 days of
parenteral treatment). T he first dose of ACT should be taken 8 to 12 hours after the last injection of
artesunate.
For information (WHO weight-based dosage):

Artesunate (arginine/NaHCO3 solvent) 20 mg/ml solution for IV or IM

Weight Dose per Dose per Weight Dose per Dose per
injection (mg) injection injection injection
(ml) (mg) (ml)

Child 6 to < 20 kg

6 to < 7 kg 20 mg 1 ml 14 to < 17 kg 50 mg 3 ml

7 to < 11 kg 30 mg 2 ml 17 to < 20 kg 60 mg 3 ml

11 to < 14 kg 40 mg 2 ml ─ ─ ─

Child ≥ 20 kg and adult

20 to < 26 kg 60 mg 3 ml 55 to < 59 kg 140 mg 7 ml

26 to < 30 kg (a) 70 mg 4 ml 59 to < 63 kg 150 mg 8 ml

30 to < 34 kg 80 mg 4 ml 63 to < 67 kg 160 mg 8 ml

34 to < 38 kg 90 mg 5 ml 67 to < 71 kg 170 mg 9 ml

38 to < 42 kg 100 mg 5 ml 71 to < 76 kg 180 mg 9 ml

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required
42 toin< order
46 kgto use the website;
110 mg functional cookies,
6 ml which 76provide
to < 80better
kg easy of use
(a)
190when
mg using the10website;
ml
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use46 to cookies.
of all < 51 kg You can accept
120 mg 6 ml cookie
and reject individual 80types
to < and
84 kg 200 mgfor the future
revoke your consent 10 ml
at any
time at "Settings".
51 to < 55 kg (a) 130 mg 7 ml 84 to < 88 kg 210 mg 11 ml

Settings Decline Accept

Page 360/ 663

 a For pat ient s over 26 kg, a 2n d vial must be prepared t o obt ain t he volume needed, a 3rd vial f or pat ient s
over 51 kg and a 4th vial f or pat ient s over 76 kg.

Contra-indications, adverse effects, precautions

May cause: gastrointestinal disturbances, dizziness, headache, fever, muscle and joint pain,
pruritus; rarely rash, delayed haemolytic anaemia (appearing 2 to 3 weeks after treatment,
especially in case of hyperparasitaemia and in young children).
Pregnancy and breast-feeding: no contra-indication

Remarks
T he solution should be clear, do not use if the solution is cloudy or if a precipitate is present.
Artesunate 60 mg 1-step formulation and artesunate 2-step formulation are bioequivalent and can
be used interchangeably during the course of a treatment. For preparation, use only the
solvent/diluent provided by the manufacturer for each formulation. However, to avoid confusion
and reduce the risk of preparation errors, it is recommended to use only one formulation per patient
per treatment course.

Storage
– Below 30 °C
Once reconstituted, the solution must be used immediately.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 361/ 663

 ATROPINE injectable
Last updated: November 2024

Prescription under medical supervision

Do not exceed recommended doses, especially in children and older patients (risk of
severe anticholinergic effects).

Therapeutic action
Parasympatholytic, antispasmodic

Indications
Premedication in anaesthesia
Spasms of the gastrointestinal tract
Organophosphorus pesticide poisoning

Forms and strengths, route of administration

1 mg atropine sulfate in 1 ml ampoule (1 mg/ml) for SC, IM, IV injection
Also comes in 0.25 mg/ml and 0.5 mg/ml ampoules.

Dosage and duration

Premedication in anaesthesia
Child: 0.01 to 0.02 mg/kg by SC or IV injection
Adult: 1 mg by SC or IV injection

Spasms of the gastrointestinal tract

Child
We use from 2 to
a selection 6 years:
of our 0.25
own and mg by SC
third-party injection,
cookies single
on the dose
pages of this website: Essential cookies, which are
required
Childinover
order6toyears:
use the0.5
website;
mg byfunctional cookies,
SC injection, which
single dose provide better easy of use when using the website;
performance cookies,
Adult: 0.25 to 1 which
mg bywe SCuse to generate
injection, aggregated
every 6 hours data on website
if necessary use and
(max. statistics;
2 mg daily) and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Organophosphorus
time at "Settings". pesticide poisoning
Child: 0.02 to 0.05 mg/kg by IM or slow IV injection
Adult: 2 mg by IM or slow IV injection
Settings Decline Accept

Page 362/ 663

 Repeat every 5 to 10 minutes until signs of atropinisation appear (reduced secretions, tachycardia,
dilatation of the pupils).

Contra-indications, adverse effects, precautions

Do not administer to patients with urethro-prostatic disorders, cardiac disorders, glaucoma.
Do not administer to children with high fever.
May cause: urinary retention, dryness of the mouth, constipation, dizziness, headache, dilatation of
the pupils, tachycardia.
Administer with caution and under close supervision to patients taking other anticholinergic drugs
(antidepressants, neuroleptics, H1 antihistamines, antiparkinsonians, etc.).
Pregnancy: no contra-indication; NO PROLONGED T REAT MENT
Breast-feeding: avoid; NO PROLONGED T REAT MENT

Remarks
Atropine IV is also used to prevent bradycardic effects of neostigmine when used to reverse the
effects of competitive muscle relaxants: 0.02 mg/kg in children; 1 mg in adults.
Do not mix with other drugs in the same syringe.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 363/ 663

 AZITHROMYCIN injectable
Last updated: June 2025

Prescription under medical supervision

Therapeutic action
Macrolide antibacterial

Indications
Macrolide-sensitive severe infections, when oral administration is not possible (e.g. sepsis,
diphtheria)

Forms and strengths, route of administration

Powder for injection, in 500 mg vial, to be dissolved in 4.8 ml of water for injection, for IV infusion in
0.9% sodium chloride or 5% glucose
DO NOT ADMINIST ER BY IV or IM INJECT ION.

Dosage
Sepsis
Child: 10 to 20 mg/kg (max. 500 mg) once daily
Adult: 500 mg to 1 g once daily

Diphtheria
Child: 10 to 12 mg/kg (max. 500 mg) once daily
Adult: 500 mg once daily

Dilute each dose in 0.9% sodium chloride or 5% glucose to obtain a final concentration of 2 mg/ml
and administer over 60 minutes.
Examples:
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
for a
required inchild
orderweighing
to use the15 kg, 150
website; mg (10 mg
functional x 15 which
cookies, kg) in 75 ml ofbetter
provide 0.9%easy
sodium
of usechloride or 5%
when using the glucose
website;
for an adult, 500 mg in 250 ml (or 1 g in 500 ml) of 0.9% sodium chloride or 5% glucose
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Duration
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Change to oral treatment as soon as possible.

Contra-indications,
Settings adverse effects, precautions Decline Accept

Page 364/ 663

 Do not administer to patients with allergy to azithromycin or another macrolide, nor to patients with
severe hepatic impairment.
Administer with caution to children under 6 weeks of age (risk of hypertrophic pyloric stenosis) and
patients with risk factors for QT prolongation (e.g. electrolyte disturbances, pre-existing cardiac
and renal disorders, older patients).
May cause:
gastrointestinal disturbances, reversible hearing disorders, electrolyte disturbances, QT
prolongation;
rarely: hypersensitivity reactions (including severe cutaneous reactions such as Stevens-
Johnson, Lyell and DRESS syndromes) and life-threatening hepatotoxicity. In these cases, stop
treatment. Signs and symptoms of hypersensitivity reaction (e.g. fever, rash, mouth ulcers,
bleeding) and hepatic disorders (e.g. anorexia, nausea, general malaise, dark urine, pale stools,
hepatomegaly, jaundice) require immediate medical attention.
Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co-
artemether, fluconazole, haloperidol, mefloquine, moxifloxacin, ondansetron, pentamidine, quinine,
etc.).
Administer with caution and monitor use in patients taking digoxin (increased digoxin toxicity).
Pregnancy and breast-feeding: no contra-indication

Remarks
Do not mix with other drugs in the same infusion.

Storage
– Below 25 °C
Once reconstituted, the solution must be used immediately; discard any unused open vial.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 365/ 663

 BENZATHINE BENZYLPENICILLIN injectable
Prescription under medical supervision

Therapeutic action
Long-acting penicillin antibacterial

Indications
Early syphilis (primary, secondary, or early latent infection of less than 12 months duration)
Late latent syphilis (infection of more than 12 months duration or of unknown duration)
Congenital syphilis (absence of clinical signs in the neonate and adequate treatment in the mother)
Endemic treponematoses (yaws, bejel, pinta)
Streptococcal tonsillitis
Prophylaxis of diphtheria in the event of direct contact
Primary and secondary prophylaxis of rheumatic fever

Forms and strengths, route of administration

Powder for injection in vials of:
1.2 MIU (900 mg), to be dissolved in 4 ml of water for injection, for IM injection
2.4 MIU (1.8 g), to be dissolved in 8 ml of water for injection, for IM injection
NEVER FOR IV INJECT ION NOR INFUSION

Dosage
Syphilis
Child: 50 000 IU (37.5 mg)/kg per injection (max. 2.4 MIU or 1.8 g per injection)
Adult: 2.4 MIU (1.8 g) per injection

Yaws, bejel, pinta

Child
We use under 10
a selection ofyears:
our own 1.2and
MIU (900 mg)cookies
third-party per injection
on the pages of this website: Essential cookies, which are
Child
required in10 years
order and
to use theover and adult:
website; 2.4 MIU
functional (1.8 which
cookies, g) perprovide
injectionbetter easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Streptococcal
cookies, which aretonsillitis, prophylaxis
used to display of diphtheria,
relevant content prophylaxis
and advertising. of rheumatic
If you choose "Accept fever
all", you consent to the
use ofChild
all cookies.
under 30You
kg:can
600accept
000 and rejectmg)
IU (450 individual cookie types and revoke your consent for the future at any
per injection
time Child
at "Settings".
30 kg and over and adult: 1.2 MIU (900 mg) per injection

Duration
Settings Decline Accept

Page 366/ 663

 Early syphilis, congenital syphilis, tonsillitis, yaws, bejel, pinta, prophylaxis of diphtheria, primary
prophylaxis of rheumatic fever: single dose
Late latent syphilis: one injection/week for 3 weeks
Secondary prophylaxis of rheumatic fever: one injection every 4 weeks for several years

Contra-indications, adverse effects, precautions

Do not administer to penicillin-allergic patients.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) and
renal impairment (reduce dosage).
May cause:
gastroinstestinal disturbances, pain at injection site, allergic reactions sometimes severe;
Jarisch-Herxheimer reaction (fever, chills, myalgia, tachycardia) in patients with syphilis;
convulsions in the event of high dosages or renal impairment;
symptoms of shock with neuropsychiatric disorders in case of accidental IV injection.
Ensure that the IM injection does not enter a blood vessel.
Do not combine with methotrexate.
Pregnancy and breast-feeding: no contra-indication

Remarks
For a 2.4 MIU (1.8 g) dose, administer 1.2 MIU (900 mg) in each buttock.
Do not confuse long-acting benzathine benzylpenicillin, for IM injection, with rapidly acting
benzylpenicillin (or penicillin G), administered by Iv route.
Do not mix with other drugs in the same syringe.

Storage
– – Below 25 °C
Once reconstituted, suspension must be used immediately.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 367/ 663

 BENZYLPENICILLIN = PENICILLIN G
injectable
Last updated: June 2025

Prescription under medical supervision

T his penicillin should be administered in a hospital setting (injections every 4 to 6 hours).

Therapeutic action
Short-acting penicillin antibacterial

Indications
Diptheria, when oral treatment is not possible
Severe leptospirosis, neurosyphilis
Congenital syphilis (presence of clinical signs in the neonate and lack of adequate treatment in the
mother)

Forms and strengths, route of administration

Powder for injection in vials of:
1 MIU (600 mg), to be dissolved in 2 ml of water for injection or 0.9% sodium chloride
5 MIU (3 g), to be dissolved in 5 ml of water for injection or 0.9% sodium chloride
For IM injection, or slow IV injection through an infusion tube (3 to 5 minutes), or IV infusion (60
minutes) in 0.9% sodium chloride or 5% glucose.

Dosage
Diphtheria
We use a selection
Child: 25 000ofIUour own and(max.
(15mg)/kg third-party
1 MIU cookies
or 600onmg)
theby
pages of IV
IM or thisinjection
website:every
Essential cookies, which are
6 hours
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Adult: 1 MIU (600 mg) by IM or IV injection every 6 hours
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies,
Severewhich are used to display relevant content and advertising. If you choose "Accept all", you consent to the
leptospirosis
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Child: 50 000 IU (30 mg)/kg (max. 2 MIU or 1200 mg) by IV injection every 6 hours
time at "Settings".
Adult: 1 to 2 MIU (600 to 1200 mg) by IV injection every 6 hours

Neurosyphilis
Settings Decline Accept
Adult: 2 to 4 MIU (1200 to 2400 mg) by IV injection every 4 hours

Page 368/ 663

 Congenital syphilis
50 000 IU (30 mg)/kg by IV injection every 12 hours from D1 to D7, then
50 000 IU (30 mg)/kg by IV injection every 8 hours from D8 to D10

Duration
Diphtheria: change to an oral treatment as soon as the patient can swallow, to complete 14 days
of treatment
Severe leptospirosis: 7 days
Neurosyphilis: 14 days
Congenital syphilis: 10 days

Contra-indications, adverse effects, precautions

Do not administer to penicillin-allergic patients.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) and
renal impairment (reduce dosage in patients with neurosyphilis).
May cause:
gastroinstestinal disturbances, pain at injection site, anaemia, allergic reactions sometimes
severe;
Jarisch-Herxheimer reaction (fever, chills, myalgia, tachycardia) in patients with syphilis;
convulsions in the event of rapid IV injection, high dosages or renal impairment.
Do not combine with methotrexate.
Pregnancy and breast-feeding: no contra-indication

Remarks
Do not confuse short-acting benzylpenicillin, administered several times a day by IV route, with
long-acting penicillins (benzathine benzylpenicillin and procaine benzylpenicillin) administered by IM
route only.
Do not mix with other drugs in the same syringe or infusion.

Storage
– Below 25 °C
Once reconstituted, suspension must be used immediately.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Page 369/ 663

 BENZYLPENICILLIN PROCAINE = PENICILLIN
G PROCAINE injectable
Last updated: June 2025

Prescription under medical supervision

Therapeutic action
Long-acting penicillin antibacterial (12 to 24 hours)

Indications
Diphtheria, when oral treatment is not possible
Congenital syphilis, if the neonate has clinical signs of syphilis or the mother did not receive
adequate treatment for syphilis during pregnancy

Forms and strengths, route of administration

Powder for injection in vials of:
0.6 MIU (600 mg) vial, to be dissolved with the diluent supplied by the manufacturer (4 ml-
ampoule of water for injection)
1.2 MIU (1.2 g) vial, to be dissolved with the diluent supplied by the manufacturer (5 ml-ampoule
of water for injection)
For IM injection only. NEVER ADMINIST ER BY IV INJECT ION OR INFUSION.

Dosage
Diphtheria
Child: 50 000 IU/kg (= 50 mg/kg) once daily (max. 1.2 MIU = or 1.2 g daily)
Adult:
We use 1.2 MIU
a selection of(=
our1.2 g) once
own daily
and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Congenitalcookies,
performance syphiliswhich we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used
Neonate: 50 000 IU/kg to display relevant
(= 50 mg/kg)content and advertising. If you choose "Accept all", you consent to the
once daily
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Duration
Diphtheria: change to an oral treatment as soon as the patient can swallow, to complete 14 days
Settings Decline Accept
of treatment

Page 370/ 663

 Congenital syphilis: 10 days

Contra-indications, adverse effects, precautions

Do not administer to patients allergic to penicillin and/or procaine.
Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) or with
renal impairment.
May cause:
gastrointestinal disturbances;
allergic reactions sometimes severe. In the event of allergic reactions, stop treatment
immediately.
Ensure that the needle does not accidentally enter a vessel (risk of serious neurovascular damage).
Pregnancy and breast-feeding: no contra-indication

Remarks
Also comes in 1 MIU, and 3 MIU and 4 MIU vials of powder for injection.
Do not confuse procaine benzylpenicillin with short-acting benzylpenicillin (penicillin G), administered
several times per day by IV route.
Do not mix with other drugs in the same syringe.

Storage
– Below 25 °C
Once reconstituted, suspension must be used immediately.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 371/ 663

 BUTYLSCOPOLAMINE injectable
See HYOSCINE BUT YLBROMIDE injectable

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Page 372/ 663

 CALCIUM GLUCONATE injectable
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Calcium therapy
Antidote to magnesium sulfate

Indications
Severe hypocalcaemia
Magnesium sulfate intoxication

Forms and strengths, route of administration

1 g ampoule (100 mg/ml, 10 ml; 10% solution) for slow IV injection or infusion in 5% glucose or
0.9% sodium chloride or Ringer lactate
For slow IV injection in children, dilute 1 part of calcium gluconate to 4 parts of diluent (i.e. 1 ml of
calcium gluconate to 4 ml of diluent), however it may be administered undiluted in emergencies.
For continuous infusion:
T he calcium concentration in the infusion fluid should not exceed 50 mg/ml.
Mix thoroughly the calcium and the infusion fluid by inverting at least 5 times the infusion bottle
or bag.
NEVER USE BY IM OR SC INJECT ION.

Dosage
Severe hypocalcaemia
Neonate and child under 20 kg: 0.5 ml/kg (max. 10 ml) by slow IV injection (over at least 5
minutes) then 2 to 4 ml/kg (max. 40 ml) in a 100 ml bottle or bag by continuous infusion over 24
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250 ml or 500 ml bottle or bag by continuous infusion over 24 hours
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Magnesium sulfate intoxication
time at "Settings".
Child under 20 kg: 0.5 ml/kg (max. 10 ml) by slow IV injection (over at least 5 minutes)
Child 20 kg and over and adult: 10 ml by slow IV injection (over at least 5 minutes)
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Duration
Page 373/ 663
 According to clinical response and plasma-calcium levels.
For hypocalcaemia, change to oral route as soon as possible.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe renal disease or patients receiving cardiac glycosides.
Do not administer ceftriaxone to neonates receiving calcium gluconate (risk of precipitation of
ceftriaxone-calcium salts in lungs and kidneys).
May cause:
tingling sensations, warm flushes, dizziness;
tissue necrosis in the event of extravasation;
hypercalcaemia in the event of too rapid IV injection or overtreatment. First signs of
hypercalcaemia include nausea, vomiting, thirst and polyuria. In severe cases, risk
of hypotension, bradycardia, arrhythmia, syncope and cardiac arrest.
Hypercalcaemia can be confirmed by monitoring of serum-calcium levels and ECG changes. Do not
use in prolonged treatment if plasma-calcium levels cannot be monitored.
T he patient should be placed in the horizontal position prior to injection and should remain lying
down for 30 to 60 minutes.
Pregnancy and breast-feeding: no contra-indication

Remarks
Calcium gluconate is also administered as adjunctive therapy in insect bites or stings (black widow
spider, scorpions) for the management of muscle pain and spasms. Several doses at 4-h intervals
may be necessary.
1 g of calcium gluconate (2.2 mmol or 4.5 mEq) is equivalent to 89 mg of calcium.
Calcium gluconate is incompatible with many drugs: do not mix with other drugs in the same syringe
or infusion fluid. Flush the IV line thoroughly between infusions, especially in patients receiving
ceftriaxone, cefazolin, amphotericin B and sodium bicarbonate.
Do not use if the solution appears cloudy or particles are visible (calcium gluconate precipitate).

Storage
– Below 25 °C

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Page 374/ 663

 CEFOTAXIME injectable
Prescription under medical supervision

Therapeutic action
T hird-generation cephalosporin antibacterial

Indications
In neonates:
Bacterial meningitis, in combination with another antibacterial
Urinary infection
Pneumonia (ampicillin + gentamicin is preferred for this indication)
Gonococcal conjunctivitis (if ceftriaxone is not available or contraindicated)

Forms and strengths, route of administration

Powder for injection, in 250 mg and 500 mg vials, to be dissolved in 2 ml water for injection, for IM
or slow IV injection (3 to 5 minutes) or IV infusion (20 to 60 minutes) in 0.9% sodium chloride or 5%
glucose.

Dosage
Meningitis, urinary infection, pneumonia
0 to 7 days (< 2 kg): 50 mg/kg every 12 hours
0 to 7 days (≥ 2 kg): 50 mg/kg every 8 hours
8 days to < 1 month: 50 mg/kg every 8 hours

Gonococcal conjunctivitis
100 mg/kg IM single dose

We use
For IVaadministration,
selection of our cefotaxime
own and third-party
powdercookies on the
can only pages of this
be dissolved in website:
water forEssential cookies,
injection. which are
For infusions,
required in order to use the website; functional cookies, which provide better easy of use when using the website;
each dose of cefotaxime must be dissolved in 5 ml/kg of 0.9% sodium chloride or 5% glucose.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Duration
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time at "Settings".
Depending on indication and clinical response

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Page 375/ 663

 Do not administer to patients allergic to cephalosporins or penicillins (risk of cross-sensitivity).
Administer with caution and reduce dosage in patients with renal impairment.
Avoid or monitor combination with other nephrotoxic drugs: amphotericin B, aminoglycosides,
pentamidine, etc.
May cause: gastrointestinal disturbances (diarrhoea, nausea), haematological disorders
(neutropenia, leucopenia), heart rhythm disorders if IV injection is too fast, allergic reactions and
cutaneous reactions (Stevens-Johnson and Lyell syndromes), sometimes severe.

Remarks
Do not mix with other drugs in the same syringe or bottle.

Storage
– – Below 25 °C
Once reconstituted, the solution must be used immediately.

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Page 376/ 663

 CEFTRIAXONE injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
T hird-generation cephalosporin antibacterial

Indications
Severe bacterial infections: septicaemia, meningitis, pneumonia, typhoid fever, shigellosis,
leptospirosis, tick-borne relapsing fevers, pyelonephritis, neurosyphilis, etc.
Cervicitis, urethritis and conjunctivitis due to Neisseria gonorrhoeae (in combination with a
treatment for chlamydia, except in neonates), chancroid

Forms and strengths, route of administration

Powder for injection, in 250 mg or 1 g vials, to be dissolved:
with the solvent containing lidocaine for IM injection only. DO NOT ADMINIST ER BY IV
INJECT ION OR INFUSION the solution reconstituted with this solvent.
with water for injection for slow IV injection (3 minutes) or infusion (30 minutes) in 0.9% sodium
chloride or 5% glucose

Dosage and duration

Severe bacterial infections
T he dose varies according to indication:
Child 1 month and over (< 50 kg): 50 to 100 mg/kg (max. 4 g) once daily
Child 50 kg and over and adult: 1 to 2 g once daily (up to 2 g 2 times daily or 4 g once daily for
meningitis and typhoid fever)
Duration varies according to indication and clinical response. Change to oral treatment as soon as
We use a selection
possible. of ourof
T he choice own and
oral third-party
antibiotic cookieson
depends on indication.
the pages of this website: Essential cookies, which are
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Child under 45 kg: 125 mg IM single dose and advertising. If you choose "Accept all", you consent to the
which are used to display relevant content
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can accept and reject
and adult: 500 mgindividual cookie
IM single dosetypes
(250and
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IM single consent
forfor the future at any
chancroid)
time at "Settings".
Gonococcal conjunctivitis
Neonate: 50 mg/kg IM single dose (max. 125 mg)
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Adult: 1 g IM single dose Decline Accept

Page 377/ 663

 For administration by IV route, ceftriaxone powder is to be dissolved in water for injection only. For
administration by IV infusion, dilute each dose of ceftriaxone in 5 ml/kg of 0.9% sodium chloride or 5%
glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in
children 20 kg and over and in adults.

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to cephalosporins or penicillins (cross-sensitivity may
occur) and to neonates with jaundice (risk of bilirubin encephalopathy) or receiving calcium
gluconate (risk of precipitation of ceftriaxone-calcium salts in lungs and kidneys).
Administer with caution in patients with hepatic or renal impairment. Reduce dosage in patients with
severe renal impairment (max. 50 mg/kg daily or 2 g daily in IV).
May cause: gastrointestinal disturbances, hepatic dysfunction, blood disorders (anaemia,
leucopenia, neutropenia), renal dysfunction; allergic reactions sometimes severe (Stevens-Johnson
syndrome).
Do not mix ceftriaxone with calcium-containing solutions such as Ringer lactate (risk of particulate
formation).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Doses greater than 1 g IM should be administered in 2 equally divided injections (one in each
buttock).
Doses greater than 2 g should be administered by IV infusion only.
Do not mix with another drug in the same syringe or infusion.

Storage
– Below 25 °C
Once reconstituted, the solution must be used immediately.

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Page 378/ 663

 CHLORAMPHENICOL injectable
Last updated: September 2022

Prescription under medical supervision

Therapeutic action
Phenicol antibacterial

Indications
Plague meningitis

Forms and strengths, route of administration

1 g powder for injection, to be dissolved in 10 ml of water for injection, for IV injection over 1 to 2
minutes

Dosage and duration

Child 1 to 12 years: 25 mg/kg every 8 hours for 10 to 14 days
Child 13 years and over and adult: 1 g every 8 hours for 10 to 14 days

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Page 379/ 663

 1 g vial
Age Weight
(to be dissolved in 10 ml)

1 to < 2 years 10 to < 13 kg 3 ml x 3

2 to < 3 years 13 to < 15 kg 3.5 ml x 3

3 to < 6 years 15 to < 20 kg 5 ml x 3

6 to < 8 years 20 to < 25 kg 6 ml x 3

8 to < 9 years 25 to < 30 kg 7 ml x 3

9 to < 11 years 30 to < 35 kg 8 ml x 3

11 to < 13 years 35 to < 45 kg 9 ml x 3

≥ 13 years and adult ≥ 45 kg 10 ml x 3

Contra-indications, adverse effects, precautions

Do not administer to children under 1 year.
Do not administer to patients with:
history of allergic reaction or bone marrow depression during a previous treatment with
chloramphenicol;
G6PD deficiency.
May cause:
dose-related haematological toxicity (bone marrow depression, anaemia, leucopenia,
thrombocytopenia), allergic reactions. In these events, stop treatment immediately;
gastrointestinal disturbances, peripheral and optic neuropathies.
Reduce dosage in patients with hepatic or renal impairment.
Avoid or monitor combination with potentially haematotoxic drugs (carbamazepine, co-
trimoxazole, flucytocine, pyrimethamine, zidovudine, etc.).
We use a selectionand
Pregnancy of our own and third-party
breast-feeding: cookies on the pages
no contra-indication forofplague
this website: Essential cookies, which are
meningitis.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
If used during the 3rd trimester of pregancy, risk of grey syndrome in the neonate (vomiting,
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, hypothermia,
which are usedblue-grey
to display skin colour
relevant and and
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advertising. Ifdepression).
you choose "Accept all", you consent to the
use of allIfcookies.
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haematological disorders and gastrointestinal disturbances.

Storage
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– Below 25 °C
Page 380/ 663
 CLINDAMYCIN injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Lincosamide antibacterial

Indications
Second-line treatment of severe infections due to anaerobic bacteria, staphylococci and/or
streptococci (e.g. cellulitis, erysipelas, pneumonia, septicaemia), alone or in combination with other
antibacterials, depending on indication
Necrotizing skin and soft tissues infections (necrotizing fasciitis, gas gangrene, etc.), severe
cutaneous anthrax, in combination with other antibacterials

Forms and strengths, route of administration

300 mg in 2 ml ampoule (150 mg/ml), for IV infusion in 0.9% sodium chloride or 5% glucose, to be
administered over 30 minutes.
NEVER USE BY DIRECT UNDILUTED IV.

Dosage
Severe infections due to anaerobic bacteria, staphylococci and/or streptococci
Neonate 0 to 7 days (< 2 kg): 5 mg/kg every 12 hours
Neonate 0 to 7 days (≥ 2 kg): 5 mg/kg every 8 hours
Neonate 8 days to < 1 month (< 2 kg): 5 mg/kg every 8 hours
Neonate 8 days to < 1 month (≥ 2 kg): 10 mg/kg every 8 hours
Child 1 month and over: 10 mg/kg (max. 600 mg) every 8 hours
Adult: 600 to 900 mg every 8 hours
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required infections,
in order severe functional
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Child 1 month andtoover:
which are used display
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(max. advertising.
mg) everyIf you choose "Accept all", you consent to the
8 hours
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Adult: 900 mg every 8 hours
time at "Settings".
Dilute each dose of clindamycin in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than
20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg Decline
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Page 381/ 663

 Duration
Cellulitis, erysipelas: 7 to 10 days
Pneumonia: 10 to 14 days
Severe cutaneous anthrax: 14 days
Other infections: according to clinical evolution
Change to oral route as soon as possible.

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to lincosamides or history of pseudomembranous colitis.
Reduce dosage in patients with hepatic impairment.
May cause: pseudomembranous colitis, rash, jaundice, severe allergic reactions. In these cases,
stop treatment.
In the event of pseudomembranous colitis, treat for Clostridium difficile infection (oral
metronidazole).
Pregnancy: no contra-indication
Breast-feeding: use only when there are no therapeutic alternative. Check child's stools (risk of
pseudomembranous colitis).

Remarks
Do not mix with other drugs in the same infusion.
Some formulations contain benzyl alcohol and should not be used in neonates.

Storage
– Below 25 °C

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Page 382/ 663

 CLOXACILLIN injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Penicillin antibacterial

Indications
Severe infections due to streptococci and/or staphylococci: meningitis, pneumonia, omphalitis,
septicaemia of cutaneous origin, endocarditis, osteomyelitis, necrotizing skin and soft tissues
infections, etc.
Erysipelas, cellulitis

Forms and strengths, route of administration

Powder for injection, in 500 mg vial, to be dissolved in 4 ml of water for injection, for IV infusion in
0.9% sodium chloride or 5% glucose, to be administered in 60 minutes

Dosage
Severe infections
Neonate:
0 to 7 days (< 2 kg): 50 mg/kg every 12 hours
0 to 7 days (≥ 2 kg): 50 mg/kg every 8 hours
8 days to < 1 month (< 2 kg): 50 mg/kg every 8 hours
8 days to < 1 month (≥ 2 kg): 50 mg/kg every 6 hours
Child 1 month and over: 25 to 50 mg/kg (max. 2 g) every 6 hours
Adult: 2 g every 6 hours

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Page 383/ 663

 500 mg vial
Age Weight
(diluted in 4 ml, 125 mg/ml)

1 to < 3 months 4 to < 6 kg 1 ml x 4

3 months to < 1 year 6 to < 10 kg 2 ml x 4

1 to < 5 years 10 to < 20 kg 4 ml x 4 (1 vial x 4)

5 to < 8 years 20 to < 28 kg 8 ml x 4 (2 vials x 4)

8 to < 12 years 28 to < 38 kg 12 ml x 4 (3 vials x 4)

≥ 12 years and adult ≥ 38 kg 16 ml x 4 (4 vials x 4)

Dilute each dose of cloxacillin in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than
20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg and over and in
adults.

Erysipelas, cellulitis
Neonate, child and adult: half of above dose

Duration
Change to oral route as soon as possible with amoxicillin/clavulanic acid or cefalexin depending on
the indication. Do not use oral cloxacillin for completion treatment following parenteral therapy.

Contra-indications, adverse effects, precautions

Do not administer to penicillin-allergic patients.
Administer with caution to patients with allergy to cephalosporins (cross-sensitivity may occur) or
with renal impairment (reduce the dose).
May cause: gastrointestinal disturbances (particularly diarrhoea), allergic reactions sometimes
severe; rarely, haematological disorders.
Do not combine with methotrexate (increased methotrexate toxicity).
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Pregnancy of our own and third-party
breast-feeding: cookies on the pages of this website: Essential cookies, which are
no contra-indication
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Dicloxacillin, flucloxacillin and oxacillin are used for the same indications.
time at "Settings".
Do not mix with other drugs in the same infusion.

Storage
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Page 384/ 663

 – Below 25 °C
Reconstituted solution must be used immediately.

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Page 385/ 663

 CO-AMOXICLAV injectable
See AMOXICILLIN/CLAVULANIC ACID injectable

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 386/ 663

 DEXAMETHASONE injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Long-acting steroidal anti-inflammatory drug (corticosteroid)

Indications
Symptomatic treatment of severe allergic and inflammatory reactions, when oral administration is
not possible
Foetal lung maturation, in the event of threatened premature delivery before 34 weeks of gestation

Forms and strengths, route of administration

4 mg dexamethasone phosphate in 1 ml ampoule (4 mg/ml) for IM or IV injection or infusion

Dosage and duration

Symptomatic treatment of severe allergic and inflammatory reactions
Dosage varies according to indication, reaction severity and clinical response:
Child: 0.15 to 0.6 mg/kg (max. 16 mg) by IM or IV injection once daily
Adult: 0.5 to 24 mg by IM or IV injection once daily
Duration varies according to indication. Due to dexamethasone’s long half-life, a treatment of 1 or
2 days is usually sufficient in asthma or croup. For longer treatments, change to oral route as soon
as possible. In the event of treatment longer than 10 days, decrease doses gradually to avoid
adrenal suppression.

Foetal lung maturation

Administer to the mother: 6 mg by IM injection every 12 hours for 2 days (total dose: 24 mg)

WeContra-indications,
use a selection of our own adverse effects,
and third-party precautions
cookies on the pages of this website: Essential cookies, which are
required
In case of systemic infections, only administer which
in order to use the website; functional cookies, provide
if patient betterantimicrobial
is under easy of use when using the website;
treatment.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
May cause (if prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofretardation,
all cookies. increased susceptibility
You can accept to infections,
and reject individual sodium
cookie andrevoke
types and water your
retention (oedema
consent and at any
for the future
time hypertension),
at "Settings". osteoporosis, hypokalaemia, digitalis toxicity due to potassium loss in patients
taking digitalis glycosides.
Pregnancy and breast-feeding: no contra-indication; for symptomatic treatment of severe
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allergic and inflammatory reactions, use the lowest effective dose.

Page 387/ 663

 Remarks
Foetal lung maturation:
after 34 weeks of gestation, corticosteroid treatment is not indicated;
dexamethasone may be replaced by betamethasone: 2 doses of 12 mg by IM injection at 24-
hour interval (total dose: 24 mg).
0.75 mg of dexamethasone has the same anti-inflammatory activity as 5 mg of prednisolone or
prednisone and 20 mg of hydrocortisone.
Dexamethasone acetate, insoluble in water, is a suspension used only for local treatment: intra-
articular or peri-articular injection, epidural injection (sciatica).

Storage
– Below 25 °C
T he solution precipitates at 0 °C, it must not be exposed to cold temperatures.

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Page 388/ 663

 DIAZEPAM injectable
Last updated: October 2024

Prescription under medical supervision

During and after administration, have ventilation equipment (Ambu and mask) and
solutions for fluid replacement ready for use.
For seizures, preferably use the rectal route in children.

Therapeutic action
Antiseizure (anticonvulsant), muscle relaxant, sedative, anxiolytic

Indications
First-line treatment of convulsive status epilepticus
Muscle spasms due to tetanus
Severe agitation in adults

Forms and strengths, route of administration

10 mg in 2 ml ampoule (5 mg/ml) for IM injection, slow IV injection (3 to 5 minutes) or IV infusion in
0.9% sodium chloride or 5% glucose
T he injectable solution may be used rectally.

Dosage and duration

Convulsive status epilepticus
Child 1 month to 11 years:
Rectal route: one dose of 0.5 mg/kg (0.1 ml/kg); max. 10 mg (2 ml)
Slow IV injection: one dose of 0.2 to 0.3 mg/kg (0.04 to 0.06 ml/kg); max. 10 mg (2 ml)

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Page 389/ 663

 10 mg/2 ml solution
Age Weight
Rectal route IV injection

1 to < 4 months 3 to < 6 kg 0.4 ml 0.25 ml

4 to < 12 months 6 to < 10 kg 0.7 ml 0.4 ml

1 to < 3 years 10 to < 15 kg 1.2 ml 0.6 ml

3 to < 5 years 15 to < 20 kg 1.5 ml 1 ml

5 to < 9 years 20 to < 30 kg 2 ml 1.2 ml

9 to < 12 years 30 to < 40 kg 2 ml 2 ml

Child 12 years and over and adult:

Rectal route: one dose of 10 to 20 mg (2 to 4 ml); one dose of 10 mg (2 ml) in older patients
Slow IV injection: one dose of 10 mg (2 ml); one dose of 5 mg (1 ml) in older patients
In children and adults, if seizures do not stop 5 minutes after the first dose, readminister the same
dose, regardless of the route of administration. Do not administer more than 2 doses in total.

Muscle spasms due to tetanus

T he dosage range is variable, depending on the severity of symptoms and clinical response. For
information:
Child 1 month and over and adult: 0.1 to 0.3 mg/kg by slow IV injection every 1 to 4 hours or 0.1 to
0.5 mg/kg/hour by IV infusion over 24 hours

Severe agitation
Adult: 10 mg (2 ml) by IM injection, to be repeated once after 30 to 60 minutes if necessary

Rectal administration technique

Lay the patient on their side.
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Contra-indications, adverse effects, precautions

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Page 390/ 663

 Do not administer to neonates (contains benzyl alcohol) and to patients with severe respiratory
insufficiency or severe hepatic impairment.
Administer with caution:
to older patients and patients with renal or hepatic impairment (reduce the dose by half);
to patients with history of substance abuse or mental disorders.
May cause:
pain at injection site;
hypotension, muscle weakness, ataxia, hypotonia, drowsiness, lethargy, confusional state;
respiratory depression, especially if injected rapidly by IV route and if large doses are
administered;
coma in the event of overdose.
Avoid or monitor in combination with:
opioid analgesics, antipsychotics, first-generation antihistamines (hydroxyzine, promethazine),
antidepressants, other antiseizure medications, etc. (increased sedation);
enzyme inducers such as rifampicin, rifabutin, nevirapine, phenobarbital, phenytoin,
carbamazepine, etc. (reduced effect of diazepam);
omeprazole, macrolides, ritonavir, isoniazid, fluconazole, itraconazole, etc. (increased
diazepam toxicity);
phenytoin (increased phenytoin toxicity).
Pregnancy and breast-feeding: avoid, except if vital (passage through the placenta and breast
milk)

Remarks
Diazepam is subject to international controls: follow national regulations.
For administration by IV infusion, the concentration of diazepam in the solution should not exceed
0.25 mg/ml (e.g. 1 mg in at least 4 ml).
Diazepam slow IV is also used in delirium tremens (alcohol withdrawal) in adults: 10 to 20 mg every 4
to 6 hours under close supervision in intensive care unit.
Do not mix with other drugs in the same syringe or infusion.

Storage
– Below 25 °C

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Page 391/ 663

 DICLOFENAC injectable
Last updated: October 2024

Prescription under medical supervision

Do not exceed the recommended duration of treatment.

Therapeutic action
Non-steroidal anti-inflammatory drug (NSAID), analgesic

Indications
Moderate pain due to inflammation (acute sciatic neuralgia, renal colic, postoperative pain, etc.)

Forms and strengths, route of administration

75 mg in 3 ml ampoule (25 mg/ml) for deep IM injection or IV infusion

Dosage
Adult : 75 mg by deep IM injection, to be repeated after 6 hours if necessary
For postoperative pain, may be administered by infusion: 75 mg over 30 to 120 minutes, to be
repeated after 4 to 6 hours if necessary.
Do not exceed 150 mg in 24 hours.

Duration
Maximum 2 days
Change to oral treatment with an analgesic, e.g. ibuprofen or paracetamol, as soon as possible.

Contra-indications, adverse effects, precautions

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May cause: local reactions at the injection site, renal impairment, gastrointestinal disturbances,
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Page 392/ 663

 Administer with caution and carefully monitor use in older patients or patients with cardiovascular
disorders (hypertension, diabetes, etc.).
Do not combine with other NSAID (aspirin, ibuprofen, etc.), diuretics, anticoagulants.
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: CONT RA-INDICAT ED

Remarks
For infusion, use a solution of 5% glucose or 0.9% sodium chloride and add 0.5 ml of 8.4% sodium
bicarbonate per 500 ml.
Diclofenac is not included in the WHO list of essential medicines.

Storage
– Below 25 °C

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Page 393/ 663

 DIGOXIN injectable
Last updated: October 2024

Prescription under medical supervision

Due to narrow margin between therapeutic and toxic dose, patients should be kept under
close surveillance.

Therapeutic action
Cardiotonic

Indications
Supraventricular arrhythmias (fibrillation, flutter, paroxysmal tachycardia)
Heart failure

Forms and strengths, route of administration

500 micrograms ampoule (250 micrograms/ml, 2 ml) for slow IV injection or infusion in 5% glucose
or 0.9% sodium chloride

Dosage
Adult:
Loading dose: 500 to 1000 micrograms
T he loading dose can be administered either by intravenous infusion as a single dose given over
2 hours minimum or in divided doses, by slow IV injections over 5 minutes minimum.
Maintenance dose: change to oral treatment
Reduce the dose by one half in older patients and in patients with renal impairment.
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margin between therapeutic and toxic dose.
May cause in the event of overdose: gastrointestinal disturbances (nausea, vomiting, diarrhoea),
blurred vision, headache, confusion, conduction and rhythm disorders. If so, reduceDecline
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treatment.

Page 394/ 663

 Do not combine with calcium, particularly by IV injection (serious arrhythmias).
Monitor combination with:
amiodarone, macrolides, itraconazole, quinine, chloroquine (increased digoxin concentration);
potassium-depleting drugs: diuretics, corticoids, amphotericin B (increased risk of digoxin
toxicity).
Monitor if possible serum potassium level in patients taking potassium-depleting drugs and serum
creatinine level in patients with renal impairment.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
A loading dose may be administered in arrhythmias if a rapid digitalisation is required. It is usually not
required for heart failure.

Storage
– Below 25 °C

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Page 395/ 663

 EFLORNITHINE injectable
Last updated: October 2024

Prescription under medical supervision

Therapeutic action
Trypanocide

Indications
Meningoencephalitic stage of African trypanosomiasis due to T.b. gambiense, in combination with
nifurtimox (first choice treatment) or in monotherapy if nifurtimox is not available or is contra-
indicated

Forms and strengths, route of administration

10 g in 50 ml ampoule (200 mg/ml) to be diluted in 250 ml bag of water for injection (or, if not
available, 0.9% sodium chloride), for IV infusion administered over 2 hours

Dosage and duration

In combination with nifurtimox
Child and adult: 200 mg/kg every 12 hours for 7 days

In monotherapy
Child under 12 years: 150 mg/kg every 6 hours for 14 days
Child 12 years and over and adult: 100 mg/kg every 6 hours for 14 days

Contra-indications, adverse effects, precautions

May cause: haematological disorders (anaemia, leucopenia, thrombocytopenia), gastrointestinal
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T he catheter must be handled relevant
withcontent and advertising.
great attention If you
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bacterial
use ofsuperinfections:
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ensure secure catheter fixation and change the catheter every 48 hours or earlier in the event of
phlebitis.
Pregnancy: CONT RA-INDICAT ED unless, due to the mother’s general condition, treatment
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be delayed until after delivery.
Page 396/ 663
 Remarks
When administering nifurtimox-eflornithine combined therapy, the dosage of nifurtimox in children
and adults is 5 mg/kg every 8 hours for 10 days.
Eflornithine is also called difluoromethylornithine or DFMO.

Storage
– Below 25 °C
Diluted solution must be kept refrigerated (2 °C to 8 °C) and used within 24 hours.

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Page 397/ 663

 EPINEPHRINE = EPN = ADRENALINE
injectable
Last updated: June 2025

Prescription under medical supervision

Check the route of administration indicated on the ampoule.

IV route should only be used by well trained personnel in well-equipped hospitals.

Therapeutic action
Sympathomimetic

Indications
Severe anaphylactic reaction
Acute hypotension despite fluid therapy in shock

Forms and strengths, route of administration

1 mg in 1 ml ampoule (1 mg/ml) for IM injection only
1 mg in 1 ml ampoule (1 mg/ml) for IV injection or infusion only

Dosage
Severe anaphylactic reaction
Administer undiluted solution by IM route (anterolateral part of the thigh) using a 1 ml syringe
graduated in 0.01 ml:
Child under 6 months: 0.1 to 0.15 ml
Child 6 months to 5 years: 0.15 ml
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Repeat after 5 minutes if no or poor clinical improvement (up to a total of 3 IMall",
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Acute
time hypotension despite fluid therapy or anaphylactic reaction unresponsive to epinephrine IM
at "Settings".
Use diluted solution in 0.9% sodium chloride (NaCl 0.9%) or 5% glucose (G5%) or Ringer lactate
(RL):
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Page 398/ 663

 Child under 40 kg: add 2 ml of EPN (2 amp. of 1 mg/ml for IV route) to 38 ml of NaCl 0.9%, G5%
or RL to obtain a 0.05 mg/ml (50 micrograms/ml) solution.
Child 40 kg and over and adult: add 4 ml of EPN (4 amp. of 1 mg/ml for IV route) to 36 ml
of NaCl 0.9%, G5% or RL to obtain a 0.1 mg/ml (100 micrograms/ml) solution.
Administer by continuous IV infusion using an infusion or syringe pump:
Child and adult: 0.1 microgram/kg/min, increase if necessary by 0.05 micrograms/kg/min every
10 min for the first hour, then every hour (max. 1 microgram/kg/min)
Once desired response is achieved, discontinue gradually, in decrements of 0.05
micrograms/kg/min every hour. Do not discontinue abruptly.
T he infusion rate is calculated as follows: [desired dose (microgram/kg/min) x weight (kg) x 60
min]/concentration (microgram/ml).
Example, for a child 20 kg, dose 0.1 microgram/kg/min, solution concentration 50 micrograms/ml:

EPN dose (microgram/kg/min) 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45 0.5

Infusion rate (ml/hour) 2.4 3.6 4.8 6 7.2 8.4 9.6 10.8 12

Contra-indications, adverse effects, precautions

Administer with caution to patients with hypertension, angina, ischaemic heart disease,
hyperthyroidism and to older patients.
May cause: arrhythmia, hypertension, agitation, headache; tissue necrosis following extravasation
(use a large vein for IV administration).
Pregnancy and breast-feeding: no contra-indication

Remarks
In anaphylaxis, use IV treatment only if no or poor improvement after 3 IM injections or if there is a
circulatory collapse.
Epinephrine can be used via nebulizer in the management of airway obstruction due to certain
respiratory diseases (e.g. croup, diphtheria): 0.5 mg/kg (max. 5 mg) to be repeated every 20 minutes
if necessary.
Epinephrine is colourless: discard any ampoules with a pink or brownish colour.
Also comes in 0.15 mg/0.3 ml and 0.3 mg/0.3 ml pre-filled auto-injector.

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– Below 25 °C
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 399/ 663

 ETONOGESTREL subdermal implant
Prescription under medical supervision

Therapeutic action
Hormonal contraceptive, progestogen

Indications
Long-acting contraception

Forms and strengths, route of administration

Flexible rod containing 68 mg of etonogestrel, in a sterile disposable applicator, to be inserted
subdermally into the inner side of the non-dominant arm, 6 to 8 cm above the elbow crease, under
local anaesthesia and aseptic conditions

Dosage
T he implant may be inserted at any moment of the cycle if it is reasonably certain the woman is not
pregnant, including when switching from another form of contraception.
Use condoms for 7 days after insertion of the implant if it is inserted:
more than 7 days after the start of menstruation;
more than 28 days postpartum if not breastfeeding;
more than 7 days after an abortion.

Duration
As long as this method of contraception is desired and it is well tolerated, for max. 3 years after
which it no longer provides contraception and must be changed.

Contra-indications, adverse effects, precautions

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Do not administer to patients with breast cancer, severe or recent liver disease, unexplained vaginal
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
bleeding,
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use of all cookies. You can accept and reject amenorrhoea,
May cause: menstrual irregularities, menometrorrhagia,
individual cookie breast
types and revoke your tenderness,
consent headache,
for the future at any
time weight gain, itching, acne, mood changes, abdominal pain, gastrointestinal disturbances, allergic
at "Settings".
reactions.
Enzyme-inducing drugs (rifampicin, rifabutin, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital,
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phenytoin, carbamazepine, griseofulvin, etc.) reduce the effectiveness of the contraceptive.

Page 400/ 663

 Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Remarks
Fertility returns rapidly after removal of the implant.
For the conditions for insertion or removal the implant, follow manufacturer’s instructions.

Storage
– Below 25 °C

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Page 401/ 663

 FLUCONAZOLE injectable
Last updated: November 2022

Prescription under medical supervision

Therapeutic action
Antifungal

Indications
Severe fungal infections, when oral administration is not possible:
Cryptococcal meningitis, in combination with amphotericin B or flucytosine
Severe oesophageal candidiasis

Forms and strengths, route of administration

200 mg in 100 ml bottle or bag (2 mg/ml), for IV infusion

Dosage
Cryptococcal meningitis, in combination with amphotericin B or flucytosine
Child 1 month and over: 12 mg/kg (max. 800 mg) once daily administered over 20 minutes minimum
(max. 5 ml/minute)
Adult: 1200 mg once daily, administered over 10 minutes minimum (max. 10 ml/minute)

Severe oesophageal candidiasis

Child 1 month and over: 3 to 6 mg/kg (max. 200 mg) once daily
Adult: 200 mg (max. 400 mg) once daily

Duration
Change to oral treatment as soon as possible.
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Administer with caution to patients with hepatic or renal impairment, cardiac disorders (bradycardia,
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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at "Settings".
Reduce the dose by half in patients with renal impairment.
May cause: gastrointestinal disturbances, headache, skin reactions sometimes severe,
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anaphylactic reactions; severe hepatic disorders, haematological (leukopenia, thrombocytopenia)

Page 402/ 663

 and cardiac disorders (QT-prolongation). Stop treatment in the event of anaphylactic reaction,
hepatic disorders or severe skin reaction.
Avoid or monitor combination with:
drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, haloperidol,
mefloquine, pentamidine, quinine);
warfarin, carbamazepine, phenytoin, rifabutin, benzodiazepines, calcium-channel blockers,
certain antiretrovirals (e.g. nevirapine, zidovudine): increased plasma concentrations of these
drugs;
rifampicin: decreased plasma concentrations of fluconazole.
Pregnancy and breast-feeding: use only in severe or life-threatening infections, particularly during
the first trimester of pregnancy (risk of foetal malformations).

Remarks
As in neonates the half-life of fluconazole is prolonged, fluconazole should be administered every
72 hours (neonates < 14 days) or every 48 hours (neonates ≥ 14 days).
For cryptococcocal meningitis, when amphotericin B is not available or not tolerated, fluconazole
may be administered alone during the induction phase (same doses as the oral route).
Do not add any drug in the infusion bottle or bag.

Storage
Below 25 °C. Do not store in a refrigerator.

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Page 403/ 663

 FUROSEMIDE injectable
Prescription under medical supervision

Therapeutic action
Diuretic

Indications
Emergency treatment of:
Oedema caused by renal, hepatic or congestive heart failure
Hypertensive crisis (except that of pregnancy)
Pulmonary oedema

Forms and strengths, route of administration

20 mg in 2 ml ampoule (10 mg/ml) for IM or slow IV injection

Dosage
Child: 0.5 to 1 mg/kg/injection
Adult: 20 to 40 mg/injection

Repeat after 2 hours if necessary.

For pulmonary oedema: if an initial IV injection of 40 mg does not produce a satisfactory response
within one hour, the dose may be increased to 80 mg by slow IV injection.

Duration
According to clinical response;
If prolonged use is required, change to oral treatment 3 hours after the last injection.

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are used toindisplay
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Do not administer in case of hepatic encephalopathy.
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time May cause: hypokalaemia, especially in cases of cirrhosis, denutrition, congestive heart failure.
at "Settings".
Closely monitor combination with digoxin (furosemide enhances toxicity of digoxin).
Pregnancy: CONT RA-INDICAT ED to treat hypertension in pregnancy
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Breast-feeding: avoid (excreted in milk and may reduce milk production)

Page 404/ 663

 Remarks
If doses greater than 50 mg are required, it is recommended that they be given by IV infusion.

Storage
– Below 25 °C

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Page 405/ 663

 GENTAMICIN injectable
Last updated: September 2023

Prescription under medical supervision

Given the risk of renal and auditory toxicity, do not prolong treatment unnecessarily.

Therapeutic action
Aminoglycoside antibacterial

Indications
Severe bacterial infections: plague, septicaemia, meningitis, pneumonia, pyelonephritis, postpartum
upper genital tract infections, brucellosis, etc., in combination with other antibacterials

Forms and strengths, route of administration

10 mg in 1 ml ampoule (10 mg/ml) and 80 mg in 2 ml ampoule (40 mg/ml) for IM or slow IV injection (3
minutes) or IV infusion (30 minutes) in 0.9% sodium chloride or 5% glucose

Dosage
Meningitis in young children, in combination with ampicillin or cloxacillin
Neonate:
0 to 7 days (< 2 kg): 3 mg/kg once daily by IV injection or infusion
0 to 7 days (≥ 2 kg): 5 mg/kg once daily by IV injection or infusion
8 days to < 1 month: 5 mg/kg once daily by IV injection or infusion
Child 1 to 3 months: 2.5 mg/kg every 8 hours by IV injection or infusion

Other severe bacterial infections

Neonate : as above
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of gentamicin revoke your
5 ml/kg ofconsent for the future
0.9% sodium at any
chloride or
time at "Settings".
5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose
in children 20 kg and over and in adults.
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Duration
Page 406/ 663
 Plague: 10 to 14 days
Other infections: according to indication and clinical response

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to aminoglycosides.
Administer with caution to patients with history of renal, vestibular or auditory problems.
Reduce dosage in patients with renal impairment.
May cause: irreversible ototoxicity (vestibular and auditory damage), nephrotoxicity, neuropathy,
paraesthesia, neuromuscular blockade; rarely, allergic reactions.
Stop treatment in the event of dizziness, tinnitus or hearing loss (ototoxicity).
Do not combine with another aminoglycoside.
Avoid or monitor combination with: furosemide, amphotericin B, vancomycin (enhanced renal and/or
auditory toxicity); neuromuscular blockers (increased neuromuscular blockage).
Pregnancy: administer only if clearly needed (risk of fetal ototoxicity).
Breast-feeding: no contra-indication

Remarks
Do not mix with other drugs in the same syringe or infusion.

Storage
– Below 25 °C

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Page 407/ 663

 GLUCOSE 50% = DEXTROSE 50%
injectable
Prescription under medical supervision

Indications
Treatment of severe hypoglycaemia

Forms and strengths, route of administration

50% hypertonic glucose solution in 50 ml vial (500 mg/ml), for slow IV injection (3 to 5 minutes).
NEVER BY IM OR SC INJECT ION.

Dosage and duration

Adult: 1 ml/kg by slow IV injection
Check blood glucose level 15 minutes after injection. If blood glucose level is still < 3.3 mmol/litre or
< 60 mg/dl, administer a second dose or give oral glucose, according to the patient's clinical
condition.

Contra-indications, adverse effects, precautions

May cause:
vein irritation;
severe tissue damage (necrosis) in the event of extravasation.
T he solution is viscous: use a large vein and a large calibre needle.

Remarks
50% glucose solution is too viscous, concentrated and irritant to be used in children.
We use a selection
In children useof10%
our own and third-party
glucose solution. cookies on the pages
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this website: Essential
solution is notcookies, which
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required in order to use the website; functional cookies, which provide better easy of use when
ml of 50% glucose per 100 ml of 5% glucose to obtain a 10% glucose solution. T he dose of 10%using the website;
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glucose to be administered is 2 ml/kg by slow IV injection.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Storage
time at "Settings".

Below 25° C
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Page 408/ 663

 HALOPERIDOL injectable
Last updated: February 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of haloperidol, patients should
be kept under close surveillance.

Therapeutic action
Antipsychotic

Indications
Acute confusional state (delirium) and acute alcohol intoxication
Agitation or aggressive behaviour in patients with acute or chronic psychosis, in combination with
promethazine

Forms and strengths, route of administration

5 mg in 1 ml ampoule (5 mg/ml) for IM injection

Dosage and duration

Acute confusional state (delirium) and acute alcohol intoxication
Adult: 0.5 to 1 mg, to be repeated after 30 to 60 minutes if necessary. If needed, administer
additional doses every 4 hours (max. 5 mg) for 7 days max.

Agitation or aggressive behaviour in patients with acute or chronic psychosis, with

promethazine
Adult: 5 mg, to be repeated after 30 minutes if necessary

WeChange to oral treatment

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Reduceinthe
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not administer to patients with cardiac disorders (cardiac failure, recent myocardial infarction,
conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease
and history of neuroleptic malignant syndrome.
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Page 409/ 663

 Administer with caution and carefully monitor use in older patients and patients with hypokalaemia,
hypotension, hyperthyroidism, renal or hepatic impairment, history of seizures.
May cause: drowsiness, extrapyramidal syndrome, dyskinesia, anticholinergic effects
(constipation, dry mouth), sexual dysfunction, QT-prolongation, ventricular arrhythmia, orthostatic
hypotension; neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular
disorders), rare but requiring immediate treatment discontinuation.
Avoid or monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.);
fluoxetine, paroxetine, sertraline, ritonavir (increased plasma concentrations of haloperidol);
carbamazepine, rifampicin, phenobarbital, phenytoin (decreased plasma concentrations of
haloperidol);
antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone,
chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
Keep the patient in the supine position for 30 minutes after injection (risk of orthostatic
hypotension):
Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, administer at the
lowest effective dose. Observe the neonate the first few days (risk of agitation, tremors,
hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under
treatment in the 3rd trimester.
Breast-feeding: if absolutely necessary, do not exceed 10 mg daily.

Remarks
Haloperidol decanoate is a long-acting form used as maintenance therapy of chronic psychotic
disorders after stablisation with oral treatment.

Storage
– Below 25 °C

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Page 410/ 663

 HALOPERIDOL decanoate injectable
Last updated: February 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of haloperidol, patients should
be kept under close surveillance.

Therapeutic action
Long-acting antipsychotic

Indications
Chronic psychosis, maintenance therapy after stabilisation with oral haloperidol

Forms and strengths, route of administration

50 mg in 1 ml ampoule (50 mg/ml) for IM injection
DO NOT ADMINIST ER BY IV INJECT ION.

Dosage and duration

Adult: one injection every 3 to 4 weeks
T he initial dose of haloperidol decanoate corresponds to approximately 10 times the daily dose of
oral haloperidol.

Daily dose Monthly dose 50 mg solution

oral haloperidol haloperidol decanoate IM haloperidol decanoate IM

2.5 mg 25 mg ½ amp
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10 mg 100 mg 2 amp
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15 mg 150 mg 3 amp

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Page 411/ 663

 Contra-indications, adverse effects, precautions
Do not administer to patients with cardiac disorders (cardiac failure, recent myocardial infarction,
conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease
and history of neuroleptic malignant syndrome.
Administer with caution and carefully monitor use in older patients and patients with hypokalaemia,
hypotension, hyperthyroidism, renal or hepatic impairment, history of seizures.
May cause: drowsiness (caution when driving/operating machinery), extrapyramidal syndrome, early
or tardive dyskinesia, constipation, dry mouth, sexual dysfunction, QT-prolongation, ventricular
arrhythmia, orthostatic hypotension.
In case of extrapyramidal symptoms, try reducing the dose of haloperidol decanoate or, if
the extrapyramidal symptoms are severe, add biperiden or trihexyphenidyl.
Avoid or monitor combination with:
fluoxetine, paroxetine, sertraline, promethazine, ritonavir (increased plasma concentrations of
haloperidol);
carbamazepine, rifampicin, phenobarbital, phenytoin (decreased plasma concentrations of
haloperidol);
drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, fluconazole,
mefloquine, pentamidine, quinine, etc.).
Avoid alcohol during treatment (increased risk of adverse effects).
Avoid in women of childbearing age or offer effective contraception.
Pregnancy and breastfeeding: avoid

Remarks
Change buttock for each injection.

Storage
– Below 25 °C

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Page 412/ 663

 HEPARIN sodium injectable
Prescription under medical supervision

T his drug should only be used by well trained personnel in well-equipped

hospitals. During treatment, have protamine ready for use.
Due to narrow margin between therapeutic and toxic dose, coagulation parameters
should be monitored.

Therapeutic action
Anticoagulant
By IV injection: acts immediately for about 2 to 4 hours
SC injection: acts within 1 hour for about 8 to 12 hours

Indications
Venous and arterial thrombosis: pulmonary embolism, myocardial infarction, thrombophlebitis
Prevention of venous and arterial thrombosis, especially in pre-operative and postoperative period
and in patients on bedrest
Prescription of heparin requires systematic monitoring of coagulation parameters.

Forms and strengths, route of administration

1000 IU in 1 ml ampoule (1000 IU/ml) and 5000 IU in 1 ml ampoule (5000 IU/ml) for IV injection or
infusion, diluted in an isotonic solution of glucose or sodium chloride
25 000 IU in 1 ml ampoule (25 000 IU/ml) for SC injection
Also comes in various concentrations (500 IU, 12 500 IU, 20 000 IU/ml) and volumes (0.5 ml, 2 ml, 5
ml). Check label before use.

Dosage
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By IV route
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Child
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which adult:
usedinitial dose of
to display 50 tocontent
relevant 100 IU/kg
and followed byIf400
advertising. youto 600 IU/kg
choose daily,
"Accept all",by continuous
you consent to the
infusion over 24 hours or by IV injection every 2 to 4 hours. Adjust dosage according to coagulation
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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at "Settings".
By SC route
Child and adult: 1 SC injection every 12 hours. Start with an initial dose of 250 IU/kg and adjust
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dosage according to coagulation tests.

Page 413/ 663

 Preventive treatment
Usually: 5000 IU by SC injection 2 hours before surgery, repeated every 8 to 12 hours.
Dosage depends on patient's weight and risk of thrombo-embolic complications: 75 IU/kg 2 times
daily or 50 UI/kg 3 times daily.

Duration
About 7 to 10 days or more according to clinical response.
In postoperative period, administer until fully ambulatory.
For long-term therapy, administer heparin simultaneously with oral anticoagulants for 2 to 3 days
before stopping heparin.

Contra-indications, adverse effects, precautions

Do not administer if:
haemorrhage or risk of haemorrhage: haemophilia, active peptic ulcer, acute bacterial
endocarditis, severe hypertension; in postoperative period after neurosurgery or ophtalmic
surgery;
thrombocytopenia or history of heparin-induced thrombocytopenia.
Do not administer by IM route. SC injections must be made deep into abdominal fat, between
umbilicus and iliac crest.
Intramuscular or intra-arterial injections and infiltrations are contra-indicated during heparin therapy.
May cause:
severe thrombocytopenia, usually after 5 days of heparin, with thrombo-embolic complications
requiring discontinuation of treatment;
localised reactions at the injection site, rarely, necrosis;
allergic reactions, osteoporosis after prolonged use, alopecia;
haemorrhage in case of overdosage, pre-existing lesions, trauma.
Use with caution and reduce dosage in elderly patients and in hepatic or renal failure.
Overdosage: neutralise heparin by slow IV injection of protamine. 1 mg protamine neutralises 100 IU
of heparin.
Reduce doses of protamine if more than 15 minutes has elapsed since heparin administration.
Laboratory tests:
Monitor coagulation parameters in order to adjust dose. Partial thromboplastin time should be
maintained at 1.5 to 2 times the control value (Howell's test at 2 to 3 times the control value).
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Monitor platelet count prior to initiation of treatment and then 2 times per week.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use to generate anti-inflammatory
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haemorrhage.
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with corticosteroids,
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and transition to an oral anticoagulant.
Pregnancy: CONT RA-INDICAT ED at the end of pregnancy (risk of haemorrhage during delivery)
Breast-feeding: no contra-indication
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Page 414/ 663

 Remarks
Preparations containing calcium salt of heparin are also available. Check label before use.
Do not mix with other drugs in the same syringe.

Storage
– Below 25 °C

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Page 415/ 663

 HYDRALAZINE injectable
Last updated: October 2024

Prescription under medical supervision

T his drug should only be used by well trained personnel in well-equipped hospitals.

Therapeutic action
Antihypertensive vasodilatator

Indications
Hypertension in pregnancy, in case of severe symptoms or when oral treatment is not possible

Forms and strengths, route of administration

Powder for injection, in 20 mg vial, to be dissolved in 1 ml of water for injection, for IV infusion or
slow diluted IV injection

Dosage
Dosage should be adjusted according to blood pressure (BP). T he goal is to reduce the blood
pressure to 140/90 mmHg. Diastolic BP must not fall below 90 mmHg.

By IV infusion
Dilute 100 mg (5 vials of reconstituted hydralazine solution) in 500 ml of 0.9% sodium chloride or
Ringer lactate, to obtain a solution containing 200 micrograms/ml.
Initial dose: 200 to 300 micrograms/minute
Maintenance
We use a selection ofdose: 50 to
our own and150 micrograms/minute
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Administer by increasing the rate up to cookies,
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which provide 30 drops/minute),
better easy of use when check
usingBP
the every 5
website;
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As soon as hypertension is controlled, decrease progressively the rate (15 drops/minute, then 10,
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time then 5) until stopping infusion. An abrupt discontinuation may provoke a hypertensive crisis.
at "Settings".

By slow diluted IV injection

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Dilute 20 mg (1 vial of reconstituted hydralazine solution in 1 ml of water for injection) in 9 ml Accept
of
0.9% sodium chloride, to obtain 10 ml of solution containing 2 mg/ml.
Page 416/ 663
 Administer 5 mg (2.5 ml of the diluted solution) over 2 to 4 minutes. Check BP for 20 minutes. If BP
remains uncontrolled, repeat injection. Continue repeating if necessary, waiting 20 minutes between
each injection (max. 20 mg total dose).

Duration
According to clinical response.
Change to oral treatment as soon possible with labetalol or methyldopa.

Contra-indications, adverse effects, precautions

Administer with caution to patients with heart failure, coronary insufficiency, recent myocardial
infarction, severe tachycardia, history of stroke.
May cause:
hypotension, tachycardia, headache, gastrointestinal disturbances;
abrupt fall in maternal blood pressure with placental hypoperfusion and foetal death when
administered too rapidly by IV injection or in case of overdose.
Reduce doses in patients with renal or hepatic impairment.
Do not exceed recommended dosage and administration rate. During administration, monitor
maternal BP and heart rate, as well as foetal heart rate.
In the event of hypotension, administer Ringer lactate to maintain diastolic BP ≥ 90 mmHg.
Breast-feeding: no contra-indication

Remarks
For administration, only use sodium chloride 0.9% or Ringer lactate (incompatibility with glucose
and other solutions).
Do not mix with other drugs in the same syringe or infusion bottle.

Storage
– Below 25 °C
Reconstituted solution must be used immediately.

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Page 417/ 663

 HYDROCORTISONE injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Short-acting steroidal anti-inflammatory drug (corticosteroid)

Indications
Symptomatic treatment of severe allergic and inflammatory reactions, when oral administration is
not possible

Forms and strengths, route of administration

Powder for injection, 100 mg hydrocortisone (hemisuccinate, succinate or phosphate) in vial, to be
dissolved in 2 ml water for injection, for IM or slow IV injection or infusion

Dosage and duration

Child one month to 11 years: 4 mg/kg (max. 100 mg)
Child 12 years and over and adult: 100 to 200 mg
Doses may be repeated at 6 or 8 hour-intervals up to 3 or 4 times according to reaction severity and
clinical response. Change to oral route with prednisolone as soon as possible.

Contra-indications, adverse effects, precautions

In case of systemic infection, only administer if patient is under antimicrobial treatment.
Avoid prolonged administration in patients with peptic ulcer, diabetes mellitus or cirrhosis.
May cause (if prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth
retardation, increased susceptibility to infections, sodium and water retention (oedema and
hypertension), osteoporosis, hypokalaemia, digitalis toxicity due to potassium loss in patients
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Pregnancy:
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Breast-feeding: no contra-indication
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Remarks
time at "Settings".

20 mg of hydrocortisone has the same anti-inflammatory activity as 5 mg of prednisolone or

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prednisone and 0.75 mg of dexamethasone.

Page 418/ 663

 Hydrocortisone acetate is a suspension insoluble in water, used as a local treatment only: intra- or
periarticular injection, epidural (sciatic neuralgia).

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 419/ 663

 HYOSCINE BUTYLBROMIDE =
BUTYLSCOPOLAMINE injectable
Last updated: November 2024

Prescription under medical supervision

Do not exceed recommended doses, especially in children and older patients (risk of
severe anticholinergic effects).

Therapeutic action
Antispasmodic, anticholinergic drug

Indications
Spasms of the gastrointestinal tract and genitourinary tract

Forms and strengths, route of administration

20 mg in 1 ml ampoule (20 mg/ml) for IM, SC or slow IV injection

Dosage
Adult: 20 to 40 mg to be repeated if necessary (max. 100 mg daily)

Duration
According to clinical response; no prolonged treatment.

WeContra-indications,
use a selection of our ownadverse effects,
and third-party precautions
cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Do not cookies,
performance administer to patients
which we use towith benign
generate prostatic
aggregated hyperplasia,
data on website urinary
use and retention, closed-angle
statistics; and marketing
glaucoma,
cookies, tachycardia.
which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofMay cause: urinary
all cookies. You canretention,
accept anddryness of the mouth,
reject individual cookieconstipation, blurred
types and revoke your vision,
consenttachycardia
for the future at any
time (anticholinergic
at "Settings". effects).
Administer with caution and under close supervision:
in the event of heart failure, coronary insufficiency, cardiac rhythm disorders, hypertension;
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Page 420/ 663

 to patients taking other anticholinergic drugs (antidepressants, antipsychotics, H-1
antihistamines, antiparkinsonians, etc.).
Administer with caution to patients with fever (may affect thermoregulation).
Pregnancy: no contra-indication; NO PROLONGED T REAT MENT
Breast-feeding: no contra-indication; NO PROLONGED T REAT MENT

Storage
– Below 25 °C

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Page 421/ 663

 INSULIN injectable
Prescription under medical supervision

General information on use of insulin by SC route

Therapeutic action
Pancreatic hormone, antidiabetic

Types of insulin

Intermediate- Biphasic insulin

Short-acting
SC (a) acting human
human insulin
administration insulin
(Actrapid®) human analogue
(Insulatard®)

30 minutes
Onset 1 to 2 hours 30 minutes 10 to 20 minutes
to 1 hour

Peak time 2 to 4 hours 4 to 12 hours 2 to 8 hours 2 to 8 hours

Duration 7 to 8 hours around 24 hours around 24 hours around 24 hours

Dosage form solution suspension suspension suspension

Aspect clear cloudy cloudy cloudy

a Short -act ing insulin is also known as regular insulin.

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and aggregated
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of activity on indicated
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thestatistics; and marketing
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cookies, which are used to display relevant content and advertising. If you choose "Accept
Nevertheless, for the same preparation, onset and duration vary from one patient to all", youanother.
consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
In one same patient, duration of activity varies depending on the dose, site of injection, blood flow,
time at "Settings".
body temperature and exercise.
T he type of insulin used depends of several factors: type of diabetes, patient's age, patient's
response (blood glucose levels).
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Page 422/ 663

 Analogue insulins have a different chemical structure to human insulin that modifies their onset and
duration of activity after SC injection.

Indications
Type 1 and type 2 diabetes
Diabetes during pregnancy
Transient therapy of type 2 diabetes during periods of severe infection, trauma, surgery

Dosage
Dosage must be individualised. Frequency of administration depends on the type of insulin and the
patient's response.

Duration
Type 1 diabetes: life-time treatment
Other indications: according to clinical response and laboratory tests

Contra-indications, adverse effects, precautions

Do not administer in patients with allergy to insulin (rare).
May cause :
hypoglycaemia due to overdosage or inadequate diet;
local reactions: pain, erythema at the injection site, lipodystrophy. Rotate injection sites
systematically and use all available sites (abdomen, thigh, buttock or arm);
weight gain.
Monitor combination with:
drugs enhancing hypoglycaemic effect of insulin: acetylsalicylic acid, angiotensin-converting
enzyme inhibitors, beta-blockers (which in addition, may mask symptoms of hypoglycaemia);
drugs increasing blood glucose levels: corticosteroids, hydrochlorothiazide, salbutamol,
chlorpromazine.
Avoid alcohol (enhances and prolongs hypoglycaemic effect of insulin).
In the event of renal or hepatic impairment and during the first trimester of pregnancy, reduce insulin
doses.
In the event of infection, emotional stress, accident or surgical intervention and during the last 2
trimesters of pregnancy, increase insulin doses.
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Insulin cannot be administered by mouth since it is inactivated in the gastrointestinal tract.
After SC injection, insulin absorption is rapid in the abdomen, slower in thighs, buttocks and arms.
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Page 423/ 663

 When using an insulin pen, hold the needle in the skin at least six seconds to ensure the entire dose
is injected.

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Page 424/ 663

 INSULIN, INTERMEDIATE-ACTING injectable
Prescription under medical supervision

Therapeutic action
Intermediate-acting pancreatic antidiabetic hormone mixed with protamine, in order to prolong the
duration of activity

Indications
Diabetes

Forms and strengths, route of administration

1000 IU of insulin suspension in 10 ml vial (100 IU/ml) for deep SC injection (abdomen, thigh, buttock
or arm), administered with a syringe calibrated in insulin units for U-100 insulin (100 IU/ml).
NEVER ADMINIST ER BY IV INJECT ION.

Dosage
Child and adult: one to 2 injections daily in combination with short-acting insulin or metformine

Dosage must be individualised according to need. Adapt dose in the event of physical activity, change
in diet or infection.

Contra-indications, adverse effects, precautions

See "insulin: general information".
Do not administer if known allergy to protamine.
In the event of combination with short-acting insulin, always prepare the mix in the syringe
immediately before administration and in the following order: first draw the short-acting insulin then
the intermediate-acting insulin.
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After
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content to reach room
and advertising. temperature.
If you choose "Accept all", you consent to the
use ofShake
all cookies. You
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use.
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Storage
Settings
– Do not freeze. Decline Accept

Page 425/ 663

 Unopened vial: to be kept refrigerated (2 °C to 8 °C)
Opened vial: max. 4 weeks at below 25 °C and protected from light.

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Page 426/ 663

 INSULIN, LONG-ACTING injectable
See INSULIN, INT ERMEDIAT E-ACT ING injectable

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Page 427/ 663

 INSULIN, SHORT-ACTING injectable
Last updated: October 2024

Prescription under medical supervision

Therapeutic action
Rapid-acting pancreatic antidiabetic hormone

Indications
Diabetes
Emergency treatment of hyperglycaemia (diabetic ketoacidosis and hyperosmolar hyperglycaemic
state)

Forms and strengths, route of administration

Solution of 100 IU of insulin/ml in:
3 ml pre-filled pen (300 IU/3 ml), for deep SC injection only (abdomen, thigh, buttock or arm)
10 ml vial (1000 IU/10 ml), for deep SC injection or IV injection (administered with a
syringe calibrated in insulin units) or for IV infusion

Dosage
Diabetes
Child and adult: one SC injection 15 to 30 minutes before a meal, in combination with intermediate-
acting insulin
Dosage must be individualised according to need. Adapt dose in the event of physical activity,
change in diet or infection.

Emergency treatment of hyperglycaemia

We use a selection
Adult: of ourofown
initial dose 0.1and third-party
IU/kg cookiesthen
by IV injection on the pages
0.1 of this website:
IU/kg/hour EssentialIVcookies,
by continuous infusion.which arethe
Adapt
required in order to use the website;
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Contra-indications, adverse effects, precautions
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
See "Insulin: general information".
In the event of combination with intermediate-acting insulin, always prepare the mix in the syringe
immediately before administration and in the following order: first draw the short-acting
Settings insulin
Decline then
Accept
the intermediate-acting insulin.
Page 428/ 663
 Remarks
By IV route, insulin has a very short half-life of around 5 minutes and the effect disappears within 30
minutes of injection.

Storage
– Do not freeze.
Unopened vial: to be kept refrigerated (2 °C to 8 °C)
Opened vial: max. 4 weeks at below 25 °C and protected from light.

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Page 429/ 663

 INSULIN, BIPHASIC injectable
Prescription under medical supervision

Therapeutic action
Pancreatic antidiabetic hormone: combination of short-acting + intermediate acting insulin

Indications
Diabetes

Forms and strengths, route of administration

1000 IU vial containing a combination of 30% short-acting insulin + 70% intermediate-acting
insulin in suspension (100 IU/ml with a ratio of 30:70, 10 ml), for deep SC injection (abdomen, thigh,
buttock or arm), administered with a syringe calibrated in insulin units for U-100 insulin (100 IU/ml).
NEVER ADMINIST ER BY IV INJECT ION.

Dosage
Child and adult: one to 2 injections daily
Dosage must be individualised according to need. Adapt dose in the event of physical activity,
change in diet or infection.

Contra-indications, adverse effects, precautions

See "Insulin: general information".
Do not administer if known allergy to protamine.

Remarks
After removing vial from the refrigerator, leave to reach room temperature.
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Also comes in biphasic human insulin 30/70 cookies,
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Storage
time at "Settings".

– Do not freeze.
Unopened vial: to be kept refrigerated (2 °C to 8 °C)
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Page 430/ 663

 Opened vial: max. 4 weeks at below 25 °C and protected from light. Follow manufacturer’s
instructions

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Page 431/ 663

 ISOSORBIDE DINITRATE injectable
Last updated: August 2021

Prescription under medical supervision

Therapeutic action
Vasodilator, antianginal

Indications
Adjunctive therapy in acute heart failure (acute pulmonary oedema)

Forms and strengths, route of administration

10 mg in 10 ml ampoule (1 mg/ml), for slow IV injection or IV infusion in 5% glucose or 0.9% sodium
chloride

Dosage
Adult: 2 mg (= 2 ml) by slow IV injection (2 minutes) then, if necessary, 2 to 10 mg/hour by continuous
infusion with an electric syringe pump
Monitor blood pressure during administration. T he objective is to lower the systolic pressure to
120-150 mmHg and the diastolic pressure to under 110 mmHg.

Contra-indications, adverse effects, precautions

Do not administer to patients with obstructive cardiomyopathy, hypotension, shock, intracranial
hypertension or neurologic injury.
May cause:
orthostatic hypotension (especially in older patients), headache, nausea, flushing of the
face, haemolytic anaemia in patients with G6PD deficiency;
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use when using the website;
Avoid combination
performance cookies, whichor we
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thetolowest effective
generate dose
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websitetaking
use andanother nitrate
statistics; derivative, a
and marketing
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vasodilator, a diuretic or an antihypertensive drug (enhances hypotensive effects), and consent
which are used to display relevant content and advertising. If you choose "Accept all", you in olderto the
use ofpatients.
all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Do not combine with sildenafil or other drugs used for erectile dysfunction (risk
of severe hypotension, syncope and acute coronary syndrome).
Pregnancy and breast-feeding: avoid, use only if clearly needed (safety not established)
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Page 432/ 663

 Remarks
Injectable isosorbide dinitrate is not included in the WHO list of essential medicines.

Storage
Below 25 °C

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Page 433/ 663

 KETAMINE injectable
Prescription under medical supervision

Therapeutic action
General anaesthetic

Indications
Induction and maintenance of general anaesthesia

Forms and strengths, route of administration

250 mg in 5 ml ampoule (50 mg/ml) for IM, IV injection or infusion

Dosage
Child and adult:
Induction
IV: 2 mg/kg to be injected slowly. Anaesthesia is produced within one minute and lasts 10 to 15
minutes.
IM: 8 to 10 mg/kg. Anaesthesia is produced within 5 minutes and lasts 15 to 30 minutes.
Maintenance
IV: 0.5 to 1 mg/kg depending on recovery signs (approximately every 15 minutes)
IM: 5 mg/kg approximately every 20 to 30 minutes

Duration
Depending on duration of the operation

Contra-indications, adverse effects, precautions

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Doa not
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administer own and third-party
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with intraocular the pages of this website: Essential cookies, which are
pre-eclampsia.
required in order to use the website; functional cookies, which provide better easy of usecoronary
Administer with caution to patients with arterial or intracranial hypertension, when using the website;
insufficiency,
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
psychiatric disorders.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofMay cause: hypertension,
all cookies. You can accepthypersalivation, hallucinations
and reject individual cookie typesduring recovery
and revoke your(less frequent
consent for theinfuture
children or
at any
time when injected IM), apnoea following rapid IV injection.
at "Settings".
Premedication to prevent hypersalivation and hallucinations:
atropine IV: 0.01 to 0.015 mg/kg + diazepam slow IV: 0.1 mg/kg, during induction
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or

Page 434/ 663

 atropine IM: 0.01 to 0.015 mg/kg + diazepam IM: 0.1 mg/kg, 30 minutes before induction
Technical equipment for intubation and ventilation must be available and ready for use.
Pregnancy: no contra-indication, except in pre-eclampsia. For ceaserean sections, do not exceed
1 mg/kg by IV injection (risk of neonatal respiratory depression at higher doses).
Breast-feeding: no contra-indication

Remarks
Ketamine has no muscle relaxant properties.
In some countries, ketamine is on the list of narcotics: follow national regulations.
Also comes in 10 ml ampoule containing 500 mg (50 mg/ml).

Storage
– Below 25 °C

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Page 435/ 663

 LABETALOL injectable
Last updated: October 2024

Prescription under medical supervision

T his drug should only be used by well trained personnel in well-equipped hospitals.

Therapeutic action
Non cardioselective beta-blocker

Indications
Hypertension in pregnancy, in case of severe symptoms or when oral treatment is not possible

Forms and strengths, route of administration

100 mg ampoule (5 mg/ml, 20 ml) for IV injection

Dosage
Dosage should be adjusted according to blood pressure (BP). T he goal is to reduce the blood
pressure to 140/90 mmHg. Diastolic BP must not fall below 90 mmHg.
One dose of 20 mg (4 ml) over at least one minute. If hypertension remains uncontrolled 5 and 10
minutes after injection, administer another dose of 20 mg (4 ml). Administer additional doses of 40
mg (8 ml) then 80 mg (16 ml) at 10 minute intervals as long as hypertension is not controlled (max.
300 mg total dose).

Duration
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Do not administer to patients with asthma, chronic obstructive bronchopneumonia, heart failure,
severe hypotension, bradycardia < 50/minute, atrio-ventricular heart blocks, Raynaud's syndrome,
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May cause:
Page 436/ 663
 bradycardia, orthostatic hypotension, heart failure, bronchospasm, hypoglycaemia,
gastrointestinal disturbances, dizziness, headache, weakness, urinary retention;
abrupt fall in maternal blood pressure with placental hypoperfusion and foetal death when
administered too rapidly by IV injection or in case of overdose.
Administer with caution to patients with diabetes (risk of hypoglycaemia).
Reduce dosage in patients with renal impairment.
Do not exceed recommended dosage and administration rate. During administration, monitor
maternal BP and heart rate, as well as foetal heart rate.
In the event of anaphylactic shock, risk of resistance to epinephrine.
Avoid or monitor combination with: mefloquine, digoxin, amiodarone, diltiazem, verapamil (risk of
bradycardia); tricyclic antidepressants, neuroleptics, other anti- hypertensive drugs (risk of
hypotension).
Monitor the newborn: risk of hypoglycaemia, bradycardia, respiratory distress occurring most often
during the first 24 hours and until 72 hours after the birth.
In the event of hypotension, administer Ringer lactate to maintain diastolic BP ≥ 90 mmHg.
Breast-feeding: no contra-indication

Remarks
Labetalol IV is also used in the treatment of hypertensive crises with serious end-organ damage.

Storage
– Below 25 °C

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Page 437/ 663

 LEVETIRACETAM = LEV injectable
Last updated: October 2024

Prescription under medical supervision

During and after administration, have ventilation equipment (Ambu and mask) and solutions
for fluid replacement ready for use.

Therapeutic action
Antiseizure (anticonvulsant)

Indications
Second-line treatment of convulsive status epilepticus

Forms and strengths, route of administration

500 mg in 5 ml vial (100 mg/ml) for slow IV injection or IV infusion in 0.9% sodium chloride or
5% glucose
DO NOT ADMINIST ER T HE SOLUT ION UNDILUT ED BY IV INJECT ION. DO NOT ADMINIST ER
BY SC INJECT ION.

Dosage and duration

Loading dose:
Child 1 month and over:
Use diluted solution: add 3 ml (300 mg) of LEV to 17 ml of 0.9% NaCl to obtain 20 ml of
solution containing 15 mg of LEV per ml.
Administer 40 mg/kg (max. 3 g) over 10 minutes by IV infusion using a syringe pump or by very
slow IV injection.
If seizures
We use a selection of ourdoownnotand
stop after the
third-party end ofonthe
cookies thefirst
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of this half-dose:
website: Essential 20 which
cookies, mg/kgare
required in order
(max.to1.5
useg)theaswebsite;
above.functional cookies, which provide better easy of use when using the website;
performanceDo cookies, which we
not exceed theuse to generate
total dose ofaggregated
60 mg/kgdata on g.
or 4.5 website use and statistics; and marketing
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Adult:
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
60 mg/kg (max. 4.5 g) single dose over 15 minutes
time at "Settings".
Use diluted solution as above (15 mg/ml) if administered by IV infusion using a syringe pump.
Use undiluted solution if administered by IV infusion in a bag of 100 ml of 0.9% NaCl.
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In children and adult, do not exceed an infusion rate of 5 mg/kg/minute.

Page 438/ 663

 If maintenance treatment is indicated after the loading dose: change to oral route as soon as
possible.

Contra-indications, adverse effects, precautions

Administer with caution to patients with renal impairment (reduce dosage) or heart disorders.
May cause:
drowsiness, headache, asthenia, dizziness, behavioural disturbances;
haematologic disorders, gastrointestinal disturbances, cough, nasopharyngitis;
rarely: QT prolongation, hypersensitivity reactions sometimes severe;
respiratory depression and coma in the event of overdose.
Avoid or monitor the combination with:
mefloquine (reduced effect of LEV);
drugs that prolong the QT interval (antimalarials, antipsychotics, fluconazole, fluoroquinolones,
hydroxyzine, macrolides, ondansetron, etc.);
benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines
(hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased
sedation).
Pregnancy and breast-feeding: the risks linked to status epilepticus appear greater than risks
linked to LEV.

Remarks
Do not mix with other drugs in the same syringe or infusion.

Storage
– Below 25 °C

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Page 439/ 663

 LEVONORGESTREL subdermal implant
Prescription under medical supervision

Therapeutic action
Hormonal contraceptive, progestogen

Indications
Long-acting contraception

Forms and strengths, route of administration

Set of two flexible rods containing 75 mg of levonorgestrel, with a sterile applicator, to be inserted
subdermally into the inner side of the non-dominant arm, 6 to 8 cm above the elbow crease, under
local anaesthesia and aseptic conditions

Dosage
T he implant may be inserted at any moment of the cycle if it is reasonably certain the woman is not
pregnant, including when switching from another form of contraception.
Use condoms for 7 days following the insertion of the implant if it is inserted:
more than 7 days after the start of menstruation;
more than 28 days postpartum if not breastfeeding;
more than 7 days after an abortion.

Duration
As long as this method of contraception is desired and it is well tolerated, for max. 5 years (4 years
in obese women) after which it no longer provides contraception and must be changed.

Contra-indications, adverse effects, precautions

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Do innotorder to use the
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severe better easy
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using the website;
vaginal
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bleeding, active thromboembolic disorders.
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use ofMay cause: menstrual
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types and revoke your tenderness,
consent headache,
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time weight gain, itching, acne, mood changes, abdominal pain, gastrointestinal disturbances, allergic
at "Settings".
reactions.
Enzyme-inducing drugs (rifampicin, rifabutin, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital,
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phenytoin, carbamazepine, griseofulvin, etc.) reduce the effectiveness of the contraceptive.

Page 440/ 663

 Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Remarks
Fertility returns rapidly after removal of the implant.
T he duration of action of the levonorgestrel implant (5 years) is longer than that of the etonogestrel
implant (3 years). However, the etonogestrel implant (one rod) is easier to insert and remove than
the levonorgestrel implant (2 rods).
For the conditions for insertion or removal the implant, follow manufacturer’s instructions.

Storage
– Below 25 °C

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Page 441/ 663

 LIDOCAINE = LIGNOCAINE injectable
Prescription under medical supervision

Therapeutic action
Local anaesthetic

Indications
Local anaesthesia:
minor operations: 1% lidocaine
dental surgery: 2% lidocaine (plain or with epinephrine)

Forms and strengths, route of administration

1% solution in 20 and 50 ml vials (10 mg/ml), for SC infiltration
2% solution in 20 and 50 ml vials (20 mg/ml), for SC infiltration

Dosage
T he volume to be injected depends on the surface area to be anesthetised.
Do not exceed:
Child: 5 mg/kg/injection
Adult: 200 mg = 20 ml of lidocaine 1% or 10 ml of lidocaine 2%

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use ofOne injection,
all cookies. repeated
You if necessary.
can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Contra-indications, adverse effects, precautions
Do not administer if known allergy to lidocaine, impaired cardiac conduction.
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Page 442/ 663

 When anaesthetising the extremities, inject distally (at the base), in circle, without tourniquet and
without epinephrine (adrenaline).
Do not use lidocaine for the incision of abscesses: risk of spreading the infection.
Lidocaine with epinephrine (adrenaline):
in dental surgery, epinephrine added to lidocaine prolongs anaesthesia;
never use solutions with epinephrine for the anaesthesia of extremities (fingers, penile nerve
block): risk of ischemia and necrosis.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Anaesthesia is produced within 2 to 5 minutes and lasts 1 to 1.5 hours.
Do not confuse with lidocaine 5% hyperbaric which is reserved for spinal anaesthesia.
T he more concentrated the lidocaine, the more localised the anaesthetic effect.
To simplify protocols, use lidocaine 2% with epinephrine for dental anaesthesia and lidocaine 1%
without epinephrine for cutaneous anaesthesia.

Storage
– Below 25 °C

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Page 443/ 663

 MAGNESIUM SULFATE = MgSO4 injectable
Last updated: October 2024

Prescription under medical supervision

T his drug should only be used by well trained personnel in well-equipped hospitals. During
and after administration, have ventilation equipment (Ambu and mask), calcium gluconate
and solutions for fluid replacement ready for use.

Therapeutic action
Calcium antagonist, anticonvulsant

Indications
Severe pre-eclampsia: prevention of eclamptic seizures
Eclampsia: treatment of eclamptic seizures and prevention of recurrence

Forms and strengths, route of administration

5 g ampoule (0,5 g/ml, 10 ml) for IM injection or IV infusion

Dosage and duration

IV/IM protocol
4 g by IV infusion in 100 ml of 0.9% sodium chloride over 15 to 20 minutes then, 10 g by IM route (5 g in
each buttock) then, 5 g by IM route every 4 hours (changing buttock for each injection)

IV protocol
4 g by IV infusion in 100 ml of 0.9% sodium chloride over 15 to 20 minutes then 1 g per hour by
continuous IV infusion

WeRegardless of the
use a selection of protocol
our own andchosen:
third-party cookies on the pages of this website: Essential cookies, which are
Continue
required the
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use the website; hours after
functional the delivery
cookies, or thebetter
which provide last seizure.
easy of use when using the website;
performance cookies,
If seizures which
persist we useadminister
or recur, to generateaaggregated
further 2 gdata on website
(patients less use
thanand
70statistics;
kg) to 4 and
g bymarketing
IV infusion,
cookies, which are used to display relevant content and
without exceeding 8 g total dose during the first hour.advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Contra-indications, adverse effects, precautions
Reduce the dose in patients with renal impairment; do not administer to patients with severe renal
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impairment.

Page 444/ 663

 May cause:
pain at the injection site, warm flushes; decreased fetal heart rate;
in case of overdosage (hypermagnesaemia):
For the mother: diminished then absent patellar reflex (early sign), hypotension, drowsiness,
confusion, difficulty in speaking, bradycardia, respiratory depression (respiratory rate <
12/minute).
For the neonate (if the mother is treated for pre-eclampsia or eclampsia): hypotonia,
neurobehavioural impairment, apnoea, respiratory depression.
Do not combine with nifedipine.
Check urine output every hour. In the event of decreased urine output (< 30 ml/hour or 100 ml/4
hour), stop magnesium sulfate and perform delivery as soon as possible. If delivery cannot be
performed immediately in a woman with eclampsia, stop magnesium sulfate for one hour then
resume magnesium sulfate perfusion until delivery.
Check patellar reflex, blood pressure, heart and respiratory rate every 15 minutes during the first
hour of treatment. If no signs of overdosage are observed, continue this surveillance every hour. If
signs of overdosage are observed: stop magnesium sulfate and give 1 g calcium gluconate by slow
IV route as an antidote (in this event, seizures may recur).
Breast-feeding: no contra-indication

Remarks
Magnesium sulfate is also used as an adjunctive treatment in severe asthma attack in children and
adults: 40 mg/kg (max. 2 g) by IV infusion in 5 ml/kg of 0.9% of sodium chloride in children less than
20 kg and in 100 ml of 0.9% sodium chloride in children 20 kg and over and in adults, to be
administered over 20 minutes, using an infusion or a syringe pump.
Also comes in ampoules containing 1 g (0.5 mg/ml, 2 ml) and many other dosages. Check the
strength of the ampoule carefully before use.
1 g magnesium sulfate contains approximately 4 mmol (8 mEq) of magnesium.
Do not mix with other drugs in the same syringe or infusion fluid.

Storage
– Below 25 °C

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Page 445/ 663

 MEDROXYPROGESTERONE acetate
injectable
Last updated: October 2024

Prescription under medical supervision

Therapeutic action
Hormonal contraceptive, progestogen

Indications
Long-acting contraception
Long-term treatment of functional uterine bleeding

Forms and strengths, route of administration

150 mg in 1 ml vial (150 mg/ml) for IM injection

Dosage
Adolescent and adult: 150 mg every 3 months (13 weeks). Subsequent injections may be
administered up to 2 weeks before or 4 weeks after the scheduled date.
T he injection may be administered at any moment of the cycle if it is reasonably certain the woman
is not pregnant, including when switching from another form of contraception.
For contraception, use condoms for 7 days after the injection if it is administered:
more than 7 days after the start of menstruation;
more than 28 days postpartum if not breastfeeding;
more than 7 days after an abortion.

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Duration
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contraception: as long as this method of contraception is desired and well tolerated.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofLong-term
all cookies.treatment of functional
You can accept and rejectuterine bleeding:
individual cookie according to clinical
types and revoke your response.
consent for the future at any
time at "Settings".
Contra-indications, adverse effects, precautions
Do not administer to patients with breast cancer, severe hypertension (≥ 160/100),Decline
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thromboembolic disorders, uncontrolled or complicated diabetes, severe or recent
Page 446/ 663
 hepatic disease.
May cause: menstrual irregularities, amenorrhoea, menometrorrhagia, breast tenderness, headache,
weight gain, acne, mood change, abdominal pain, gastrointestinal disturbances.
T he contraceptive efficacy of medroxyprogesterone does not seem to be reduced in women
taking enzyme-inducing drugs.
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Remarks
Shake the vial vigorously before use to homogenise the suspension.
Return to fertility is delayed for 3 to 12 months after stopping injections.
Also comes in prefilled single-use injection system (104 mg/0.65 ml) for SC self-administration in the
abdomen or anterior thigh.

Storage
– Below 25 °C

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Page 447/ 663

 MELARSOPROL injectable
Last updated: December 2023

Prescription under medical supervision

Due to high toxicity and numerous adverse effects of melarsoprol, patients must be
treated in hospital, under close medical supervision.

Therapeutic action
Trypanocide (arsenical derivative)

Indications
Meningoencephalitic stage of African trypanosomiasis due to T. b. gambiense and T. b.
rhodesiense

Forms and strengths, route of administration

180 mg in 5 ml ampoule (36 mg/ml), 3.6 % solution in propylene glycol, for slow IV injection
DO NOT ADMINIST ER BY IM or SC INJECT ION.

Dosage and duration

Child and adult: 2.2 mg/kg (max. 5 ml) once daily for 10 days

Contra-indications, adverse effects, precautions

May cause:
reactive encephalopathy (5-10% of cases): repeated or prolonged seizures, coma, mental
disorders, usually between the 5th and the 8th day of treatment (but sometimes later, even after
the patient has been discharged);
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arsenical reactions: headache, fever, tachycardia, hypertension, jaw pain, neurological disorders
required in order to use the website; functional cookies, which provide better easy of use when using the website;
(hyperreflexia);
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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and advertising. dermatitis,
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anaemia your consent
in patients for the
with G6PD future at any
deficiency,
time at "Settings".
agranulocytosis), hepatic or renal impairment, myocardial damage;
swelling, pain, phlebitis, venous sclerosis, necrosis at injection site in the event of extravasation
Settings during IV administration. Decline Accept
As propylene glycol can dissolve plastic, syringes should be prepared just before injections.

Page 448/ 663

 Pregnancy: CONT RA-INDICAT ED

Remarks
Oral prednisolone is frequently associated during the course of treatment.
For the meningoencephalitic stage of gambiense trypanosomiasis, the treatment of choice is
nifurtimox + eflornithine (NECT ).

Storage
– Below 25 °C

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Page 449/ 663

 METHYLERGOMETRINE injectable
Prescription under medical supervision

Therapeutic action
Uterotonic, oxytocic

Indications
Postpartum haemorrhage due to uterine atony (preferably use oxytocin for this indication)

Forms and strengths, route of administration

0,2 mg in 1 ml ampoule ( 0,2 mg/ml), for IM injection

Dosage
Adult: 0,2 mg every 2 to 4 hours if necessary (max. 1 g)

Contra-indications, adverse effects, precautions

Do not administer during delivery or labour.
Do not administer in case of allergy to ergot alkaloids (cabergoline, bromocriptine, ergotamine,
etc.), severe hypertension, pre-eclampsia, eclampsia, and septicaemia.
Do not combine with another ergot alkaloid.
Administer with caution to patients with hepatic or renal impairment, ischemic disorders.
Do not administer simultaneously with prostaglandins or oxytocin (addition of uterotonic activity).
May cause: gastrointestinal disturbances, headache, paraesthesia, confusion, dizziness, tinnitus,
hypertension, peripheral vasoconstriction, chest pain.
Monitor combination with: metronidazole, azole antifungals, macrolides, protease inhibitors,
efavirenz, fluoxetine (risk of ergotism).
Pregnancy: CONT RA-INDICAT ED
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Breast-feeding:
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not confuse with dihydroergotamine, another ergot alkaloid used for totally different
at "Settings".
indications.
Methylergometrine is also called methylergonovine or methylergobasine.
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Ergometrine is another uterotonic used for the same indications.

Page 450/ 663

 Storage
– To be kept refrigerated (2 °C to 8 °C). Do not freeze.
Expiry date indicated on the label is only valid if stored under refrigeration and protected from light.
Exposure to heat and especially light causes the deterioration of the active ingredient and thus loss
of efficacy.
T he solution must be colourless. Discolouration indicated a deterioration of the active ingredient.
Never use a coloured solution.
If refrigeration is not available, vials can be kept for one month on condition that they are protected
from light and the temperature remains under 25 °C.

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Page 451/ 663

 METOCLOPRAMIDE injectable
Last updated: February 2024

Prescription under medical supervision

Do not exceed the recommended dose and duration of treatment (risk of serious
neurological adverse effects).

Therapeutic action
Antiemetic (dopamine antagonist)

Indications
Prevention or symptomatic treatment of nausea and vomiting in adults

Forms and strengths, route of administration

10 mg in 2 ml ampoule (5 mg/ml) for IM or slow IV injection (3 to 5 minutes)

Dosage
Adult: 10 mg every 8 hours if necessary

Duration
Change to oral treatment as soon as possible.

Contra-indications, adverse effects, precautions

Do not administer to children < 18 years or to patients with gastrointestinal haemorrhage,
obstruction or perforation.
Reduce
We use the dose
a selection of ourby halfand
own in third-party
patients with severe
cookies renal
on the impairment.
pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which
Administer with caution and monitor use in patients > 60 yearsprovide better
andeasy of usewith
patients whenepilepsy
using theorwebsite;
performance cookies,
Parkinson's which we use to generate aggregated data on website use and statistics; and marketing
disease.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
May cause: drowsiness, dizziness, confusion, extrapyramidal symptoms, seizures (especially in
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time patients with epilepsy), allergic reactions, cardiac disorders (hypotension, bradycardia, cardiac
at "Settings".
arrest); neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular disorders),
rare but requiring immediate treatment discontinuation.
Settings
Do not combine with levodopa (antagonism). Decline Accept

Page 452/ 663

 Avoid combination with CNS depressants (opioid analgesics, antipsychotics, sedatives,
antidepressants, antihistamines, etc.) and antihypertensive drugs (increased risk of hypotension).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
For postoperative nausea and vomiting in adults, efficacy of metoclopramide is limited:
ondansetron is preferred.

Storage
– Below 25 °C

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Page 453/ 663

 METRONIDAZOLE injectable
Prescription under medical supervision

Therapeutic action
Antiprotozoal, antibacterial

Indications
Severe infections due to anaerobic bacteria (Bacteroides sp, Clostridium sp, etc.)

Forms and strengths, route of administration

500 mg in 100 ml vial or bag (5 mg/ml), for infusion, to be administered over 30 minutes

Dosage
Child 1 month and over: 10 mg/kg every 8 hours (max. 1500 mg daily)
Adult: 500 mg every 8 hours

Duration
According to indication.
Change to oral treatment as soon as possible.

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to metronidazole or another nitroimidazole (tinidazole,
secnidazole, etc.).
Do not drink alcohol during treatment (antabuse reaction).
May cause: gastrointestinal disturbances, brownish urine, allergic reactions, headache, dizziness.
Monitor combination with anticoagulants (increased risk of haemorrhage), lithium, phenytoin and
We use a selection (increased
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of this website: Essential cookies, which are
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Administer with caution, reduce total daily dose to ⅓ and give better
onceeasy of use
daily when using
to patients thesevere
with website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
hepatic impairment.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofPregnancy: no contra-indication
all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Breast-feeding:
at "Settings". avoid (significantly excreted in milk)

Remarks
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Metronidazole is as effective by oral route as by parenteral route.
Page 454/ 663
 Do not add any drug in the infusion vial.

Storage
– Below 25 °C

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Page 455/ 663

 MIDAZOLAM injectable
Last updated: October 2024

Prescription under medical supervision

During and after administration, have ventilation equipment (Ambu and mask) and
solutions for fluid replacement ready for use.
For seizures, preferably use the buccal or intranasal route, especially in children.

Therapeutic action
Short-acting antiseizure (anticonvulsant), muscle relaxant, sedative-hypnotic, anxiolytic

Indications
First-line treatment of convulsive status epilepticus

Forms and strengths, route of administration

5 mg in 5 ml ampoule (1 mg/ml) and 50 mg in 10 ml ampoule (5 mg/ml), for administration
by buccal or intranasal route or IM injection
For buccal or intranasal administration, preferably use the 50 mg in 10 ml ampoule (5 mg/ml).
For IM injection, use only the 5 mg in 5 ml ampoule (1 mg/ml).

Dosage and duration

Child 1 month to 11 years:
Buccal or intranasal route: one dose of 0.2 to 0.3 mg/kg (0.04 to 0.06 ml/kg of the 5 mg/ml
solution or 0.2 to 0.3 ml/kg of the 1 mg/ml solution); max. 10 mg
IM injection: one dose of 0.15 to 0.2 mg/kg (0.15 to 0.2 ml/kg of the 1 mg/ml solution); max. 10
mg
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Page 456/ 663

 5 mg/ml solution 1 mg/ml solution

Age Weight
Buccal/ Buccal/ IM
intranasal route intranasal route injection

1 to < 4 months 3 to < 6 kg 0.25 ml 1 ml 0.6 ml

1.8 ml
4 to < 12 months 6 to < 10 kg 0.4 ml 1.2 ml
(max. 2 ml)

1 to < 3 years 10 to < 15 kg 0.6 ml – 2 ml

3 to < 5 years 15 to < 20 kg 1 ml – 3 ml

5 to < 9 years 20 to < 30 kg 1.2 ml – 4 ml

9 to < 12 years 30 to < 40 kg 2 ml – 6 ml

Child 12 years and over and adult:

Buccal or intranasal route: one dose of 10 mg (2 ml of the 5 mg/ml solution)
IM injection: one dose of 10 mg (10 ml of the 1 mg/ml solution)

In children and adults, if seizures do not stop 5 minutes after the first dose, readminister the same
dose, regardless of the route of administration. Do not administer more than 2 doses in total.

Buccal/intranasal administration technique

Buccal route:
Lay the patient on their side. Withdraw the required dose using a 1 ml or 2 ml syringe. Remove the
needle. Insert the tip of the syringe into the space between the gum and cheek. Administer the dose by
slowly pushing the syringe plunger.
Intranasal route:
Lay the patient on their back or side. Withdraw the required dose using a 1 ml or 2 ml syringe (add an
additional 0.1 ml to the calculated dose to account for the remaining liquid in the atomising device).
We use a selection
Remove of ourAttach
the needle. own and
thethird-party
intranasalcookies on the pages
atomisation deviceofto
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the Essential
syringe. Brisklycookies,
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syringe
required in order to use the website; functional cookies, which provide better easy of use when using the
plunger to spray the dose into the nostril. T he dose can be split in both nostrils to reduce irritation. website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Contra-indications, adverse effects, precautions
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Do not administer to patients with severe respiratory insufficiency or severe hepatic impairment.
Administer with caution to older patients and patients with renal or hepatic impairment.
May cause:
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pain at injection site; nasal irritation (if used intranasally);
Page 457/ 663
 hypotension, muscle weakness, ataxia, hypotonia, drowsiness, lethargy, confusional state;
respiratory depression and coma in the event of overdose.
Avoid or monitor in combination with:
opioid analgesics, antipsychotics, first-generation antihistamines (hydroxyzine, promethazine),
antidepressants, other antiseizure medications, etc. (increased sedation);
enzyme inducers such as rifampicin, rifabutin, nevirapine, phenobarbital, phenytoin,
carbamazepine, etc. (reduced effect of midazolam);
omeprazole, macrolides, ritonavir, isoniazid, fluconazole, itraconazole, etc. (increased
midazolam toxicity);
phenytoin (increased phenytoin toxicity).
Pregnancy and breast-feeding: avoid, except if vital (passage through the placenta and breast
milk)

Remarks
Midazolam is subject to international controls: follow national regulations.
Midazolam is also used as premedication prior to surgical procedures, for sedation in medical
procedures and intensive care, for induction of general anaesthesia, etc.
Do not mix with other drugs in the same syringe.

Storage
– Below 25 °C

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Page 458/ 663

 MORPHINE injectable
Last updated: October 2024

Prescription under medical supervision

During and after administration, have ventilation equipment (Ambu and mask), naloxone and
solutions for fluid replacement ready for use.

Therapeutic action
Centrally acting opioid analgesic

Indications
Severe pain, especially in surgery, trauma and neoplastic disease

Forms and strengths, route of administration

10 mg ampoule (10 mg/ml, 1 ml) for SC, IM or IV injection

Dosage
SC and IM route
Child over 6 months and adult: 0.1 to 0.2 mg/kg every 4 hours if necessary

IV route
Child over 6 months and adult: 0.1 mg/kg administered in fractionated doses (0.05 mg/kg every 10
minutes) every 4 hours if necessary

Duration
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Change to oral treatment as soon as possible.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not administer to patients with severe respiratory impairment or decompensated hepatic
at "Settings".
impairment.
May cause:
Settings dose-related sedation and respiratory depression, nausea, vomiting, constipation,
Decline
urinaryAccept
retention, confusion, raised intracranial pressure, pruritus;
Page 459/ 663
 in the event of overdose: excessive sedation, respiratory depression, coma.
Monitor patient closely for several hours after administration.
Administer with caution to patients with respiratory impairment, head injury, raised intracranial
pressure, uncontrolled epilepsy or urethroprostatic disorders.
In older patients and in patients with severe renal or hepatic impairment: reduce doses by half and
administer less frequently, according to clinical response (risk of accumulation).
Do not combine with opioid analgesics with mixed agonist-antagonist activity such as
buprenorphine, nalbuphine, pentazocine (competitive action).
Increased risk of sedation and respiratory depression, when combined with alcohol and drugs
acting on the central nervous system: benzodiazepines (diazepam, etc.), antipsychotics
(chlorpromazine, haloperidol, etc.), antihistamines (chlorphenamine, promethazine), phenobarbital,
etc.
Pregnancy and breast-feeding: no contra-indication. T he child may develop withdrawal
symptoms, respiratory depression and drowsiness when the mother receives morphine at the end
of the 3rd trimester and during breast-feeding. In these situations, administer with caution, for a
short period, at the lowest effective dose, and monitor the child.

Remarks
Administer an appropriate laxative (e.g. lactulose) if analgesic treatment continues more than 48
hours.
Morphine is on the list of narcotics: follow national regulations

Storage

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Page 460/ 663

 NALOXONE injectable
Last updated: November 2024

Prescription under medical supervision

Naloxone should be used in addition to assisted ventilation and by well trained personnel.
Closely monitor vital signs, in particular respiratory rate, during administration and for at
least 12 hours after respiratory function is restored.

Therapeutic action
Specific opioid antagonist

Indications
Respiratory depression induced by opioids (analgesia, anaesthesia, intoxication)

Forms and strengths, route of administration

0.4 mg in 1 ml ampoule (0.4 mg/ml) for IV, IM injection or infusion in sodium chloride 0.9% or glucose
5%

Dosage
IV route is preferred, use IM route if IV route is not feasible:
Child: 5 to 10 micrograms/kg by IV injection, repeated if necessary after 2 to 3 minutes, until
adequate spontaneous ventilation is restored, followed by a continuous infusion of 1 to 5
micrograms/kg/hour, or by 5 to 10 micrograms/kg by IM injection every 90 minutes
Adult: 1 to 3 micrograms/kg by IV injection, repeated if necessary after 2 to 3 minutes, until
adequate spontaneous ventilation is restored, followed by a continuous infusion of 1 to 5
micrograms/kg/hour,
We use orand
a selection of our own by 5third-party
to 10 micrograms/kg
cookies on theby IM injection
pages every Essential
of this website: 90 minutes
cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Duration cookies, which we use to generate aggregated data on website use and statistics; and marketing
performance
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofT all
he cookies.
durationYou can accept
of action and reject (20
of naloxone individual cookie types
to 30 minutes by IVand revoke
route) your consent
is shorter for the
than that offuture at any
opioids:
time administration
at "Settings". must be maintained several hours even if breathing improves.

Contra-indications, adverse effects, precautions

Settings Decline Accept
May cause:
Page 461/ 663
 tachycardia, fibrillation, hypertension, pulmonary oedema when given postoperatively, due to a
sudden reversal of analgesia;
nausea, vomiting;
acute withdrawal syndrome in opioid-dependent patients.
Administer with caution and reduce dosage in case of heart failure or coronary artery disease.
Naloxone is used in addition to assisted ventilation and must be administered under close medical
supervision.
Pregnancy: risks linked to respiratory depression appear greater than risks linked to naloxone.
Breast-feeding: no contra-indication

Remarks
Naloxone is a specific opioid antidote. It cannot be used to antagonise the effects of other drugs
producing CNS or respiratory depression.
Efficacy in antagonising opioid effects depends not only on the dose of naloxone but also on the
dose and potency of the specific opioid involved.

Storage
– Below 25 °C

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Page 462/ 663

 NOREPINEPHRINE tartrate = NEP =
NORADRENALINE tartrate injectable
Last updated: September 2023

Prescription under medical supervision

T his drug should only be used by well trained personnel in well-equipped hospitals.

Therapeutic action
Sympathomimetic

Indications
Acute hypotension despite fluid therapy in shock (in children, preferably use epinephrine for this
indication)

Forms and strengths, route of administration

8 mg of norepinephrine tartrate in 4 ml ampoule (2 mg/ml), equivalent to 4 mg of norepinephrine
base in 4 ml (1 mg/ml), for IV infusion

Dosage
T he doses are expressed as norepinephrine tartrate and intended for peripheral IV administration only.
Use diluted solution in 0.9% sodium chloride (NaCl 0.9%) or 5% glucose (G5%) or Ringer lactate
(RL):
Child under 40 kg: add 1 ml (2 mg of NEP tartrate) to 39 ml of NaCl 0.9%, G5% or RL to obtain
a 0.05 mg/ml (50 micrograms/ml) solution
Child 40 kg and over and adult: add 2 ml (4 mg of NEP tartrate) to 38 ml of NaCl 0.9%, G5% or
We use aRL selection of our
to obtain ownmg/ml
a 0.1 and third-party cookies on thesolution
(100 micrograms/ml) pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Administer by continuous IV infusion using an infusion or syringe pump:
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, Child
whichand adult:to0.1
are used microgram/kg/min,
display relevant content increase if necessary
and advertising. by 0.05"Accept
If you choose micrograms/kg/min every
all", you consent to the
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You canthe first and
accept hour,reject
thenindividual
every hour (max.types
cookie 1 microgram/kg/min)
and revoke your consent for the future at any
time at "Settings".
Once desired response is achieved, discontinue gradually, in decrements of 0.05
micrograms/kg/min every hour. Do not discontinue abruptly.
T he infusion rate is calculated as follows: [desired dose (microgram/kg/min) x weight (kg) x 60 min] ÷
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concentration (microgram/ml).

Page 463/ 663

 Example, for a child 20 kg, dose 0.1 microgram/kg/min, solution concentration 50 micrograms/ml:

NEP dose (microgram/kg/min) 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45 0.5

Infusion rate (ml/hour) 2.4 3.6 4.8 6 7.2 8.4 9.6 10.8 12

Contra-indications, adverse effects, precautions

Administer with caution to patients with hypertension, hypotension due to volume depletion (except
as an emergency measure), thrombosis, hyperthyroidism and to older patients.
May cause: arrhythmia, hypertension, agitation, headache; tissue necrosis following extravasation
(use a large vein for IV administration).
Pregnancy and breast-feeding: no contra-indication

Remarks
Norepinephrine is colourless: discard any ampoules with a pink or brownish colour.

Storage
– Below 25 °C

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 OMEPRAZOLE injectable
Prescription under medical supervision

Therapeutic action
Antiulcer drug (proton pump inhibitor)

Indications
Peptic ulcer perforation

Forms and strengths, route of administration

Powder for injection, 40 mg vial, to be dissolved in 100 ml of 0.9% sodium chloride or 5% glucose,
for IV infusion

Dosage
Adult: 40 mg once daily to be administered over 20 to 30 minutes

Duration
Change to oral treatment as soon as the patient can eat.

Contra-indications, adverse effects, precautions

May cause: headache, diarrhoea, skin rash, nausea, abdominal pain, dizziness.
Avoid combination with itraconazole and ketoconazole (decreases efficacy of these drugs).
Monitor combination with warfarin, digoxin, phenytoin.
Do not exceed 20 mg daily in patients with severe hepatic impairment.
Pregnancy: no contra-indication
Breast-feeding: avoid, administer only if clearly need
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Onlywhich are used
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or 5% and advertising.
glucose for dilution.If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Injectable omeprazole is not included in the WHO list of essential medicines.
time at "Settings".

Storage
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– Below 25 °C

Page 465/ 663

 ONDANSETRON injectable
Prescription under medical supervision

Therapeutic action
Antiemetic (serotonin 5-HT 3 receptor antagonist)

Indications
Prevention of post-operative nausea and vomiting in children
Treatment of post-operative nausea and vomiting

Forms and strengths, route of administration

4 mg ampoule (2 mg/ml, 2 ml) for slow IV injection (3 to 5 minutes)

Dosage and duration

Prevention of post-operative nausea and vomiting
Child over 1 month: 0.1 mg/kg at the end of surgery (max. 4 mg per injection)

Treatment of nausea and vomiting

Child over 1 month:
No prophylactic dose of ondansetron received: 0.1 mg/kg every 8 hours if necessary
Prophylactic dose of ondansetron received and late postoperative vomiting (≥ 6 hours after
surgery): 0.1 mg/kg every 6 hours if necessary
Do not exceed 4 mg per injection and 3 injections per 24 hours.
Adult: 4 mg every 8 hours if necessary (max. 3 injections per 24 hours)

Contra-indications, adverse effects, precautions

Do not administer to children less than 1 month of age.
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disorders, QT interval prolongation, extrapyramidal reactions, seizures, cutaneous allergic reactions
(Lyell’s and Stevens-johnson syndromes).
Avoid or monitor combination with:
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Page 466/ 663

 drugs that prolong the QT interval: amiodarone, bedaquilline, chloroquine, co-artemether,
erythromycin, fluconazole, haloperidol, moxifloxacin, mefloquine, pentamidine, quinine, etc.;
serotonergics: fluoxetine, paroxetine, tricyclic antidepressants, etc.;
enzyme inducers: rifampicin, rifabutin, nevirapine, ritonavir, phenobarbital, phenytoin,
carbamazepine, griseofulvin, etc. (efficacy of ondansetron reduced);
tramadol (antalgic effect reduced).
Pregnancy: avoid during the first trimester; not recommended for nausea and vomiting of
pregnancy
Breast-feeding: not recommended

Storage
– Below 25 °C

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Page 467/ 663

 OXYTOCIN injectable
Prescription under medical supervision

Therapeutic action
Synthetic oxytocic

Indications
Induction and augmentation of labour in the event of dynamic dystocia
Postpartum haemorrhage due to uterine atony
Prevention of postpartum haemorrhage, after vaginal delivery or caesarean section

Forms and strengths, route of administration

10 IU in 1 ml ampoule (10 IU/ml) for IM or slow IV injection or infusion

Dosage
Induction and augmentation of labour
Dilute 5 IU in 500 ml or 10 IU in 1 litre of Ringer lactate or 0.9% sodium chloride to obtain a solution of
10 milliunits per ml. Start an infusion of 5 drops/minute, then increase by 5 drops/minute every 30
minutes (max. 60 drops/minute) until efficient contractions are obtained (3 to 4 contractions lasting 40
seconds over 10 minutes).

Treatment of postpartum haemorrhage due to uterine atony

20 IU in 1 litre of Ringer lactate or 0.9% sodium chloride, administered over 2 hours (160 drops/minute).
Simultaneously, 5 to 10 IU by slow IV injection, to be repeated if necessary until the uterus is retracted
(max. total dose 60 IU).

Prevention of postpartum haemorrhage (vaginal delivery)

We use10
5 to a selection
IU by slowof our own
IV or IM and third-party
injection before cookies on the
or after thepages of this
delivery website: Essential cookies, which are
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can accept cord clamping,
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individual 20 UItypes
cookie in 1 litre of Ringer
and revoke yourlactate
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the future at any
chloride,
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at "Settings".

Duration
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According to clinical response
Page 468/ 663
 Contra-indications, adverse effects, precautions
Do not administer by rapid IV injection (risk of hypotension with flushing and reflex tachycardia,
uterine hypertonia and/or rupture, foetal distress).
During labour:
Do not administer to patients with history of two caesarean sections or more.
Administer with caution and do not exceed 30 drops/minute in patients with history of single
caesarean section and in grand multipara (risk of uterine rupture).
Respect the dosage and rate of administration, monitor uterine contractility and foetal heart
rate.
May cause: nausea, vomiting, heart rhythm disorders.
Do not administer simultaneously with prostaglandins. Only administer oxytocin 6 hours after the
last administration of prostaglandins.

Storage
– To be kept refrigerated (2 °C to 8 °C). Do not freeze.
Expiry date indicated on the label is only valid if stored under refrigeration and protected from light.
Exposure to light and heat causes the deterioration of the active ingredient and thus loss of
efficacy.
If refrigeration is not available, ampoules kept below 25 °C and protected from light may be s tored
for a maximum of one month.

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 PARACETAMOL = ACETAMINOPHEN
injectable
Last updated: February 2024

Prescription under medical supervision

Do not exceed indicated doses, especially in children and older patients. Paracetamol
intoxications are severe (hepatic cytolysis).

Therapeutic action
Analgesic, antipyretic

Indications
Very high fever, only when oral administration is not possible
Mild pain, only when oral administration is not possible

Forms and strengths, route of administration

500 mg (10 mg/ml, 50 ml) and 1 g (10 mg/ml, 100 ml) vials, for infusion

Dosage
Neonate: 7.5 mg/kg (0.75 ml/kg) every 6 hours, to be administered over 15 minutes (max. 30 mg/kg
daily)
Child ≥ 1 month and < 10 kg: 10 mg/kg (1 ml/kg) every 6 hours, to be administered over 15 minutes
(max. 30 mg/kg daily)
Patient ≥ 10 kg and < 50 kg: 15 mg/kg (1.5 ml/kg) every 6 hours, to be administered over 15 minutes
(max. 60 mg/kg daily)
We use a selection
Patient ≥ 50 of
kg:our
1 gown and
(100 ml)third-party cookiestoonbethe
every 6 hours, pages of this over
administered website: Essential(max.
15 minutes cookies,
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Duration
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time According to clinical response.
at "Settings".
Change to oral route as soon as possible.

Contra-indications,
Settings adverse effects, precautions Decline Accept

Page 470/ 663

 Do not administer to patients with severe hepatic impairment.
Administer with caution to patients with moderate hepatic impairment, severe renal impairment,
chronic alcoholism, malnutrition, dehydration.
May cause (very rarely): malaise, hypotension and rash.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
As the efficacy of IV paracetamol is not superior to the efficacy of oral paracetamol, the IV route
is restricted to situations where oral administration is not possible.
For mild pain, IV paracetamol is used alone or in combination with an NSAID administered
parenterally.
For moderate pain, IV paracetamol is used in combination with an NSAID and tramadol
administered parenterally.
For severe pain, IV paracetamol is used in combination with an NSAID and morphine administered
parenterally.
Paracetamol has no anti-inflammatory properties.
Do not mix with other drugs in the same infusion bottle.

Storage
– Below 25 °C

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Page 471/ 663

 PENICILLIN G injectable
See BENZYLPENICILLIN injectable

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Page 472/ 663

 PENTAMIDINE injectable
Last updated: November 2024

Prescription under medical supervision

Due to the numerous and potentially severe adverse effects of pentamidine, patients
should be kept under close surveillance.

Therapeutic action
Antiprotozoal active against Pneumocystis jiroveci (carinii)

Indications
Second-line treatment of pneumocystosis, in the event of contra-indication, intolerance or
unresponsiveness to co-trimoxazole

Forms and strengths, route of administration

Powder for injection, 200 mg and 300 mg vials, to be dissolved in 10 ml water for injection, for IM
injection or infusion in 250 ml of 5% glucose

Dosage and duration

Child and adult: 4 mg/kg once daily by IM injection or infusion (60 minutes minimum) for 14 to 21
days

Contra-indications, adverse effects, precautions

Do not administer to patients with severe renal impairment.
Reduce dosage in patients with renal impairment.
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May cause:
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arrhythmia, torsades de pointes, hypoglycaemia followed by hyperglycaemia.
Do not combine with drugs inducing torsades de pointes: anti-arrhythmics, neuroleptics, tricyclic
antidepressants, IV erythromycin, halofantrine, etc.
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Page 473/ 663

 Avoid combination with: mefloquine, cardiac glycosides, azole antifungals, drugs inducing
hypokalaemia (diuretics, glucocorticoids, injectable amphotericin B, etc.).
Administer on a empty stomach, keep the patient supine during injection and 30 minutes after.
Monitor blood pressure, blood glucose level, serum creatinine level, blood counts.
Pregnancy and breast-feeding: CONT RA-INDICAT ED, except if vital and there is no therapeutic
alternative.

Remarks
For the prophylaxis of pneumocystosis, pentamidine may be used by inhalation of nebulised
solution using suitable equipment.
Pentamidine is also used in the treatment of African trypanosomiasis and leishmaniasis.

Storage
– Below 25 °C
Once reconstituted, solution keeps for 24 hours maximum, between 2 °C to 8 °C.

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 PHENOBARBITAL = PB injectable
Last updated : October 2024

Prescription under medical supervision

During and after administration, have ventilation equipment (Ambu and mask) and solutions
for fluid replacement ready for use.

Therapeutic action
Antiseizure (anticonvulsant), sedative

Indications
Second-line treatment of convulsive status epilepticus

Forms and strengths, route of administration

200 mg in 1 ml ampoule (200 mg/ml) for IV infusion in 0.9% sodium chloride
DO NOT ADMINIST ER BY DIRECT IV INJECT ION. DO NOT ADMINIST ER T HE SOLUT ION
UNDILUT ED.
DO NOT ADMINIST ER BY SC INJECT ION (risk of necrosis).

Dosage and duration

Loading dose:
Child 1 month and over:
Use diluted solution: add 1 ml (200 mg) of PB to 9 ml of 0.9% NaCl to obtain 10 ml of
solution containing 20 mg of PB per ml.
Administer 20 mg/kg (max. 1 g) over 20 minutes by IV infusion using a syringe pump (or only if
not available, using a pediatric infusion set).
If seizures
We use a selection of ourdo notand
own stop after the
third-party end ofonthe
cookies thefirst
pagesdose, readminister
of this half dose:
website: Essential 10 mg/kg
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Adult:
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15 mg/kg (max. 1 g) single dose over 15 minutes
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Use diluted solution as above (20 mg/ml) if administered by IV infusion using a syringe pump.
time at "Settings".
Use undiluted solution if administered by IV infusion in a bag of 100 ml of 0.9% NaCl.
Do not exceed an infusion rate of 1 mg/kg/minute in children and 100 mg/minute in adults.
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Page 475/ 663

 If maintenance treatment is indicated after the loading dose: change to oral route as soon as
possible.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe impairment of respiratory, renal or hepatic function (risk
of accumulation).
Administer with caution in children, older patients and patients with mild to moderate impairment of
respiratory, renal or hepatic function.
May cause :
drowsiness, dizziness, headache, behavioural disturbances;
dose-dependant respiratory depression;
hypotension, apnoea, laryngospasm, shock, especially if administered rapidly by IV route and if
large doses are administered;
haematologic disorders, gastrointestinal disturbances;
hypersensitivity reactions sometimes severe;
coma in the event of overdose.
Monitor closely respiratory rate and blood pressure during and after administration.
Avoid or monitor the combination with:
mefloquine (reduced effect of PB);
benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines
(hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased
sedation).
Use with extreme caution with benzodiazepines and opioids analgesics (increased risk of
respiratory depression).
PB may reduce the effect of many drugs:
diazepam, midazolam, antimicrobials, some antiretrovirals, corticosteroids, tricyclic
antidepressants, itraconazole, direct-acting antivirals for chronic hepatitis C, warfarin,
etc. Adjust dosage if necessary.
implants and oral contraceptives: use condoms until next menstruation.
Pregnancy and breast-feeding: prefer a safer drug (levetiracetam). If PB is the only option, the
risks linked to status epilepticus appear greater than risks linked to PB.

Remarks
PB is subject to international controls: follow national regulations.
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Do not mix with other drugs in the same syringe or infusion.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Storage
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Below 25 °C

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Page 476/ 663

 PHENYTOIN = PHT injectable
Last updated: October 2024

Prescription under medical supervision

T his drug should only be used by well-trained personnel in well-equipped hospitals.

During and after administration have ventilation equipment (Ambu and mask) and
solutions for fluid replacement ready for use.

Therapeutic action
Antiseizure (anticonvulsant)

Indications
Second-line treatment of convulsive status epilepticus

Forms and strengths, route of administration

250 mg in 5 ml ampoule or vial (50 mg/ml), for IV route only, to be administered through a large
central or peripheral vein.
Dilute the solution in 0.9% sodium chloride only. DO NOT DILUT E IN GLUCOSE.
For administration use a infusion set or line with a 0.2 micron filter.
DO NOT ADMINIST ER BY RAPID IV INJECT ION.

Dosage and duration

Loading dose:
Child and adult: 20 mg/kg (max. 2 g) single dose

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 Patients Mode of administration Duration of infusion Max. rate

Children ≥ 1 month Use diluted solution: add 1 ml 20 min 1 mg/kg/min

and ≤ 25 kg (50 mg) of PHT to 9 ml of 0.9%
NaCl to obtain 10 ml of solution
containing 5 mg of PHT per ml.
Administer by IV infusion using a
(a)
syringe pump .

Children > 25 kg Add undiluted solution to a 100 ml ≤ 1 g or ≤ 50 kg: 20 min 50 mg/min

and adults bag of 0.9% NaCl. Administer by
IV infusion. > 1 g and ≤ 1.5 g or > 50
kg and ≤ 75 kg: 30 min

> 1.5 g and ≤ 2 g or > 75

kg and ≤ 100 kg: 40 min

Older patients Add undiluted solution to a 100 ml ≤ 1 g or ≤ 50 kg: 40 min 25 mg/min

(≥ 65 years) bag of 0.9% NaCl​​. Administer by
and adults with IV infusion. > 1 g and ≤ 1.5 g or > 50
cardiac disorders kg and ≤ 75 kg: 60 min

> 1.5 g and ≤ 2 g or > 75

kg and ≤ 100 kg: 80 min

a Or only if syringe pump is not available, use a paediat ric inf usion set .

If maintenance treatment is indicated after the loading dose: change to oral route as soon as
possible.

Contra-indications, adverse effects, precautions

Do not administer to patients with bradycardia or atrioventricular block.
Administer with caution in patients with hepatic impairment (reduce dosage), heart failure, cardiac
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to use the website; functional cookies, which provide better easy of use when using the website;
May cause:
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at injection content and advertising.
necrosis If you
in the event of choose "Accept all", you consent to the
extravasation;
use of alldrowsiness,
cookies. Youdizziness,
can accept headache,
and reject individual cookie
behavioural types and revoke your consent for the future at any
disturbances;
time at "Settings".
hypotension, bradycardia, conduction disorders, when injected too rapidly;
gastrointestinal disturbances (nausea, vomiting), hepatotoxicity;
Settings haematologic disorders and hypersensitivity reactions sometimes severe; Decline Accept
cardiac complications and coma in the event of overdose.
Page 478/ 663
 Closely monitor heart rate and blood pressure during and after administration. Reduce the infusion
rate in the event of bradycardia or drop in blood pressure.
Avoid IV placement in the hand, foot or wrist. Closely monitor injection site, during and after
administration, in particular in:
older or very young patients (fragile veins),
patients with cardiovascular disease.
Before and after infusion, flush the catheter with 0.9% NaCl to limit venous irritation and potential
incompatibility with other drugs.
Avoid or monitor the combination with:
rifampicin, mefloquine (reduced effect of PHT );
sulfonamides, chloramphenicol, fluconazole, isoniazid, fluoxetine, omeprazole (increased PHT
toxicity);
benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines
(hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased
sedation).
PHT may reduce the effect of many drugs:
diazepam, midazolam, digoxin, corticosteroids, antimicrobials, some antiretrovirals,
itraconazole, warfarin, etc. Adjust dosage if necessary.
implants and oral contraceptives: use condoms until next menstruation.
Pregnancy and breast-feeding: prefer a safer drug (levetiracetam). If PHT is the only option, the
risks linked to status epilepticus appear greater than risks linked to PHT.

Remarks
Do not mix with other drugs in the same syringe or infusion.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 479/ 663

 PHYTOMENADIONE = VITAMIN K1 injectable
Last updated: March 2024

Prescription under medical supervision

Therapeutic action
Vitamin, anti-haemorrhagic

Indications
Prophylaxis and treatment of haemorrhagic disease of the newborn

Forms and strengths, route of administration

2 mg ampoule (10 mg/ml, 0.2 ml), for oral administration, IM or slow IV injection

Dosage
Prophylaxis of haemorrhagic disease of the newborn
By IM route, the day of birth:
Neonate < 1.5 kg: 0.5 mg single dose
Neonate ≥ 1.5 kg: 1 mg single dose
Treatment of haemorrhagic disease of the newborn
By IM or slow IV route:
1 mg every 8 hours if necessary, depending on clinical evolution and coagulation tests results

Contra-indications, adverse effects, precautions

May cause: allergic reactions, especially by IV route; haematoma at IM injection site.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Alsowhich
cookies, comesare in 10 to
used mgdisplay
ampoules (10 content
relevant mg/ml, and
1 ml) for use inIfadults
advertising. only (treatment
you choose of you
"Accept all", haemorrhage
consent to the
use ofdue
all to
cookies. You can
antivitamin K accept
agents,and reject
etc.) . individual cookie types and revoke your consent for the future at any
time at "Settings".
Vitamin K1 is also used as prophylaxis for neonatal hypoprothrombinemia in mothers treated with
enzyme-inducing antituberculosis drugs (rifampicin, rifabutin) during pregnancy. Use 10 mg
ampoules (10 mg/ml, 1 ml): administer 10 mg/day of vitamin K1 by oral route for 15Decline
Settings days before
Accept

Page 480/ 663

 birth. T his maternal prevention does not change the need for IM administration of vitamin K1 in
neonates.
Do not dilute or mix with other drugs in the same syringe.

Storag
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 481/ 663

 POTASSIUM CHLORIDE 15% = KCl 15%
injectable
Last updated: February 2024

Prescription under medical supervision

T his drug should only be used by well-trained personnel in well-equipped hospitals.

Indications
Treatment of severe hypokalaemia (arrhythmia, marked muscular weakness and/or serum
potassium level ≤ 2.5 mmol/litre)

Forms and strengths, route of administration

Ampoule containing 15% potassium chloride hypertonic solution (150 mg/ml, 10 ml = 2 mmol/ml),
i.e. 1.5 g of potassium chloride (KCl) per 10 ml ampoule
Ionic composition:
potassium (K+): 20 mmol per 10 ml ampoule (20 mEq)
chloride (Cl–): 20 mmol per 10 ml ampoule (20 mEq)
Check concentration before use: potassium chloride also comes in ampoules containing 7.5%,
10%, 11.2% and 20% solutions.
Potassium chloride must always be administered by slow IV infusion, diluted in 0.9% sodium
chloride.
For dilution:
T he potassium concentration in the infusion fluid should not exceed 40 mmol/litre.
Mix thoroughly the potassium and the 0.9% sodium chloride solution by inverting at least 5
times the infusion bottle or bag.
NEVER USE BY DIRECT UNDILUT ED IV OR IM OR SC INJECT ION.
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Dosagewhich are used
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time at "Settings".
Child over one month: 0.2 mmol/kg/hour for 3 hours
Each mmol of potassium is diluted in 25 ml of 0.9% sodium chloride.
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Page 482/ 663

 0.2 (mmol) x 10 (kg) = 2 mmol/hour x 3 hours = 6 mmol
10 kg 6 mmol (= 3 ml of 15% KCl solution) diluted in 150 ml of NaCl 0.9% and administered
over 3 hours

0.2 (mmol) x 15 (kg) = 3 mmol/hour x 3 hours = 9 mmol

15 kg 9 mmol (= 4.5 ml of 15% KCl solution) diluted in 225 ml of NaCl 0.9% and administered
over 3 hours

Adult: 40 mmol (= 2 ampoules of 10 ml of 15% KCl) in one litre of 0.9% sodium chloride, to be
administered over 4 hours

Do not exceed 10 mmol/hour. T he infusion may be repeated if severe symptoms persist or if the serum
potassium level remains < 3 mmol/litre.

Contra-indications, adverse effects, precautions

Administer with caution to older adults.
Administer with caution and reduce the dose in patients with renal impairment (increased risk of
hyperkalaemia).
May cause:
pain at infusion site, venous irritation and phlebitis (use a large peripheral vein to reduce these
risks);
in the event of too rapid administration or overdose: hyperkalaemia, cardiac conduction and
rhythm disorders, potentially fatal;
in the event of extravasation: necrosis.
Monitor closely:
infusion rate; use an infusion pump or syringe pump if possible to prevent unintentional bolus;
infusion site for redness and inflammation.
Monitor electrolytes if possible to determine the need for further infusions and to avoid
hyperkalaemia.

Remarks
Higher dose or infusion rate requires continuous electrocardiogram monitoring.
Potassium chloride is also used to prevent hypokalaemia in patients unable to meet their daily
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requirements own
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route cookies on theare
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Storage
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Page 483/ 663

 PROMETHAZINE injectable
Last updated: April 2024

Prescription under medical supervision

Therapeutic action
Sedating H1 antihistamine

Indications
Agitation or aggressive behaviour in patients with acute or chronic psychosis, in combination with
haloperidol

Forms and strengths, route of administration

50 mg in 2 ml ampoule (25 mg/ml) for deep IM injection.
NEVER ADMINIST ER BY SC INJECT ION.

Dosage and duration

Adult: 25 mg, to be repeated after 30 minutes if necessary. If no response 30 minutes after the
second dose, administer 50 mg (total dose max. 100 mg).

Contra-indications, adverse effects, precautions

Administer with caution and monitor use:
in older patients;
in patients with prostate disorders, closed-angle glaucoma, epilepsy, orthostatic hypotension,
severe renal or hepatic impairment;
in patients taking central nervous system depressants (opioid analgesics, antipsychotics,
sedatives, antidepressants, etc.) or drugs known to have an anticholinergic effect (atropine,
amitriptyline, chlorpromazine, etc.).
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mouth, cookieblurred
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micturition);
tissue damage, including necrosis;
Settings rarely: seizures, extrapyramidal syndrome, neuroleptic malignant syndrome (unexplained
Decline Accept
hyperthermia with neuromuscular disorders), allergic reactions.
Page 484/ 663
 Pregnancy and breast-feeding: avoid

Remarks
Promethazine by IV route should only be used in intensive care unit, at a max. concentration of 1
mg/ml by infusion over 20 minutes using a central catheter or a large bore peripheral catheter (risk
of necrosis and peripheral gangrene).
Promethazine is not included in the WHO list of essential medicines.

Storage
– Below 25 °C

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Page 485/ 663

 PROTAMINE injectable
Last updated: August 2022

Prescription under medical supervision

Therapeutic action
Neutralisation of the anticoagulant action of unfractionated heparin
Partial neutralisation of the anticoagulant action of low molecular weight heparin

Indications
Haemorrhagic syndromes resulting from accidental heparin overdosage

Forms and strengths, route of administration

50 mg protamine sulfate in 5 ml ampoule (10 mg/ml) for slow IV injection
Concentration may be expressed in antiheparin units (AHU): 1000 AHU = 10 mg.

Dosage
Depends on the amount of heparin to be neutralised.

Heparin overdosage
If administered between 0 and 30 minutes after the heparin injection, 1 mg of protamine sulfate
(100 AHU) neutralises 100 units of heparin.
If more than 30 minutes have elapsed since the heparin injection, the dose of protamine to be given
should be one half the dose of heparin injected.
Do not administer more than 50 mg per dose

Enoxaparin overdosage

Time since last enoxaparin dose Protamine dose

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> 12 hours May not be required

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Do not administer more than 50 mg per dose.

Page 486/ 663

 Duration
According to clinical response. Monitor coagulation parameters.

Contra-indications, adverse effects, precautions

May cause: hypotension, bradycardia and dyspnoea; allergic reactions, notably in diabetics treated
by protamine-insulin.
If excessive doses are used, haemorrhage may persist or reappear, as protamine sulfate itself has
some anticoagulant activity.
Administer by very slow IV (over 10 minutes) in order to reduce risks of hypotension and
bradycardia.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Anticoagulant effect of protamine may vary according to the origin of the heparin: follow
manufacturer's recommendations.
Protamine sulfate may be used to neutralize the effect of heparin before surgery.

Storage
– To be kept refrigerated (2 °C to 8 °C)

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Page 487/ 663

 SODIUM BICARBONATE 8.4% injectable
Last updated: October 2024

Prescription under medical supervision

Indications
Severe metabolic acidosis

Forms and strengths

10 ml ampoule

Composition
Sodium bicarbonate: 8.4 g per 100 ml
Hypertonic solution
Ionic composition:
sodium (Na+): 10 mmol (10 mEq) per 10 ml ampoule
bicarbonate: 10 mmol (10 mEq) per 10 ml ampoule

Contra-indications, adverse effects, precautions

Do not use in case of alkalosis or respiratory acidosis.
Do not administer hypertonic solutions by IM or SC route. Administer under close medical
supervision, by slow direct IV injection diluted in 5% glucose or by continuous infusion in 5%
glucose.
Do not add: penicillins, chloramphenicol, aspirin, atropine, calcium, insulin, vitamins, etc. to sodium
bicarbonate solution.

Remarks
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Contains
required a to
in order high
useconcentration of bicarbonate
the website; functional cookies, and sodium
which provideions. Itseasy
better use of
is rarely
use whenjustified
using in
thecase of
website;
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cookies, which caused
we usebyto dehydration. Inaccurate
generate aggregated data onadministration
website use and may induceand
statistics; hypernatraemia
marketing
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and hypokalaemia. to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Storage
time at "Settings".

Below 25 °C
Settings Decline Accept

Page 488/ 663

 STREPTOMYCIN injectable
Last updated: September 2022

Prescription under medical supervision

Given the risk of renal and auditory toxicity, do not prolong treatment unnecessarily.

Therapeutic action
Antibacterial (group of aminoglycosides)

Indications
Alternative to gentamicin in plague
Brucellosis, in combination with doxycycline

Forms and strengths, route of administration

Powder for injection, vial containing 1 g of streptomycin base, to be dissolved in 3.2 ml of water for
injection to obtain a 250 mg/ml solution, for IM injection.
DO NOT ADMINISTER BY IV INJECTION.

Dosage
Plague
Child: 15 mg/kg (max. 1 g) every 12 hours
Adult: 1 g every 12 hours

Brucellosis
Adult: 1 g once daily

Duration
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Plague: to use
10 to the website; functional cookies, which provide better easy of use when using the website;
14 days
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Brucellosis: 2 weeks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Contra-indications,
time at "Settings". adverse effects, precautions
Do not administer in patients with allergy to aminoglycosides.
Administer with caution to patients with history of renal, vestibular or auditory problems.
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Reduce the dose in patients with renal impairment.
Page 489/ 663
 May cause: irreversible ototoxicity (vestibular and auditory damage), nephrotoxicity, neuropathy,
paraesthesia, neuromuscular blockade; rarely, allergic reactions.
Stop treatment in the event of dizziness, tinnitus or hearing loss (ototoxicity).
Drink sufficient liquid to limit the risk of renal toxicity.
Do not combine with another aminoglycoside.
Avoid or monitor combination with: furosemide, amphotericin B, vancomycin (enhanced renal and/or
auditory toxicity); neuromuscular blockers (increased neuromuscular blockage).
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Storage
– Below 25 °C

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Page 490/ 663

 SURAMIN injectable
Last updated: December 2023

Prescription under medical supervision

Due to high toxicity and numerous adverse effects of suramin, patients must be treated in
hospital, under close medical supervision.

Therapeutic action
Trypanocide

Indications
Haemolymphatic stage of African trypanosomiasis due to T. b. rhodesiense

Forms and strengths, route of administration

Powder for injection in 1 g vial, to be dissolved in 10 ml of water for injection to obtain a 10%
solution, for slow IV injection (or slow infusion in 500 ml of 0.9% NaCl).
DO NOT ADMINIST ER BY IM or SC INJECT ION.

Dosage and duration

Child and adult: 4 to 5 mg/kg by slow IV at D1 (test dose) then, in the absence of reaction after the
test dose, 20 mg/kg by slow IV at D3, D10, D17, D24 and D31 (max. 1 g per injection)

Contra-indications, adverse effects, precautions

Do not administer in patients with severe renal or hepatic disease.
May cause:
We use aanaphylactic reaction:
selection of our own andadminister
third-party acookies
test dose before
on the pages starting treatment.
of this website: In the
Essential event which
cookies, of are
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in order to use reaction, thefunctional
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cookies,never
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providesuramin again;
better easy of use when using the website;
performance cookies,(renal
proteinuria whichtoxicity),
we use todiarrhoea,
generate aggregated data on disorders
haematological website use(haemolytic
and statistics; and marketing
anaemia,
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(paraesthesia, hyperaesthesia of the palms and soles, polyneuropathy), high fever, skin eruption,
time at "Settings".
malaise, intense thirst, polyuria;
local inflammation and necrosis when administered by IM or SC injection.
Settings Decline
Before each injection, check for proteinuria: moderate proteinuria is common at the start of Accept
treatment, heavy proteinuria calls for dose reduction and modification of treatment schedule; in the
Page 491/ 663
 event of persisting heavy proteinuria, treatment should be discontinued.
Ensure that the patient is well hydrated.
Pregnancy: although suramin is toxic, it is recommended to treat pregnant women with
rhodesiense trypanosomiasis at the haemolymphatic stage. Suramin is also used at the
meningoencephalitic stage until the woman can be given melarsoprol after delivery, as melarsoprol
is contra-indicated during pregnancy.

Remarks
Suramin is not administered at the meningoencephalitic stage (except in pregnant women) as it
poorly penetrates into the cerebrospinal fluid.
Due to its toxicity, suramin is no longer used for the treatment of onchocerciasis.

Storage
– Below 25 °C

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Page 492/ 663

 THIAMINE = VITAMIN B1 injectable
Last updated: August 2021

Prescription under medical supervision

Therapeutic action
Vitamin

Indications
Initial treatment of severe thiamine (vitamin B 1) deficiency: severe acute forms of beriberi,
neurological complications of chronic alcoholism (delirium tremens, Wernicke’s encephalopathy)

Forms and strengths, route of administration

100 mg thiamine hydrochloride in 2 ml ampoule (50 mg/ml) for IM or very slow IV route (30 minutes)

Dosage and duration

Infantile beriberi
25 mg by IV route then, 25 mg by IM route once or 2 times daily then, change to oral route (10 mg once
daily) as soon as symptoms have improved.

Acute beriberi
50 mg by IM route then change to oral route (50 mg 3 times daily until symptoms improve then, 10 mg
once daily)
or, depending on severity, 50 mg by IM route every 8 hours for a few days then change to oral route (10
mg once daily).

Delirium tremens, Wernicke’s encephalopathy

We usemg
100 a selection
by IM orofIVour own3 and
route third-party
times daily forcookies
3 to 5 on the pages of this website: Essential cookies, which are
days
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Contra-indications, adverse effects, precautions
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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cause: hypotension; and reject individual cookie
reaction, types and
especially whenrevoke your consent
injected IV (injectforvery
the slowly
future atover
any
time at "Settings".
30 minutes).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
Settings Decline Accept

Page 493/ 663

 Remarks
T hiamine is also called aneurine.
Injectable thiamine is not included in the WHO list of essential medicines.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 494/ 663

 TRAMADOL injectable
Prescription under medical supervision

Therapeutic action
Opioid analgesic

Indications
Moderate pain

Forms and strengths, route of administration

100 mg ampoule (50 mg/ml, 2 ml) for IM, slow IV injection or infusion

Dosage
Child over 12 years and adult: 50 to 100 mg every 4 to 6 hours (max. 600 mg daily)

Duration
Change to oral route as soon as possible.

Contra-indications, adverse effects, precautions

Do not administer in the event of severe respiratory depression and to patients that risk seizures
(e.g. epilepsy, head injury, meningitis).
May cause:
dizziness, nausea, vomiting, drowsiness, dry mouth, sweating;
rarely: allergic reactions, seizures, confusion; withdrawal symptoms; respiratory depression in
the event of overdosage.
Do not combine with opioid analgesics, including codeine.
We use a selection
Avoid of our own
combination withand third-party cookies
carbamazepine, on the pages
fluoxetine, of this website:
chlorpromazine, Essential cookies,
promethazine, which are
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
haloperidol, digoxin.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Reduce
cookies, whichdoses by to
are used half and administer
display everyand
relevant content 12advertising.
hours in elderly
If youpatients and in patients
choose "Accept all", you with severe
consent to the
renal or hepatic impairment (risk of accumulation).
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Use tramadol by infusion over 20-30 minutes rather than by IV injection.
at "Settings".
Pregnancy: no contra-indication. T he neonate may develop withdrawal symptoms, respiratory
depression and drowsiness in the event of prolonged administration of large doses at the end of
Settings rd Decline Accept
the 3 trimester. In this event, closely monitor the neonate.

Page 495/ 663

 Breast-feeding: use with caution, for a short period (2-3 days), at the lowest effective dose.
Monitor the mother and the child: in the event of excessive drowsiness, stop treatment.

Remarks
Tramadol is approximately 10 times less potent than morphine.
In some countries, tramadol is on the list of narcotics: follow national regulations.
Tramadol is not included in the WHO list of essential medicines.

Storage
– Below 25 °C

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Page 496/ 663

 TRANEXAMIC acid injectable
Last updated: September 2023

Prescription under medical supervision

Therapeutic action
Antifibrinolytic

Indications
Postpartum haemorrhage
Heavy abnormal uterine bleeding unrelated to pregnancy
Trauma-associated haemorrhage

Forms and strengths, route of administration

500 mg in 5 ml ampoule (100 mg/ml) for slow IV injection or infusion in 0.9% sodium chloride or 5%
glucose
DO NOT ADMINIST ER BY IM ROUT E.

Dosage and duration

Postpartum haemorrhage
Adolescent under 15 years: 15 mg/kg (max. 1 g)
Adult: 1 g
Administer the dose over 15 minutes, in the first litre used for fluid resuscitation or in a bag of 100 ml of
0.9% sodium chloride, within 3 hours of delivery.
If haemorrhage persists 15 minutes after the end of first dose or restarts within 24 hours, administer a
second dose in 100 ml of 0.9% sodium chloride over 15 minutes (max. total dose 2 g).
Heavy abnormal uterine bleeding unrelated to pregnancy
Adolescent and adult: 10 mg/kg every 8 hours until bleeding is reduced (max. 600 mg/dose) then,
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change to oral route.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Trauma-associated we use to generate aggregated data on website use and statistics; and marketing
haemorrhage
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Child: 15 mg/kg (max. 1 g) relevant content and advertising. If you choose "Accept all", you consent to the
which are used to display
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Adult: 1 g
time at "Settings".
Administer the dose over 10 minutes, in 5 ml/kg of 0.9% sodium chloride in children less than 20 kg and
in 100 ml of 0.9% sodium chloride in children 20 kg and over and adults, within 3 hours of injury. T hen,
administer a second dose by continuous IV infusion over 8 hours.
Settings Decline Accept

Page 497/ 663

 Contra-indications, adverse effects, precautions
Do not administer to patients with (or with history of) venous or arterial thromboembolic
disorders, severe renal impairment, history of seizures.
Reduce dosage in patients with mild to moderate renal impairment (risk of accumulation).
May cause: gastrointestinal disturbances, hypotension and malaise if injected rapidly (rate > 1
ml/minute), seizures with high doses, visual disturbances, allergic reactions.
Avoid combination with drugs that increase the risk of thromboembolism (e.g. oestrogenes).
Pregnancy: this drug is not indicated in the event of bleeding during pregnancy.
Breast-feeding: no contra-indication

Remarks
Do not mix with benzylpenicillin (incompatibility).
Tranexamic acid can also be administered undiluted or diluted in smaller volumes of 0.9% sodium
chloride (e.g. 10 ml) in case of fluid restriction (max. 100 mg/minute or 1 ml/minute).

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 498/ 663

 VALPROIC acid = VPA = SODIUM VALPROATE
injectable
Last updated: October 2024

Prescription under medical supervision

VPA must not be used in pregnancy or in women and girls of childbearing age. T he risk
of foetal harm is higher than with other antiseizure medications.
During and after administration, have ventilation equipment (Ambu and mask) and
solutions for fluid replacement ready for use.

Therapeutic action
Antiseizure (anticonvulsant)

Indications
Second-line treatment of convulsive status epilepticus

Forms and strengths, route of administration

400 mg in 4 ml ampoule (100 mg/ml) for slow IV injection or IV infusion in 0.9% sodium
chloride or 5% glucose
DO NOT ADMINIST ER BY IM INJECT ION (risk of necrosis).

Dosage and duration

Loading dose:
Child 2 years and over:
Use diluted solution: add 4 ml (400 mg) of VPA to 6 ml of 0.9% NaCl to obtain 10 ml
We use a selection of ourcontaining
of solution own and third-party
40 mg ofcookies on ml.
VPA per the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Administer 20 mg/kg (max. 1.5 g) over 5 minutes by IV infusion using a syringe pump or by
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
slow
cookies, which areIVused
injection.
to display relevant content and advertising. If you choose "Accept all", you consent to the
If seizures
use of all cookies. You cando accept
not stop
and after
reject the end ofcookie
individual the first dose,
types andreadminister the same
revoke your consent dose:
for the 20 at
future mg/kg
any
time at "Settings".
(max. 1.5 g) as above.
Do not exceed the total dose of 40 mg/kg or 3 g.
Adult:
Settings Decline Accept
40 mg/kg (max. 3 g) single dose over 10 minutes

Page 499/ 663

 Use diluted solution as above (40 mg/ml) if administered by IV infusion using a syringe pump.
Use undiluted solution if administered by IV infusion in a bag of 100 ml of 0.9% NaCl.
In children and adults, do not exceed an infusion rate of 6 mg/kg/minute.
If maintenance treatment is indicated after the loading dose: change to oral route as soon as
possible.

Contra-indications, adverse effects, precautions

Do not administer:
to women and girls of childbearing age;
to children under 2 years (increased risk of hepatotoxicity);
to patients with pancreatitis, hepatic disease or history of hepatic disease.
Reduce dosage in patients with renal impairment.
May cause:
drowsiness, extrapyramidal symptoms, behavioural disturbances, confusional state;
menstrual irregularities, gastrointestinal disturbances, thrombocytopenia;
rarely: pancreatitis, hepatic disorders (e.g. elevated liver enzymes), prolonged bleeding time,
hypersensitivity reactions sometimes severe, hyperammonemic encephalopathy. In these cases,
stop treatment.
respiratory depression and coma in the event of overdose.
Avoid or monitor the combination with:
mefloquine, carbapenems, tricyclic antidepressants, rifampicin, protease inhibitors,
other antiseizure medications (reduced effect of VPA);
acetylsalicylic acid, erythromycin, isoniazid (increased VPA toxicity);
benzodiazepines, opioid analgesics, antipsychotics, first-generation antihistamines
(hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased
sedation).
Pregnancy: do not use except if vital and no alternative is available (risk of neural tube
defects; urogenital, limb and facial malformations; neurodevelopmental disorders). Use a safer drug
if possible (levetiracetam).
Breast-feeding: administer with caution (excreted in milk); monitor the child (risk of hepatotoxicity
and bleeding).

Remarks
We use
Doa not
selection of our
mix with owndrugs
other and third-party
in the samecookies on the
syringe pages of this website: Essential cookies, which are
or infusion.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 500/ 663

 VITAMIN B1 injectable
See T HIAMINE injectable

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Page 501/ 663

 VITAMIN K1 injectable
See PHYT OMENADIONE injectable

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Page 502/ 663

 Infusion fluids
Precautions for the use of infusion fluids

GLUCOSE 5% = DEXT ROSE 5%

GLUCOSE 10% = DEXT ROSE 10%

RINGER LACTAT E

SODIUM CHLORIDE 0.9% = NaCl 0.9%

SODIUM CHLORIDE 3% = NaCl 3%

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 Precautions for the use of infusion fluids
Last updated: November 2023

Carefully read the labels on the infusion bottle to avoid mistakes.

Indicate on the label any drugs added to the infusion as well as the patient’s name and/or bed
number.
If drugs are added to the intravenous fluid, think of the risks of:
physical and chemical incompatibilities,
microbial contamination: aseptic technique.
Examine each bottle against the light to check clearness. Discard any bottles that show particles in
suspension or cloudiness.

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Page 504/ 663

 GLUCOSE 5% = DEXTROSE 5%
Last updated: November 2023

Indications
Vehicle for the administration of drugs by IV infusion

Forms and strengths

500 ml and 1000 ml bottles or bags

Composition
5% isotonic glucose solution (50 mg of glucose/ml) for infusion

Contra-indications, adverse effects, precautions

Do not use 5% glucose solution for the administration of: hydralazine (incompatibility, rapid
degradation of hydralazine), amoxicillin/clavulanic acid, aciclovir, phenytoin, or bleomycin.
Amoxicillin diluted in 5% glucose must be administered in less than one hour. If infusion over more
than one hour is required, use 0.9% sodium chloride.

Remarks
T his solution does not contain electrolytes or lactate. Its use is not recommended for the IV
treatment of dehydration. Use Ringer lactate or 0.9% sodium chloride solutions.
Low nutritional value: 200 kcal/litre.
Also comes in a premixed solution of 5% glucose/Ringer lactate, which is the preferred infusion
solution for maintenance fluids in children.

Storage
Below 25 °C

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Page 505/ 663

 GLUCOSE 10% = DEXTROSE 10%
Last updated: November 2023

Prescription under medical supervision

Indications
Treatment of hypoglycaemia

Forms and strengths

250 ml and 500 ml bottles or bags

Composition
10% hypertonic glucose solution (100 mg of glucose/ml) for slow IV injection or IV infusion

Dosage and duration

Conscious child:10 ml/kg by oral route or nasogastric tube
Child with impaired consciousness: 2 ml/kg by slow IV injection (2 to 3 minutes)
Check blood glucose level 15 minutes after injection. If blood glucose level is still < 3.3 mmol/l or <
60 mg/dl, administer a second dose or give oral glucose, according to the patient's clinical
condition.

Contra-indications, adverse effects, precautions

Do not administer by IM or SC route.

Remarks
If ready-made 10% glucose solution is not available: remove 100 ml of 5% glucose from a 500 ml
bottle or bag, then add 50 ml of 50% glucose to the remaining 400 ml of 5% glucose to obtain 450
We use
ml aofselection of our own
10% glucose and third-party cookies on the pages of this website: Essential cookies, which are
solution.
required in order to use the website;
Nutritional value: 400 kcal/litre. functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Also comes in premixed solution of 10% glucose/0.18% sodium chloride, for maintenance IV
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use offluid therapy You
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canneonates.
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Storage
Below 25 °C
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Page 506/ 663

 RINGER LACTATE
Last updated: November 2023

Indications
Severe dehydration
Fluid replacement in trauma, surgery, anaesthesia)

Forms and strengths

500 ml and 1000 ml bottles or bags

Composition
Varies with manufacturer.
Most frequent ionic composition per litre:
sodium (Na+) 130.50 mmol (130.50 mEq)
+
potassium (K ) 4.02 mmol (4.02 mEq)
++
calcium (Ca ) 0.67 mmol (1.35 mEq)
chloride (Cl–) 109.60 mmol (109.60 mEq)
lactate 28.00 mmol (28.00 mEq)
Isotonic solution. Does not contain glucose.
Ringer Lactate provides appropriate amounts of sodium and calcium and 4 mEq of potassium/litre,
which is sufficient for short-term use. It contains lactate which is converted to bicarbonate for
correction of metabolic acidosis when it exists (if haemodynamic and liver function are
normal). Warning, some commercially available solutions do not contain lactate.

Contra-indications, adverse effects, precautions

In cases of metabolic alkalosis, diabetes, severe renal or hepatic failure, hyperkalemia, head injury:
isotonic solution of NaCl 0.9% is preferred.

Remarks
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required
Afterin infusion,
order to use the website;
Ringer lactate functional
remains incookies, which provide
the intravascular better easy of
compartment use
for 1 when using the website;
to 2 hours.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
For correction of hypovolaemia due to haemorrhage; administer 3 times the lost volume only if:
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of allblood loss
cookies. Youdoes
can not exceed
accept 1500individual
and reject ml in adults;
cookie types and revoke your consent for the future at any
cardiac and renal function are not impaired.
time at "Settings".
Ringer lactate may also be used to prevent hypotension induced by spinal anaesthesia.
Also comes in a premixed solution of 5% glucose/Ringer lactate, which is the preferred infusion
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solution for maintenance fluids in children.

Page 507/ 663

 For moderate and mild dehydration, administer oral rehydration salts (ORS).

Storage
Below 25 °C

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Page 508/ 663

 SODIUM CHLORIDE 0.9% = NaCl 0.9%
Last updated: February 2025

Indications
Vehicle for the administration of drugs by IV infusion
Severe dehydration, fluid replacement in trauma, surgery, anaesthesia (preferably use of Ringer
lactate for these indications)

Forms and strengths

100 ml, 250 ml, 500 ml and 1000 ml bottles or bags

Composition
Isotonic solution of sodium chloride (0.9 g per 100 ml) for infusion
Ionic composition:
sodium (Na+) 150 mmol (150 mEq) per litre
chloride (Cl–) 150 mmol (150 mEq) per litre

Contra-indications, adverse effects, precautions

Administer with caution to patients with conditions associated with sodium or fluid retention
(hypertension, heart failure, peripheral or pulmonary oedema, renal impairment, hepatic impairment
with cirrhosis, pre-eclampsia, etc.) or to taking drugs that increase the risk of sodium or fluid
retention (e.g. corticosteroids).
May cause: pulmonary oedema in the event of too rapid infusion or infusion of excessive amounts.
Do not use as vehicle for the administration of amphotericin B (incompatibility): use only 5%
glucose solution.

Remarks
After infusion, NaCl 0.9% remains in the intravascular compartment for 1 to 2 hours.
Fora correction
We use selection of of
ourhypovolaemia due to
own and third-party haemorrhage,
cookies administer
on the pages 3 times
of this website: the lostcookies,
Essential volumewhich
only if:
are
required blood
in orderloss does
to use the not exceed
website; 1500 ml
functional in adults;
cookies, which provide better easy of use when using the website;
performance cookies,
cardiac and which we use toare
renal function generate aggregated data on website use and statistics; and marketing
not impaired.
cookies, which are used to display relevant
0.9% sodium chloride solution may be used content and
toadvertising. If you choose
prevent hypotension "Acceptbyall",
induced youanaesthesia.
spinal consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
For external use: sterile 0.9% sodium chloride solution is used for cleansing of non-infected
time at "Settings".
wounds, wound irrigation, eye cleansing (conjunctivitis, eye irrigations), nasal lavage in the event of
obstruction, etc.
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Storage
Page 509/ 663
 Below 25 °C

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Page 510/ 663

 SODIUM CHLORIDE 3% = NaCl 3%
Prescription under medical supervision

T his drug should only be used by well trained personnel in well-equipped hospitals.
Do not exceed the recommended rate of hyponatraemia correction to minimise the risk
of neurologic complications.

Indications
Severe symptomatic hyponatraemia: serum sodium level < 120 mmol/litre with neurologic
involvement (e. g. seizures, confusional state, coma)
Increased intracranial pressure in traumatic brain injury
Cerebral oedema

Forms and strengths, route of administration

500 ml bag, for IV infusion on central line or large peripheral vein, preferably using an infusion pump.
DO NOT ADMINIST ER BY IV, IM or SC INJECT ION.

Composition
Hypertonic solution of sodium chloride (3 g per 100 ml, 15 g in 500 ml)
Ionic composition:
sodium (Na+) 513 mmol (513 mEq) per litre
chloride (Cl–) 513 mmol (513 mEq) per litre
Osmolarity: 1027 mOsmol per litre

Dosage and duration

Dosage varies according to patient’s underlying condition, severity of symptoms, clinical response and
Weserum
use asodium level.
selection For
of our owninformation:
and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Severe symptomatic
performance cookies, whichhyponatraemia
we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display
Child under 50 kg: 3 ml/kg over relevant content and advertising. If you choose "Accept all", you consent to the
20 minutes
use ofChild
all cookies.
50 kg andYouover
can accept and reject
and adult: 150 mlindividual
over 20cookie types and revoke your consent for the future at any
minutes
time at "Settings".
Check clinical response and serum sodium level. Repeat infusion up to 2 times if necessary during the
first hour, until symptoms improve or serum sodium increases by 5 mmol/litre.
Further correction of hyponatremia is based on serum sodium deficit calculation, to reach
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mmol/litre.
Page 511/ 663
 Do not increase serum sodium by more than 10 mmol/litre in the first 24 hours and 8 mmol/litre per 24
hours thereafter.

Increased intracranial pressure in traumatic brain injury, cerebral oedema

Child and adult: 3 ml/kg over 10 to 20 minutes
Repeat infusion up to 2 times if necessary, according to clinical response.

Contra-indications, adverse effects, precautions

Administer with caution and under close supervision:
to infants and older patients;
to patients with conditions associated with sodium or fluid retention (hypertension, heart failure,
peripheral or pulmonary oedema, renal impairment, hepatic impairment with cirrhosis, pre-
eclampsia, etc.) or taking drugs that increase the risk of sodium or fluid retention (e.g.
corticosteroids);
if serum sodium > 160 mmol/litre or serum osmolarity > 320 mOsm/litre.
May cause:
pain at infusion site, venous irritation, phlebitis, necrosis in the event of extravasation;
nausea, vomiting, diarrhoea, dry eyes and mouth, thirst, headache;
electrolytes disturbances (hypernatraemia, hypokalaemia, hyperchloraemia) and acid-base
imbalance;
in the event of too rapid infusion and/or overcorrection of hyponatraemia:
peripheral or pulmonary oedema;
osmotic demyelination syndrome (signs and symptoms include dysphagia, confusional state,
slurred speech, movement disorders, lethargy, muscle weakness and coma).
Closely monitor:
infusion rate; use an infusion pump to prevent unintentional bolus;
infusion site for redness and inflammation;
clinical and neurologic state, serum sodium level (and other electrolytes if possible);
urine output: a sudden increase to more than 100 ml/hour may be an early sign of
hyponatraemia overcorrection.
Pregnancy and breast-feeding: administer only if clearly needed.

Remarks
Do not use as a vehicle for administering injectable drugs, use 0.9% sodium chloride.
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3% sodium chloride is not included in the WHO list of essential medicines.
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performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Storage
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Below
time 25 °C
at "Settings".

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Page 512/ 663

 Vaccines, immunoglobulins and antisera
ORAL CHOLERA VACCINE O1 and O139

DIPHT HERIA, T ETANUS, PERT USSIS, HEPAT IT IS B, Hib VACCINE (DTwP-HepB-Hib)

HEPAT IT IS B VACCINE

JAPANESE ENCEPHALIT IS VACCINE

MEASLES VACCINE

MENINGOCOCCAL A CONJUGAT E VACCINE

MENINGOCOCCAL A+C VACCINE

MENINGOCOCCAL A+C+W135 VACCINE

HUMAN PAPILLOMAVIRUS VACCINE (HPV)

PNEUMOCOCCAL CONJUGAT E VACCINE (PCV)

INACT IVAT ED POLIOMYELIT IS VACCINE (IPV)

ORAL POLIOMYELIT IS VACCINE (OPV)

HUMAN RABIES IMMUNOGLOBULIN (HRIG)

RABIES VACCINE

ORAL ROTAVIRUS VACCINE

HUMAN T ETANUS IMMUNOGLOBULIN (HT IG)

T ETANUS-DIPHT HERIA VACCINE (T d)

T UBERCULOSIS VACCINE = BCG VACCINE

T YPHOID CONJUGAT E VACCINE (T CV)

YELLOW FEVER VACCINE

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Page 513/ 663

 ORAL CHOLERA VACCINE O1 and O139
Indications
Prevention of cholera in epidemic, endemic or humanitarian emergency contexts

Composition, forms, route of administration

Inactivated whole cell bivalent vaccine containing Vibrio cholerae O1 (serotypes Inaba and Ogawa,
and biotypes classical and El Tor) and Vibrio cholerae O139
Oral suspension, 1.5 ml in monodose plastic tube. DO NOT ADMINIST ER BY PARENT ERAL
ROUT E.

Dosage and vaccination schedule

Child 1 year and over and adult: 2 doses of 1.5 ml administered at least 14 days apart
In certain contexts (e.g. outbreak and limited number of vaccines), a single dose of 1.5 ml is
administered.
Shake the vial, squirt the entire contents of the vial into the mouth.

For young children, the contents of the vial can be drawn up in a syringe and squirted into the mouth.

Contra-indications, adverse effects, precautions

Do not administer to children less than one year.
Do not administer in the event of hypersensitivity to any component of the vaccine or history of an
allergic reaction to a previous dose.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
May cause: nausea, vomiting, abdominal cramping, diarrhoea.
Drinking water after swallowing the vaccine may reduce its unpleasant taste and prevent vomiting.
If the patient vomits the dose of vaccine, wait for 10 minutes and re-administer the same dose and
follow with a larger volume of water.
Pregnancy: can be administered (the benefits outweigh the risks).
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Breast-feeding:
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the contra-indication
website; functional cookies, which provide better easy of use when using the website;
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Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Immunity develops one week after administration and lasts up to 6 months after a single dose and
at "Settings".
at least 3 years after 2 doses.

Storage
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Page 514/ 663

 – Between 2 °C and 8 °C. Do not freeze; discard if vaccine has been frozen.
Shanchol® vaccines used in controlled temperature chain (CT C) can be stored at temperatures of up
to 40 °C for 14 days maximum. All vaccines removed from the cold chain and not used within 14 days
or exposed to temperatures > 40 °C must be discarded.

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Page 515/ 663

 DIPHTHERIA, TETANUS, PERTUSSIS,
HEPATITIS B, Hib VACCINE (DTwP-HepB-
Hib)
Last updated: December 2024

Indications
Prevention of diphtheria, tetanus, pertussis, hepatitis B and severe Haemophilus influenzae type B
(Hib) infections in children from 6 weeks to 7 years of age (primary vaccination)

Composition, forms, route of administration

Pentavalent vaccine combining diphtheria toxoid, tetanus toxoid, pertussis antigens (whole-
cell), hepatitis B surface antigen and Hib polysaccharide
Suspension for injection in multidose vial, for IM injection into the anterolateral part of the thigh in
children < 2 years and into the deltoid muscle in children ≥ 2 years.
DO NOT ADMINIST ER INT O T HE GLUT EAL MUSCLE.
Shake before use to homogenise the vaccine.

Dosage and vaccination schedule

T hree-dose primary series:
Child: 3 doses 4 weeks apart, preferably before the age of 6 months. It is recommended to
administer the 1st dose at 6 weeks of age, the 2nd dose at 10 weeks of age and the 3rd dose at
14 weeks of age.
If a child has not received the 1st dose by the age of 1 year, start vaccination as soon as
possible according to the 0-1-6 schedule: 2 doses 4 weeks apart, then a 3rd dose 6 months
after the 1st dose
If vaccine schedule has been interrupted, the missing doses should be completed and not restarted
from the beginning.
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
Contra-indications,
performance cookies, which adverse effects,
we use to generate precautions
aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofDo
allnot administer
cookies. You canin accept
the event of allergic
and reject reactions
individual cookietotypes
a previous dose
and revoke of consent
your vaccineforcontaining
the future these
at any
time strains.
at "Settings".
Do not administer at birth to vaccinate against hepatitis B.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
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not contra-indications.

Page 516/ 663

 May cause: mild local reactions (redness, pain at the injection site), fever, pain, malaise, headache,
myalgia; rarely: anaphylactic reactions.
If administered simultaneously with other vaccines, use different syringes and injection sites.

Remarks
Depending on national recommendations, primary vaccination can be done with a trivalent vaccine
(diphtheria, tetanus, pertussis), tetravalent vaccine (diphtheria, tetanus, pertussis, hepatitis B),
pentavalent vaccine (diphtheria, tetanus, pertussis, Hib, poliomyelitis) or hexavalent vaccine
(diphtheria, tetanus, pertussis, hepatitis B, Hib, poliomyelitis).
A booster dose with a vaccine containing at least diphtheria toxoid, tetanus toxoid and pertussis
antigen is recommended between 12 to 23 months of age. Other boosters are recommended
between 4 to 7 years of age and 9 to 15 years of age with a bivalent vaccine containing diphtheria
and tetanus toxoids.

Storage
– Between 2 °C and 8 °C. Do not freeze.

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Page 517/ 663

 HEPATITIS B VACCINE
Indications
Prevention of hepatitis B

Composition, forms, route of administration

Recombinant hepatitis B vaccine
Suspension for injection in monodose or multidose vial, for IM injection into the anterolateral part of
the thigh in children < 2 years and into the deltoid muscle in children ≥ 2 years.
DO NOT ADMINIST ER INT O T HE GLUT EAL MUSCLE.

Dosage and vaccination schedule

Dosage varies according to age and type of vaccine used: follow manufacturer's instructions.
Child: one dose = 5 to 10 micrograms
Adult: one dose = 10 to 20 micrograms
Standard schedule
Neonate and infant:
One dose as soon as possible after birth (preferably within the first 24 hours of life) then a
2nd dose at 6 weeks and a 3rd dose at 14 weeks
or
One dose as soon as possible after birth (preferably within the first 24 hours of life) then 3
doses administered 4 weeks apart with the 1st at 6 weeks, the 2nd at 10 weeks and the
3rd at 14 weeks
Child, adolescent, adult: schedule 0-1-6
2 doses 4 weeks apart, then a 3rd dose 6 months after the 1st dose
Accelerated schedule, when rapid protection is required in the event of post-exposure prophylaxis
3 doses administered during the same month on D0-D7-D21, then a 4th dose one year after the
1st dose

Contra-indications, adverse effects, precautions

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Do not administer in the event of allergic reactions to a previous dose of hepatitis B vaccine.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Vaccination
cookies, which areshould
used tobe postponed
display relevantincontent
the event of severe acute
and advertising. If you febrile
choose illness;
"Acceptminor infections
all", you consentare
to the
use ofnot
all contra-indications.
cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time May
at "Settings".
cause: minor local reactions (pain or redness at injection site), fever, headache, myalgia; rarely:
anaphylactic reaction.
If administered simultaneously with other vaccines, use different syringes and injection sites.
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Pregnancy and breast-feeding: no contra-indication

Page 518/ 663

 Remarks
At birth, use only the monovalent hepatitis B vaccine. For the following doses, administer a
monovalent or tetravalent (diphtheria, tetanus, pertussis, hepatitis B) or pentavalent (diphtheria,
tetanus, pertussis, hepatitis B and Haemophilus influenzae) vaccine.
If an infant was not administered the birth dose, this dose can be administered at anytime during the
first contact with health-care providers, up to the time of the next dose of the primary schedule.
If the vaccination schedule is interrupted before the complete series has been administered, it is
not necessary to start again from the beginning. Continue the vaccination schedule from where it
was interrupted and complete the series as normal.
SC route may be used, only if IM route is contra-indicated.
Shake before use to homogenise the vaccine.

Storage
– Between 2 °C and 8 °C. Do not freeze.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Page 519/ 663

 JAPANESE ENCEPHALITIS VACCINE
Indications
Prevention of Japanese encephalitis:
in children from 1 year and adults in endemic countries (rural areas of Southeast and Southwest
Asia and Western Pacific countries)
in travellers spending more than 1 month in endemic countries, in rural areas and during the wet
season

Composition, forms, route of administration

Inactivated virus vaccine
Powder for injection in single-dose vial, to be dissolved with the entire vial of the diluent supplied by
the manufacturer, for SC injection

Dosage
Child from 1 to 3 years: 0.5 ml per dose
Child over 3 years and adult: 1 ml per dose

T here are several vaccination schedules. For information, for travellers:

3 doses on Day 0, Day 7 and Day 28; a booster dose every 3 years if risk persists.

An accelerated schedule is possible (3 doses on Day 0, Day 7 and Day 14) but this is likely to result in
lower antibody levels than the standard schedule.
T he 3rd dose should be given at least 10 days before departure to ensure an adequate immune
response and access to medical care in the event of adverse reactions.

Contra-indications, adverse effects, precautions

Do not administer to patients with history of an allergic reaction to a previous injection of Japanese
encephalitis vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
not in
required contra-indications.
order to use the website; functional cookies, which provide better easy of use when using the website;
May cause:
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, redness
which areand
usedswelling
to display
at relevant content
the injection and advertising. If you choose "Accept all", you consent to the
site;
use of allfever,
cookies. You can accept
headache, and reject individual cookie types and revoke your consent for the future at any
chills, asthenia;
time at "Settings".
hypersensitivity reactions (urticaria, angioedema), immediate or delayed (up to 2 weeks after
injection);
Settings rarely: encephalitis, encephalopathy. Decline Accept
Do not mix with other vaccines in the same syringe (inactivation of vaccines).
Page 520/ 663
 If administered simultaneously with EPI vaccines, use different syringes and injection sites.
Pregnancy: only administer if there is a high risk of contamination.
Breast-feeding: no contra-indication

Remarks
Protection lasts at least 2 years after 3 doses.
Caution: there are different vaccines against EJ, with different dosages and administration
schedules (e.g. suspension for injection in pre-filled syringe, administered in 2 doses (0.5 ml on D0
and D28) in adults, by IM route). For each vaccine, follow manufacturer's instructions.

Storage

Powder: between 2 °C and 8 °C. Do not freeze.

Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: between 2 °C and 8 °C, for 6 hours maximum.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 521/ 663

 MEASLES VACCINE
Indications
Prevention of measles

Composition, forms, route of administration

Live-attenuated virus vaccine, derived from different viral strains (Schwarz, Edmonston, CAM70,
Moraten, etc.)
Powder for injection in single multidose vial, to be dissolved with the diluent supplied by the
manufacturer, for SC or IM injection into the anterolateral part of the thigh in children < 2 years
and into the deltoid muscle in children ≥ 2 years

Dosage and vaccination schedule

Routine vaccination
Child between 9 and 12 months: one dose of 0.5 ml. T he WHO recommends a 2nd dose between
15 and 18 months. Respect an interval of at least 4 weeks between doses.
Where there is high risk of infection (overcrowding, epidemics, malnutrition, infants born to a mother
with HIV infection, etc.), administer a supplementary dose from 6 months of age then continue
vaccination schedule.

Catch-up vaccination
Children under 15 years who have missed either one or both doses of routine vaccination should be
vaccinated when they come in contact with health services. Check national recommendations.

Contra-indications, adverse effects, precautions

Do not administer to patients with severe immune depression or history of an allergic reaction to a
previous injection of measles vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
We use
Maya selection of our
cause: mild ownreaction
local and third-party cookies on
(pain, redness at the
thepages of this
injection website:
site), fever,Essential cookies,
skin rash; rarely:which are
seizures,
required in order to use the website; functional cookies, which provide better easy of use when using the website;
encephalitis, anaphylactic reaction.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
If administered
cookies, simultaneously
which are used withcontent
to display relevant other vaccines, use different
and advertising. syringes
If you choose and injection
"Accept sites. to the
all", you consent
use ofPregnancy
all cookies.and
You breast-feeding: avoid
can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Remarks
Settings Decline
Combination vaccines that include measles and rubella (MR) or measles, mumps and Accept
rubella (MMR) are also available in countries where these vaccines are included in the national
Page 522/ 663
 immunization programme.

Storage

Powder: between 2 °C and 8 °C.

Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: between 2 °C and 8 °C for 6 hours maximum.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 523/ 663

 MENINGOCOCCAL A CONJUGATE VACCINE
Indications
Prevention of meningitis due to meningococcus A in countries of the African meningitis belt

Composition, forms, route of administration

Inactivated bacterial vaccine, conjugated (Neisseria meningitidis group A)
Powder for injection, to be dissolved with the entire vial of the diluent supplied by the manufacturer
Vials of 10 doses of:
5 micrograms of meningococcal A antigen per 0.5 ml dose for children aged 3 to 24 months
10 micrograms of meningococcal A antigen per 0.5 ml dose for children from 1 year and adults
up to 29 years
For deep IM injection, into the anterolateral part of the thigh in children < 2 years or into the deltoid
muscle in children ≥ 2 years and adults

Dosage and vaccination schedule

Child 3 to < 9 months: 2 doses of 0.5 ml, to be administered at least 8 weeks apart
Child 9 months and over: 0.5 ml single dose
Adult: 0.5 ml single dose

Contra-indications, adverse effects, precautions

Do not administer to patients with history of an allergic reaction to a previous injection of
meningococcal vaccine.
Vaccination should be postponed in the event of severe acute febrile illness (minor infections are
not contra-indications).
May cause: mild local reaction, mild fever.
Do not mix with other vaccines in the same syringe (inactivation of vaccines).
If administered simultaneously with other vaccines, use different syringes and injection sites.
Pregnancy: no contra-indication
We use a selection of ournoown
Breast-feeding: and third-party cookies on the pages of this website: Essential cookies, which are
contra-indication
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Immunity lasts at least 27 months.
time at "Settings".
T he WHO recommends this vaccine for routine vaccination in children aged 9 to 18 months, in
catch-up or periodic campaigns in children from 1 year and in mass vaccination campaigns during
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outbreaks due to meningococcus A in children from 1 year and adults up to 29 years.

Page 524/ 663

 Storage
– Do not freeze.
Powder: between 2 °C and 8 °C.
Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy.
Reconstituted vaccine: up to 40 °C for 6 hours maximum.
Controlled temperature chain (CT C): during mass vaccination campaigns only, the 10 microgram
vaccine can be stored in temperatures of up to 40 °C for a period of 4 days maximum. Any vaccine
removed from the cold chain and not used within 4 days or exposed to temperatures > 40 °C must
be discarded.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 525/ 663

 MENINGOCOCCAL A+C VACCINE
Indications
Prevention of meningitis due to meningococci groups A and C:
in mass immunisation campaigns in the event of an outbreak due to meningococcus A or C
in travellers spending more than 1 month in hyperendemic areas

Composition, forms, route of administration

Inactivated bacterial vaccine, polysaccharide
Powder for injection in monodose or multidose vial, to be dissolved with the entire vial of the diluent
supplied by the manufacturer, for deep SC or IM injection, into the deltoid muscle or the
anterolateral part of the thigh in children (follow manufacturer's instructions)

Dosage and vaccination schedule

Child from 2 years and adult: 0.5 ml single dose

Contra-indications, adverse effects, precautions

Do not administer to patients with history of an allergic reaction to a previous injection of
meningococcal vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
May cause: mild local reaction, mild fever.
Do not mix with other vaccines in the same syringe (inactivation of vaccines).
If administered simultaneously with EPI vaccines, use different syringes and injection sites.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Immunity
We use develops
a selection 7 toand
of our own 10 days aftercookies
third-party injection,
on and lasts of
the pages forthis
approximately 3 years.
website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Storage cookies, which we use to generate aggregated data on website use and statistics; and marketing
performance
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Powder:
at "Settings".
between 2 °C and 8 °C.
Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
Settings Decline Accept

Page 526/ 663

 lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: between 2 °C and 8 °C, for 6 hours maximum.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 527/ 663

 MENINGOCOCCAL A+C+W135 VACCINE
Indications
Prevention of meningitis due to meningococci groups A, C and W135:
in mass immunisation campaigns in the event of an outbreak due to meningococcus A, C or
W135
in travellers spending more than 1 month in hyperendemic areas

Composition, forms, route of administration

Inactivated bacterial vaccine, polysaccharide
Powder for injection in multidose vial, to be dissolved with the entire vial of the diluent supplied by
the manufacturer, for SC injection only

Dosage and vaccination schedule

Child from 2 years and adult: 0.5 ml single dose

Contra-indications, adverse effects, precautions

Do not administer to patients with history of an allergic reaction to a previous injection of
meningococcal vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
May cause: mild local reaction, mild fever.
Do not mix with other vaccines in the same syringe (inactivation of vaccines).
If administered simultaneously with EPI vaccines, use different syringes and injection sites.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Immunity
We use develops
a selection 7 toand
of our own 10 days aftercookies
third-party injection,
on and lasts of
the pages forthis
approximately 3 years.
website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Storage cookies, which we use to generate aggregated data on website use and statistics; and marketing
performance
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Powder:
at "Settings".
between 2 °C and 8 °C.
Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
Settings Decline Accept

Page 528/ 663

 lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: between 2 °C and 8 °C, for 6 hours maximum.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 529/ 663

 HUMAN PAPILLOMAVIRUS VACCINE (HPV)
Indications
Prevention of premalignant anogenital lesions, mainly of the cervix, and of cervical cancer, due to
certain types of papilloma viruses
Prevention of anogenital warts due to certain types of papilloma viruses (particularly types 6 and
11) for the quadrivalent vaccine

Composition, forms, route of administration

Recombinant bivalent (HPV type 16 and 18) or quadrivalent (HPV type 6, 11, 16 and 18) vaccine
Suspension for injection in monodose or multidose (only for bivalent vaccine) vials, for IM injection
into the deltoid muscle

Dosage and vaccination schedule

Child from 9 to 14 years:
2 doses of 0.5 ml at least 6 months apart
If the 2 doses are administered less than 5 months apart, a 3rd dose is administered at least 6
months and up to 12 months maximum after the 1st dose.
Immunocompromised or HIV-infected individuals (under treatment or not):
2 doses of 0.5 ml 1 or 2 months apart then a 3rd dose 6 months after the 1st dose
Most vaccination programmes only target young females, the population group most at risk of
papillomavirus infection complications. Acheiving high vaccination coverage in girls reduces the risk of
infection for boys. For vaccination of boys, follow national recommendations.

Contra-indications, adverse effects, precautions

Do not administer in the event of allergic reactions to a previous dose of papillomavirus vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
May cause: mild reactions at the injection site (pain, redness at the injection site), fever, headache,
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
myalgia;
required rarely:
in order post-vaccination
to use syncope,
the website; functional anaphylactic
cookies, reactions.
which provide better easy of use when using the website;
If administered
performance cookies, simultaneously
which we use to with other
generate vaccines,
aggregated useondifferent
data syringes
website use and injection
and statistics; sites.
and marketing
cookies, which are
Pregnancy: avoidused to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofBreast-feeding:
all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
no contra-indication
time at "Settings".

Remarks
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Page 530/ 663

 In individuals 15 years or over, the vaccine is administered in 3 doses (as in
immunocompromised individuals).
Shake before use to homogenise the vaccine.

Storage
– Between 2 °C and 8 °C. Do not freeze.
Once opened, the multidose bivalent (Cervarix®) vaccine vials can be stored between 2 °C and 8 °C for
6 hours maximum.
Controlled temperature chain (CT C): the quadrivalent vaccine (Gardasil®) can be stored at
temperatures of up to 42 °C for 3 days maximum. All vaccines removed from the cold chain and not
used within 3 days or exposed to temperatures > 42 °C must be discarded.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 531/ 663

 PNEUMOCOCCAL CONJUGATE VACCINE
(PCV)
Indications
Prevention of invasive infections, pneumonia and acute otitis media due to Streptococcus
pneumoniae, in children from 6 weeks of age

Composition, forms, route of administration

10 or 13 valent pneumococcal polysaccharide conjugate vaccine
Suspension for injection:
10 valent vaccine: in multidose vials
13 valent vaccine: in monodose and multidose vials
For IM injection into the anterolateral part of the thigh in children < 2 years and into the deltoid
muscle in children ≥ 2 years.
DO NOT ADMINIST ER INT O T HE GLUT EAL MUSCLE.

Dosage and vaccination schedule

Child: 0.5 ml per dose
Child from 6 weeks to < 12 months:
3p+0 schedule
3 doses 4 weeks apart at 6, 10 and 14 weeks of age
2p+1 schedule
2 doses 8 weeks apart and a booster dose between 9 and 15 months
Child from 12 months to < 2 years: 2 doses 8 weeks apart
Child from 2 to 5 years: a single dose

Contra-indications, adverse effects, precautions

Doa not
We use administer
selection of our in
owntheand
event of allergic
third-party reactions
cookies to a previous
on the pages dose of
of this website: vaccine.
Essential cookies, which are
Vaccination
required in order toshould
use thebe postponed
website; in thecookies,
functional event of severe
which acute
provide febrile
better easyillness; minorusing
of use when infections are
the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
not contra-indications.
cookies, which
May cause: aremild
usedlocal
to display relevant
reactions contentand
(redness andpain
advertising. If you choose
at the injection site),"Accept all", you consent
fever, irritability, to the
drowsiness,
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
loss of appetite; rarely: seizures, anaphylactic reactions.
time at "Settings".
If administered simultaneously with other vaccines, use different syringes and injection sites.

Remarks
Settings Decline Accept

Page 532/ 663

 If the vaccination is interrupted before the complete series has been administered, continue the
vaccination schedule from where it was interrupted, do not repeat administration of the previous
dose.
Choice of vaccines and vaccination schedule: follow national recommendations.
Shake before use to homogenise the vaccine.

Storage
– Between 2 °C and 8 °C. Do not freeze.
10 valent vaccine, 2 dose vial: if open vial is not used entirely within 6 hours it should be discarded.
10 and 13 valent vaccine, 4 dose vial: if open vial is not entirely used it can be stored for 28 days,
providing the cold chain is respected.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 533/ 663

 INACTIVATED POLIOMYELITIS VACCINE (IPV)
Indications
Prevention of poliomyelitis, alone or in combination with the oral poliomyelitis vaccine (bOPV)

Composition, forms, route of administration

Inactivated virus vaccine, trivalent (poliovirus types 1, 2 and 3)
Suspension for injection in multidose vial, for IM injection into the anterolateral part of the thigh in
children < 2 years or deep SC injection into the deltoid muscle in children ≥ 2 years and adults

Dosage and vaccination schedule

bOPV + IPV schedule
Child: 0.5 ml single dose at 14 weeks, in combination with a dose of bOPV
IPV only schedule
Child: 3 doses of 0.5 ml approximately 4 weeks apart, at 6, 10 and 14 weeks of age and a booster
dose at least 6 months after the 3rd dose

Contra-indications, adverse effects, precautions

Vaccination should be postponed in the event of severe acute febrile illness (minor infections are
not contra-indications).
May cause: mild local reaction (pain, redness at the injection site), fever; exceptionally, anaphylactic
reaction.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Protection against poliomyelitis lasts for life after 4 doses.
In children who start routine vaccination late (after the age of 3 months), the dose of IPV is
administered
We use a selection oftogether
our own with the 1st dose
and third-party of bOPV,
cookies on thefollowed by 2website:
pages of this doses of bOPV cookies,
Essential alone administered
which are
4 weeks
required apart.
in order to use the website; functional cookies, which provide better easy of use when using the website;
performance
If there cookies, which of
is a shortage weIPV
use the
to generate aggregated
intradermal route data
is anon website useifand
alternative, thestatistics;
operatorand marketing in
is experienced
cookies, which are used to display relevant content and advertising. If you choose "Accept
this administration technique. T he vaccination schedule is: 2 doses of 0.1 ml at 6 and 14 all", you consent
weeks toof
the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
age (the 2 doses must be administered at least 4 weeks apart).
time at "Settings".
Certain countries have vaccination schedules for children and adults that use only the injectable
vaccine and include booster doses: follow national recommendations.
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Storage
Page 534/ 663
 – Between 2 °C and 8 °C. Do not freeze.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 535/ 663

 ORAL POLIOMYELITIS VACCINE (OPV)
Indications
Prevention of poliomyelitis, in combination with the inactivated poliomyelitis vaccine (IPV)

Composition, forms, route of administration

Live-attenuated virus vaccine, bivalent (poliovirus types 1 and 3)
Oral suspension in multidose vial, to be administered on the tongue, with dropper

Dosage and vaccination schedule

One dose = 2 drops (approximately 0.1 ml)

In endemic areas or areas at risk of poliovirus importation, according to WHO recommendations

Child: 4 doses approximately 4 weeks apart, at birth then at 6, 10 and 14 weeks of age
T he 4th dose at 14 weeks is administered in combination with a dose of the inactivated
poliomyelitis vaccine (IPV).

Other areas
Child: 3 doses approximately 4 weeks apart, at 6, 10 and 14 weeks of age
T he 3rd dose at 14 weeks is administered in combination with a dose of the inactivated
poliomyelitis vaccine (IPV).

Contra-indications, adverse effects, precautions

Do not administer in the event of severe immunodepression (risk of paralytic poliomyelitis): use the
injectable vaccine IPV (asymptomatic HIV infection is not a contra-indication).
Vaccination should be postponed in the event of severe acute febrile illness (minor infections are
not contra-indications).
May cause (exceptionally): paralytic poliomyelitis.
In the event of vomiting or diarrhoea when the vaccine is administered, give the usual dose followed
by an extra dose once gastrointestinal symptoms have improved.
Respect an interval of at least 4 weeks between each dose.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Pregnancy:
required in order tono
usecontra-indication
the website; functional cookies, which provide better easy of use when using the website;
Breast-feeding:
performance no contra-indication
cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Remarks
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Protection against poliomyelitis lasts for life after 3 doses.
In children who start routine vaccination late (after the age of 3 months), the dose of IPV is
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administered together with the 1st dose of bOPV, followed by 2 doses of bOPV alone administered

Page 536/ 663

 4 weeks apart.
For the vaccination schedule, follow national recommendations.
Monovalent oral type 2 vaccines (mOPV and nOPV) are also available but are exclusively used for
responding to epidemics.

Storage

For prolonged storage: freeze (– 20 °C).

After defrosting: between 2 °C and 8 °C for 6 months maximum.

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Page 537/ 663

 HUMAN RABIES IMMUNOGLOBULIN (HRIG)
Therapeutic action
Neutralisation of rabies virus at wound sites

Indications
Prevention of rabies after category III exposure (except in patients who have received a full course
of pre-exposure prophylaxis against rabies), in combination with rabies vaccine
Prevention of rabies after category II and III exposures in immunocompromised patients (even in
patients who have received a full course of pre-exposure prophylaxis against rabies), in
combination with rabies vaccine

Forms and strengths, route of administration

Solution for injection, 300 IU in 1 ml ampoule (300 IU/ml) and 1500 IU in 5 ml ampoule (300 IU/ml) for
infiltration into and around the wound

Dosage and duration

Child and adult: 20 IU/kg single dose on D0, along with the first dose of rabies vaccine.
Infiltrate as much of the dose as possible into and around the wound(s), which has been cleaned
beforehand.
In the event of multiple wounds, dilute the dose 2 to 3-fold with sterile 0.9% sodium chloride to
obtain a sufficient quantity to infiltrate all the sites.
If HRIG is not available on D0, administer the first dose of rabies vaccine alone. Administer HRIG as
soon as possible between D0 and D7; from D8, it is not necessary to
administer rabies immunoglobulin as vaccine-induced antibodies begin to appear.

Contra-indications, adverse effects, precautions

May cause: fever, headache, gastrointestinal disturbances, joint pain, local reactions at the
injection
We use site of
a selection (pain, inflammation);
our own rarely:
and third-party anaphylactic
cookies reactions.
on the pages of this website: Essential cookies, which are
Aspirate
required prior
in order to injection
to use the website;to confirm
functionalthat the needle
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andofensure thatusing
use when the HRIG does
the website;
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not enter cookies,
a bloodwhich
vesselwe use
(risktoofgenerate
shock).aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant
For finger wounds, infiltrate with caution contenttoand advertising.
avoid increased If you choosein"Accept
pressure all",compartment.
the tissue you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
If administered simultaneously with rabies immunoglobulin and other vaccines, use different syringes
time at "Settings".
and injection sites.
Pregnancy and breast-feeding: no contra-indication
Settings Decline Accept
Remarks
Page 538/ 663
 Purified equine rabies immunoglobulin F(ab’)2 fragments may replace HRIG if unavailable. T he
method of administration is the same but the dose is 40 IU/kg.

Storage
– Between 2 °C and 8 °C. Do not freeze.

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Page 539/ 663

 RABIES VACCINE

Indications
Prevention of rabies after category II and III exposures

Composition, forms, route of administration

Inactivated virus vaccine, prepared from cell cultures (CCEEV): in embryonated egg or purified cells
(chick embryo-cells, Vero-cells or human diploid-cells)
Powder for injection in monodose vial, to be dissolved with the entire vial of the diluent (0.5 ml or 1
ml, supplied by the manufacturer)
IM route:
DO NOT ADMINIST ER INT O T HE GLUT EAL MUSCLE.
Child < 2 years: inject into the anterolateral part of the thigh
Child ≥ 2 years and adult: inject into the deltoid muscle
ID route:
Child and adult: inject into the deltoid muscle (or the anterolateral part of the thigh or
the suprascapular region)

Dosage and vaccination schedule

Child and adult: one IM dose = 0.5 or 1 ml, depending on the vaccine used; one ID dose = 0.1 ml,
whichever vaccine used
Vaccination schedules may vary from country to country, check national recommendations. T he
schedule depends on the patient’s vaccination status at the moment of exposure and the route of
administration used (follow manufacturer’s instructions).
T he first dose of vaccine should be administered as soon as possible after exposure, even if the
patient seeks medical attention long after exposure (rabies incubation period may last several
months). T he patient must receive all the recommended doses.
If a vaccine dose is delayed or the route of administration is changed, continue vaccination
We useaccording toof
a selection the
ourchosen route
own and of administration
third-party and
cookies on the do not
pages recommence
of this the schedule.
website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance
T he simplestcookies, which we
vaccination use to generate
schedules aggregated
endorsed by the data
WHO onare
website use and statistics; and marketing
the following:
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Page 540/ 663

 No rabies vaccination
or incomplete vaccination Complete vaccination
or complete vaccination with an NTV with a CCEEV
or unknown vaccination status

(a) (b)
IM route ID route IM or ID route

2 doses (c)
(c) 2 doses (c)
D0 (1 dose in each 1 dose 1 dose
(1 dose in each arm)
arm or thigh)

2 doses
D3 1 dose 1 dose
(1 dose in each arm)

2 doses
D7 1 dose 1 dose
(1 dose in each arm)

D14 1 dose (d)

D21 1 dose

a There are t wo possible schedules f or t he IM rout e: t he Z agreb regimen (2-0-1-0-1) over 21 days or t he 4-
dose Essen regimen (1-1-1-1-0) over 14 t o 28 days.
b Anot her possible ID schedule: 4 ID doses (1 dose in each arm and 1 dose in each t high) on D0.
c As well as a single dose of rabies immunoglobulin int o t he wound in t he event of cat egory III exposure on
D0.
d The last inject ion can be administ ered bet ween D14 and D28.

Immunocompromised patient: 1 dose on D0, D7 and between D21 and D28 by IM or ID route (as
well as a single dose of rabies immunoglobulin)

Contra-indications, adverse effects, precautions

Do not administer corticoids concomitantly (vaccine efficacy diminished).
We use
Maya selection of our own
cause: benign localand third-party
reactions at cookies on thesite
the injection pages of this
(pain, website: Essential
induration), cookies,headache,
fever, malaise, which are
required in order to use the website; functional cookies, which provide
fatigue, gastrointestinal disturbances; rarely: anaphylactic reaction. better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Ensure that the vaccine does not enter a blood vessel (risk of shock): aspirate prior to injection to
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofconfirm that You
all cookies. the can
needle is not
accept andin a vein.
reject individual cookie types and revoke your consent for the future at any
time ID vaccination: incorrect ID technique results in treatment failure. If correct ID technique cannot be
at "Settings".
assured, use IM route.
If administered simultaneously with rabies immunoglobulin and other vaccines, use different syringes
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and injection sites.

Page 541/ 663

 Pregnancy and breast-feeding: no contra-indication

Remarks
Rabies vaccine is also used for pre-exposure vaccination in persons at high risk of infection
(prolonged stay in rabies endemic areas, professionals in contact with animals susceptible of
carrying the virus).
Avoid the use of vaccines prepared from animal nerve tissue (NT Vs): they are less immunogenic
than CCEEV vaccines and more likely to cause severe adverse effects.

Storage

Powder: between 2 °C and 8 °C. Do not freeze.

Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: use immediately.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 542/ 663

 ORAL ROTAVIRUS VACCINE
Last updated: March 2025

Indications
Prevention of rotavirus gastroenteritis in children up to 24 months of age

Composition, forms, route of administration

Oral suspension, in monodose plastic tube:
Rotarix®, 1.5 ml tube, live-attenuated monovalent human rotavirus vaccine (RV1, strain
RIX4414)
Rotasiil®, 2 ml tube, live-attenuated pentavalent human-bovine reassortant rotavirus vaccine
(RV5, G1, G2, G3, G4 and G9)
Rotateq®, 2 ml tube, live-attenuated pentavalent human-bovine reassortant rotavirus vaccine
(RV5, G1, G2, G3, G4 and P1A[8])
DO NOT ADMINIST ER BY PARENT ERAL ROUT E.

Dosage and vaccination schedule

Child 6 weeks to 24 months:
Depending on the available vaccine, 2 to 3 doses at least 4 weeks apart
Shake the plastic tube, squeeze the entire content of the tube into the mouth.
Recommended schedule:

Age
Vaccine
6 weeks 10 weeks 14 weeks

Rotarix® Dose 1 Dose 2

Rotasiil®, Rotateq® Dose 1 Dose 2 Dose 3

Contra-indications, adverse effects, precautions

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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administer we use
in case of:to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
acute gastroenteritis, history of intussusception, severe immunodeficiency;
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
allergic reactions to a previous dose of vaccine.
time at "Settings".
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
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May cause: Decline Accept
diarrhoea, abdominal pain, irritability;
Page 543/ 663
 rarely: intussusception, anaphylactic reactions.
If the child regurgitates/spits out/vomits the vaccine immediately after administration, wait a few
minutes and re-administer the same dose.

Remarks
Other rotavirus vaccines may be available (e.g. Rotavac®). T he vaccination should be completed
with the same vaccine when feasible. If not possible, follow national and manufacturer
recommendations.
Rotavirus vaccine can be administered concomitantly with other vaccines recommended in
childhood.

Storage
– Between 2 °C and 8 °C. Do not freeze.
Once opened, the content must be administered immediately; discard any unused open tube.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 544/ 663

 HUMAN TETANUS IMMUNOGLOBULIN (HTIG)
Therapeutic action
Neutralisation of tetanus toxin. HT IG provides passive immunization against tetanus for 3 to 4
weeks.

Indications
Prevention of tetanus in wound management, in patients non immunised or incompletely immunised
or in patients whose immunisation status is unknown, in combination with tetanus vaccine
Treatment of clinical tetanus

Forms and strengths, route of administration

Solution for injection, in 250 IU (250 IU/ml, 1 ml) or 500 IU (250 IU/ml, 2 ml) ampoule or single-dose
syringe, for IM injection.
DO NOT ADMINIST ER BY IV ROUT E.

Dosage and duration

Prevention of tetanus
HT IG is administered in the event of tetanus-prone wounds, e.g. wounds with fracture, deep
penetrating wounds, bite wounds, wounds containing foreign bodies, wounds contaminated with
soil, infected wounds, extensive tissue damage (contusions, burns).
Child and adult: 250 IU single dose; 500 IU if more than 24 hours has elapsed
HT IG should be administered as soon as possible after injury, along with the tetanus vaccine, in a
separate syringe and injection site.

Treatment of tetanus
Neonate, child and adult: 500 IU single dose, to be injected into 2 different sites

Contra-indications, adverse effects, precautions

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Do in
required notorder
administer towebsite;
to use the patientsfunctional
with known allergy
cookies, to HT
which IG. better easy of use when using the website;
provide
performance
May cause cookies,
(verywhich weallergic
rarely): use to generate aggregated data on website use and statistics; and marketing
reactions.
cookies, which are used to display relevant content
Ensure that the HT IG does not enter a blood and vessel
advertising. If you
(risk of choose
shock): "Acceptprior
aspirate all",to
you consentto
injection to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
confirm that the needle is not in a vein.
time at "Settings".
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
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Remarks
Page 545/ 663
 For minor clean wounds, tetanus vaccine is administered alone.
SC route may be used but only if IM route is contra-indicated.

Storage
– Between 2 °C and 8 °C. Do not freeze.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 546/ 663

 TETANUS-DIPHTHERIA VACCINE (Td)

Indications
Prevention of tetanus in wound management
Prevention of tetanus and diphtheria in pregnant women or women of childbearing age
Prevention of tetanus and diphtheria in children over 4 years and adolescents (booster dose after
complete primary vaccination)

Composition, forms, route of administration

Bivalent vaccine combining tetanus toxoid and diphtheria toxoid (containing reduced dose of
diphtheria toxoid)
Suspension for injection in multidose vial, for IM injection into the deltoid muscle

Dosage and vaccination schedule

Child and adult: 0.5 ml per dose

Prevention of tetanus in wound management

Complete vaccination (3 or more

Incomplete vaccination
doses)
Type of (less than 3 doses)
Time since administration of last dose
wound or no vaccination
or unknown status
< 5 years 5-10 years > 10 years

Td
Initiate (a) or complete tetanus
Minor, clean None None 1 booster
vaccination
dose

(a)
We use a selection of our own and third-party Initiate
website:or complete tetanus
T d cookies on theTpages
d of this Essential cookies, which are
vaccination
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Other None 1 booster 1 booster
performance cookies, which we use to generate aggregated data on website anduse and statistics;
administer and marketing
tetanus
cookies, which are used to display relevantdose dose If you choose "Accept all", you consent to the
content and advertising. immunoglobulin
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
a 2 doses 4 weeks apart t hen 3 addit ional doses administ ered according t o t he vaccinat ion schedule below.

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Page 547/ 663

 Prevention of tetanus in pregnant women and women of childbearing age
5 doses administered according to the schedule below:

Td1 On first contact with the health care system or as soon as possible during pregnancy

Td2 At least 4 weeks after T d1

Td3 6 months to 1 year after T d2 or during the following pregnancy

Td4 1 to 5 years after T d3 or during the following pregnancy

Td5 1 to 10 years after T d4 or during the following pregnancy

In pregnant women, administer at least 2 doses before delivery: the 1st dose as soon as possible
during pregnancy and the 2nd dose at least 4 weeks after the 1st and at least 2 weeks before due
date. After delivery, continue vaccination as described in the table above until the required 5 doses
have been administered.

Prevention of tetanus in children over 4 years (after complete primary vaccination and 1st booster
between 12 and 23 months)
Booster dose between 4 and 7 years then between 9 and 15 years

Contra-indications, adverse effects, precautions

Do not administer in the event of allergic reactions after a previous dose of tetanus or diphtheria
vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
May cause: mild local reactions (redness, pain at the injection site), fever, pain, malaise; rarely:
anaphylactic reactions.
If administered simultaneously with other vaccines, use different syringes and injection sites.
Pregnancy and breast-feeding: no contra-indication

Remarks
T he
We use monovalent
a selection tetanus
of our own and(Tthird-party
T ) vaccinecookies
is usedonin the
certain
pagesnational protocols.
of this website: Use perferably
Essential the are
cookies, which
required in order to use the website; functional cookies, which provide better easy of use when using
conjugate tetanus-diphtheria (T d) vaccine for the prevention of tetanus in children over 7 years, the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
adolescents and adults.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofTetanus vaccination
all cookies. in pregnant
You can accept women
and reject and women
individual of child
cookie types andbearing
revoke age
your protects
consent forneonates
the futurefrom
at any
time tetanus.
at "Settings".

Storage
Settings Decline Accept
– Between 2 °C and 8 °C. Do not freeze.
Page 548/ 663
 TUBERCULOSIS VACCINE = BCG VACCINE
Indications
Prevention of tuberculosis

Composition, forms, route of administration

Live attenuated bacterial vaccine
Powder for injection in multidose vial, to be dissolved with the entire vial of the diluent supplied by
the manufacturer, for intradermal injection into the external face of the left upper arm

Dosage and vaccination schedule

Child: 0.05 ml single dose as soon after birth as possible
If child is over one year old: 0.1 ml single dose

Contra-indications, adverse effects, precautions

Do not administer to patients with immunodeficiency (symptomatic HIV infection,
immunosuppressive therapy, etc.) and malignant haemopathy.
Vaccination should be postponed in the event of evolutive extensive dermatosis, acute
complicated malnutrition (vaccine should be given just before the child is discharged from the
nutrition centre) and severe acute febrile illness (minor infections are not contra indications).
May cause:
normal local reaction 2 to 4 weeks after injection: papule which changes to an ulcer, that usually
heals spontaneously (dry dressing only), leaving a permanent scar;
occasionally: persistent ulcer with serous discharge up to 4 months after injection, non-
suppurative adenitis, keloid formation, abscess at the injection site;
exceptionally: suppurative lymphadenitis, osteitis.
Clean the injection site with boiled and cooled water and allow drying. Do not use antiseptics (risk
of inactivation of live vaccine).
Do not mix with other vaccines in the same syringe (inactivation of vaccines).
We use a selection of our
If administered own and third-party
simultaneously cookies
with EPI on theuse
vaccines, pages of this syringes
different website: Essential cookies,
and injection which are
sites.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Pregnancy: CONT RA-INDICAT ED
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Breast-feeding:
cookies, which are usedno contra-indication
to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

Inject the vaccine in the same place for each child to make it easy to find the BCG scar
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Page 549/ 663

 If the injection is correctly performed an “orange-skin” papule, measuring 5-8 mm in diameter,
should appear at the injection site.
Duration of protection is not known, and decreases over time.

Storage

Powder: between 2 °C and 8 °C. Freezing is possible but unnecessary

Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: between 2 °C and 8 °C for 6 hours maximum.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 550/ 663

 TYPHOID CONJUGATE VACCINE (TCV)
Indications
Prevention of typhoid fever in children as of 6 months and adults up to 45 years of age:
in endemic areas
in mass immunisation campaigns in the event of an outbreak or humanitarian emergency
context, based on risk assessment

Composition, forms, route of administration

Typhoid (polysaccharide) conjugate vaccine
Suspension for injection in multidose vial, for IM injection into the anterolateral part of the thigh in
children < 2 years and into the deltoid muscle in children ≥ 2 years.
DO NOT ADMINIST ER INT O T HE GLUT EAL MUSCLE.

Dosage and vaccination schedule

Child and adult: 0.5 ml single dose

Routine vaccination
Child at 9 months or during the 2nd year of life:
one single dose at the same time as other recommended vaccines. Follow national
recommendations.

Catch-up vaccination
Child up to 15 years:
one single dose. Follow national recommendations.

Contra-indications, adverse effects, precautions

Do not administer in case of allergic reactions to any component of the vaccine.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
We use
nota contra-indications.
selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
May cause: mild reactions at the injection site (pain, redness at the injection site), fever, headache,
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
myalgia;
cookies, whichrarely: anaphylactic
are used reactions.
to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofIf all
administered
cookies. Yousimultaneously with other
can accept and reject vaccines,
individual cookieuse different
types syringes
and revoke and injection
your consent for the sites.
future at any
time Pregnancy:
at "Settings". no contra-indication
Breast-feeding: no contra-indication

Settings Decline Accept

Remarks
Page 551/ 663
 Typhoid conjugate vaccine does not protect against Salmonella Paratyphi or other types of non-
typhi salmonella.
Shake before use to homogenise the vaccine.

Storage
– Between 2 °C and 8 °C. Do not freeze.
Once opened, store vial between 2 °C and 8 °C for 6 hours maximum.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 552/ 663

 YELLOW FEVER VACCINE
Indications
Prevention of yellow fever:
in children from 9 months of age and adults living in or travelling to or from endemic areas
in mass immunisation campaigns in the event of an outbreak

Composition, forms, route of administration

Live-attenuated virus vaccine, prepared by culturing the virus in embryonated chicken eggs
Powder for injection in monodose and multidose vials, to be dissolved with the entire vial of diluent
supplied by the manufacturer, for IM injection into the anterolateral part of the thigh in children < 2
years and into the deltoid muscle in children ≥ 2 years and adults

Dosage and vaccination schedule

Child and adult: 0.5 ml single dose
In routine immunisation (EPI), the vaccine is usually administered between 9 and 12 months of age,
along with the measles vaccine.
Vaccination is contra-indicated in children less than 6 months. In children between 6 and 9 months,
vaccination is only recommended in epidemics, as the risk of virus transmission may be very high.

Contra-indications, adverse effects, precautions

Do not administer to patients with history of allergy to egg; to immunocompromised patients or
patients with symptomatic HIV infection or under immunosuppressive treatment.
Vaccination should be postponed in the event of severe acute febrile illness; minor infections are
not contra-indications.
May cause: mild reactions at the injection site (redness, pain at the injection site), mild fever,
headache, myalgia; rarely: hypersensitivity reactions, neurological disorders (especially in children <
9 months and adults > 60 years), multiple organ failure (especially in adults > 60 years).
If administered simultaneously with other vaccines, use different syringes and injection sites.
We use a selection not
Pregnancy: of our own and third-party
recommended. cookies
However, on the
given thepages of this
severity of website: Essential
yellow fever, the cookies,
vaccinewhich
is are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
administered when the risk of contamination is very high (epidemics, unavoidable travel to regions
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
of high
cookies, endemicity).
which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofBreast-feeding: no contra-indication
all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Remarks
Settings Decline
A standard 0.5 ml single dose by IM injection is sufficient to confer life-long immunity. Accept
A booster
dose is no longer recommended.
Page 553/ 663
 Only in the event of limited vaccine supply during yellow fever outbreaks and according to national
recommendations, vaccination may be administered by SC or IM injection in children over 2 years
and adults with a fractional dose of 1/2 or 1/5 of the standard dose (minimum 0.1 ml) using vials
containing a maximum of 10 standard doses. Children < 2 years, pregnant women and HIV positive
individuals are administered a standard 0.5 ml dose by IM injection.

Storage

Powder: between 2 °C and 8 °C.

Diluent: a cold chain is not required for storage. However, at least 12 hours before reconstitution of
the vaccine, the diluent must be refrigerated between 2 °C and 8 °C so that the diluent and
lyophilised powder are at the same temperature: a temperature difference during reconstitution
may reduce vaccine efficacy. Do not freeze.
Reconstituted vaccine: between 2 °C and 8 °C, for 6 hours maximum.

We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 554/ 663

 Drugs for external use, antiseptics and
disinfectants
ACICLOVIR, eye ointment

ALCOHOL-BASED solution or gel

ART ESUNAT E rectal

BENZOIC acid + SALICYLIC acid ointment = Whitfield’s ointment

BENZYL BENZOAT E, lotion

CALAMINE lotion

CHLORHEXIDINE 5% solution

CHLORHEXIDINE 7.1% dermal gel

CHLORHEXIDINE 0.2% mouthwash

CHLORINE-RELEASING COMPOUNDS (NaDCC, HT H, bleach, chlorinated lime)

CIPROFLOXACIN, ear drops

CLOT RIMAZOLE, vaginal tablet

DIMET ICONE, lotion

ET HANOL

ET HYL ALCOHOL = ET HANOL

FLUORESCEIN, eye drops

HYDROCORT ISONE, cream and ointment

LEVONORGEST REL intrauterine device

MICONAZOLE, cream

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MUPIROCIN, of our own and third-party cookies on the pages of this website: Essential cookies, which are
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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NYSTAT
use IN, vaginal
of all cookies. You tablet
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OXYBUPROCAINE, eye drops

PERMET HRIN 1%, lotion

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PERMET HRIN 5%, cream
Page 555/ 663
 PILOCARPINE, eye drops

PODOPHYLLOT OXIN 0.5%, solution or gel

PODOPHYLLUM resin, solution

POVIDONE IODINE = POLYVIDONE IODINE = PVI, aqueous solution

POVIDONE IODINE = POLYVIDONE IODINE = PVI, scrub solution

SILVER SULFADIAZINE, cream

SODIUM DICHLOROISOCYANURAT E = NaDCC

T ET RACYCLINE, eye ointment

ZINC OXIDE, ointment

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Page 556/ 663

 ACICLOVIR, eye ointment
Prescription under medical supervision

Therapeutic action
Antiviral active against herpes virus

Indications
Treatment of herpes keratitis
Prevention of herpes keratitis in neonate born to a mother suffering from genital herpes at the
moment of childbirth

Forms and strengths

3% ointment, tube

Dosage and duration

Treatment of herpes keratitis
Child and adult: one application 5 times daily into the conjunctival sac of both eyes for 14 days or
for 3 days after lesions have healed

Prevention of herpes keratitis in neonate

Immediately after birth: one single application of aciclovir into the conjunctival sac of both eyes
(after washing eyes with sterile 0.9% sodium chloride)

Contra-indications, adverse effects, precautions

In neonates, wait 12 hours after application of aciclovir 3% then apply tetracycline eye ointment
1% to prevent gonococcal neonatal conjunctivitis.

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Page 557/ 663

 ALCOHOL-BASED solution or gel
Therapeutic action
Antiseptic

Indications
Antiseptic hand rub, before and after procedures, whether gloves are used or not

Forms and strengths

Ready to use alcohol-based hand rub solution or gel

Use
Alcohol-based hand rubs can only be used if hands are not visibly dirty or soiled with organic matter.
T here must be no residual powder on hands (use powder-free gloves) and hands must be dry.
Apply 3 ml of solution or gel in a cupped hand and spread to cover the entire surface of hands. Rub
hands for 20-30 seconds, palm to palm, palm over dorsum, between fingers (fingers interlaced),
around the thumbs and nails, until hands are completely dry. Do not dilute the product. Do not rinse
off or dry hands.
As long as hands are not visibly soiled, the product may be reapplied as many times as necessary
without handwashing before or after applying the product.

Contra-indications, adverse effects, precautions

Do not use if:
hands are visibly dirty or soiled with organic matter (wash hands);
there is residual powder on hands (wash hands);
hands are wet (water dilutes alcohol and impedes drying).
Do not use after direct contact with a patient with a parasitic skin infection (scabies, lice): wash
hands.
Doa not
We use use simultaneously
selection of our own and with soap cookies
third-party or another antiseptic
on the pages of (antagonism, inactivation,
this website: Essential etc.).
cookies, which are
Do in
required notorder
use to
for disinfection
use the website;offunctional
material,cookies,
patient's skinprovide
which or mucousbettermembranes.
easy of use when using the website;
performance
May cause:cookies, whichsensation
stinging we use to on
generate
brokenaggregated
skin. data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising.
In case of eye contact flush immediately with plenty of water. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".
Remarks
Dose required and duration of handrubbing may vary depending on the product used. Read the
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manufacturer's instructions carefully.

Page 558/ 663

 To avoid difficulty in putting on gloves, rub hands until the product is completely dry.
Use of alcohol-based hand rubs may result in a sticky residue on hands after several applications. In
this event, wash hands.
Some alcohol-based hand rubs can be used for surgical hand antisepsis, however the technique is
not the same as for antiseptic hand rub.

Storage
– Below 25 °C
Close bottles tightly to avoid evaporation. Keep away from sources of ignition (flame, spark,
incandescent material).

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Page 559/ 663

 ARTESUNATE rectal
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Pre-referral treatment of suspected or confirmed severe malaria, in children less than 6 years,
before transfer to a facility where parenteral antimalarial treatment can be administered

Forms and strengths, route of administration

100 mg rectal capsule

Dosage and duration

10 mg/kg as a single dose before transferring the patient
Child 2 months to < 3 years (≤ 10 kg): 1 rectal capsule single dose (100 mg)
Child 3 to < 6 years (≤ 20 kg): 2 rectal capsules single dose (200 mg)

Contra-indications, adverse effects, precautions

May cause: gastrointestinal disturbances, headache.
Buttocks should be held together for at least 1 minute to ensure retention. If capsules are expelled
from the rectum within 30 minutes of insertion, re-administer the treatment.

Remarks
Up to 2 capsules can be administered simultaneously.

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Page 560/ 663

 BENZOIC acid + SALICYLIC acid ointment =
Whitfield’s ointment
Therapeutic action
Fungistatic and keratolytic agent

Indications
Dermatophyte infection of the scalp (tinea capitis), in combination with a systemic antifungal
Dermatophyte infection of the glabrous skin and skin folds:
alone, if lesions are localised, non-extensive
in combination with a systemic antifungal, if the lesions are extensive

Forms and strengths

Benzoic acid 6% + salicylic acid 3% ointment, tube or jar

Dosage
Child and adult: one application 2 times daily, in a thin layer, to clean and dry skin

Duration
3 to 6 weeks, depending on clinical response

Contra-indications, adverse effects, precautions

Do not apply to exudative lesions, mucous membranes or eyes.
May cause: skin irritation, local benign inflammation.
In case of secondary bacterial infection, start appropriate local or systemic treatment before
applying Whitfield’s ointment.
In case
We use of contact
a selection withand
of our own eyes or mucous
third-party membranes,
cookies flush
on the pages ofimmediately with plenty
this website: Essential of water.
cookies, which are
Pregnancy:
required in order tono
usecontra-indication
the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which
Breast-feeding: we use to generate aggregated data on website use and statistics; and marketing
no contra-indication
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Whitfield’s ointment is not included in the WHO list of essential medicines.

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Storage
Page 561/ 663
 – Below 25 °C
Once the ointment has been exposed to a high temperature, the active ingredients are no longer evenly
distributed: the ointment must be homogenized before using.

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Page 562/ 663

 BENZYL BENZOATE, lotion
Therapeutic action
Scabicide

Indications
Scabies (preferably use 5% permethrin cream for this indication)

Forms and strengths

25% lotion

Preparation and use

Shake the bottle before application or dilution.
Dilute the lotion, as required, according to age. Use drinking or boiled water.
Apply the lotion to the whole body, including scalp, postauricular areas, palms of the hands and
soles of the feet, paying particular attention to skin creases and interdigital web spaces. Leave on
for recommended contact time, then rinse thoroughly with water.
In children under 2 years: wrap hands to avoid accidental ingestion and contact with eyes.

Child Child Child > 12 years Pregnant

< 2 years 2 to 12 years and adult woman

1 part of 1 part of
Undiluted 25% Undiluted 25%
Preparation 25% lotion 25% lotion
lotion lotion
+ 3 parts of water + 1 part of water

12 hours
Contact time (6 hours in children 24 hours 24 hours 12 hours
< 6 months)
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a rinse between the two applications; or all", you consent to the
and advertising. If you choose "Accept
Number of One application
use of all cookies. You can accept and reject individual cookie types and revoke consent forOne application
two successive applications 10your
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apart, when the first application has dried,
then rinse after 24 hours)
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Page 563/ 663

 Contra-indications, adverse effects, precautions
Do not apply to broken skin (risk of systemic absorption), the face or mucous membranes.
May cause: burning sensation; contact dermatitis in case of repeated applications; seizures in the
event of marked transcutaneous absorption; rarely: hypersensitivity reactions.
Avoid contact with eyes. In case of accidental contact, flush immediately with plenty of water.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. Do not apply to the breasts.

Remarks
Close contacts should be treated at the same time regardless of whether they have symptoms or
not. Decontaminate, after each treatment, the clothes and bed linen of patients and close
contacts: wash ≥ 60 °C and dry in the sun, or leave in direct sunlight or seal in a plastic bag for 72
hours.
Itching may persist for up to 4 weeks after the end of treatment (allergic reaction to dead
parasites). Do not re-treat during this period. T he treatment may be repeated if specific scabies
lesions (scabious burrows) are still present after this period.
Prepare dilution in a glass container. T he lotion may damage certain plastics.

Storage
– Below 25 °C

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Page 564/ 663

 CALAMINE lotion
Therapeutic action
Antipruritic drug

Indications
Symptomatic treatment of pruritus

Forms and strengths

Calamine 8% or 15% lotion, bottle

Dosage
Child and adult: one application 3 to 4 times daily in a thin layer

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Clean the skin before applying the lotion.
Do not apply to exudative and/or superinfected lesions, mucous membranes or eyes.
In case of contact with eyes or mucous membranes, flush immediately with plenty of water.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. Do not apply to the breasts.

Remarks
Shake the lotion well before using.

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Page 565/ 663

 CHLORHEXIDINE 5% solution
Therapeutic action
Antiseptic

Indications
Antisepsis of minor and superficial wounds and burns

Forms and strengths

5% concentrated solution of chlorhexidine gluconate, corresponding to 2.8% chlorhexidine, to be
diluted before use

Preparation
Use as a 0.05% aqueous solution:
For one litre: 10 ml of 5% concentrated solution + 990 ml of clear water, boiled a few minutes and
cooled

Dosage
Apply diluted solution to minor and superficial wounds and burns.

Contra-indications, adverse effects, precautions

Do not use undiluted solution.
Do not bring into contact with body cavities, eyes (risk of corneal damage), brain and meninges,
middle ear (risk of deafness if ear drum is perforated).
Do not use with soap or a different type of antiseptic, e.g. povidone iodine (incompatibility).
May cause: skin and mucous membrane irritation; rarely allergic reactions.
Avoid applications to mucous membranes, especially to genital mucous membranes.
Do not use cork stoppers (decreases the antibacterial activity of chlorhexidine).
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– Below 25 °C
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Once
time diluted, the solution must be used immediately; do not store the diluted solution (risk of
at "Settings".
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Page 566/ 663

 CHLORHEXIDINE 7.1% dermal gel
Therapeutic action
Antiseptic

Indications
Antisepsis of umbilical cord

Forms and strengths

7.1 % chlorhexidine digluconate dermal gel, delivering 4% chlorhexidine, in 3 g sachet and 20 g tube

Dosage and duration

One application of 3 g of gel to the umbilical cord stump immediately after cutting the cord or
during the first post-natal visit within the first 7 days of life if the neonate was born at home
In settings where traditional unhygienic practices are common: one application daily for the first 7
days of life

Contra-indications, adverse effects, precautions

Do not bring into contact with body cavities, eyes (risk of corneal damage), brain and meninges,
middle ear (risk of deafness if ear drum is perforated).
Do not use with soap or a different type of antiseptic, e.g. povidone iodine (incompatibility).
May cause: skin and mucous membrane irritation; rarely allergic reactions.
Avoid applications to mucous membranes, especially to genital mucous membranes.

Storage
– Below 25 °C

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Page 567/ 663

 CHLORHEXIDINE 0.2% mouthwash
Therapeutic action
Antiseptic

Indications
Antisepsis of noma mouth ulcers

Forms and strengths

0.2% mouthwash solution of chlorhexidine digluconate, ready to use

Dosage
Child: one application 4 to 6 times daily to oral mucosa, using a clean gauze swab wrapped around
a tongue depressor

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Do not swallow.
Do not bring into contact with eyes (risk of corneal damage), middle ear (risk of deafness if ear
drum is perforated).
May cause: reversible brown discoloration of the tongue and teeth, taste disturbances; rarely
allergic reactions.

Storage
– Below 25 °C
WeOnce
use open, the mouthwash
a selection solution
of our own and keeps
third-party for 4 on
cookies weeks maximum.
the pages of this website: Essential cookies, which are
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Page 568/ 663

 CHLORINE-RELEASING COMPOUNDS
(NaDCC, HTH, bleach, chlorinated lime)

Therapeutic action
Disinfectants

Indications
Disinfection of medical devices, instruments, linen, floors and surfaces

Forms and strengths

The potency of chlorine disinfectants is expressed in terms of active chlorine in either:
percentage (%)
g/litre or mg/litre
parts per million (ppm)
chlorometric degree (1°chl. = approximately 0.3% active chorine)
1% = 10 g/litre = 10 000 ppm
1 mg/litre = 1 ppm = 0.0001%

The most widely used chlorine disinfectants are:

Sodium dichloroisocyanurate (NaDCC), 1,67 g tab........................................1 g active chlorine/tab
Calcium hypochlorite (HT H), granules...........................................................65-70% active chlorine
Sodium hypochlorite solutions (liquid bleach):
concentrated bleach ...................................................................36°chl. = 9.6% active chlorine
bleach ...............................................................9°chl or 12°chl. = 2.6% or 3.6% active chlorine
Chlorinated lime, powder .............................................................................25-35% active chlorine
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athe"Settings".
active chlorine content must always be checked on the product packaging in order to adjust
the dilution if necessary.
Prepare solutions with cold water in non-metallic containers.
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A deposit in HT H solutions and chlorinated lime solutions is normal (use only the supernatant).

Page 569/ 663

 Surfaces,
Clean medical equipment
devices, Surfaces, beds, contaminated Corpses,
equipment, utensils in case with blood and excreta, boots
surfaces and of cholera other body fluid in case of
linen (after cleaning) spills cholera
(after cleaning) (before
cleaning)

Concentration
required, 0.1% 0.2% 0.5% 2%
expressed in = 1000 ppm = 2000 ppm = 5000 ppm = 20 000 ppm
active chlorine

NaDCC
(1 g active
1 tab/litre water 2 tab/litre water 5 tab/litre water 20 tab/litre water
chlorine/tablet

Calcium 15 g/10 litres 30 g/10 litres 300 g/10 litres

7.5 g/litre
hypochlorite = 1 level = 2 level = 20 level
= ½ tablespoon
(70% active tablespoon tablespoons tablespoons
for 1 litre water
chlorine) for 10 litres water for 10 litres water for 10 litres water

Bleach For 5 litres: For 5 litres: For 1 litre: For 5 litres:

(2.6% active 200 ml 400 ml 200 ml 4000 ml
chlorine) + 4800 ml water + 4600 ml water + 800 ml water + 1000 ml water

For more information, see Antiseptics and disinfectants, Part two.

Precautions
Handle concentrated products with caution (avoid jolts and exposure to high temperatures or
flames).
Do not bring dry products, particularly HT H and chlorinated lime, in contact with organic materials
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our of
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explosion.
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Avoid inhaling vapours and dust functional cookies, or
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Sodium dichloroisocyanurate (NaDCC) is less corrosive than the other products.
Bleach or concentrated bleach, or if not available HT H, may be used to prepare an antiseptic
solution at 0.5% active chlorine (as substitute to Dakin's solution), provided sodium
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(one tablespoon per litre) is added to the final solution to neutralise the alkalinity (e.g. for one litre:
Page 570/ 663
 200 ml of bleach 2.6% + 800 ml distilled or filtered water, or if not available, boiled and cooled
water + 1 tablespoon of sodium bicarbonate).
Chloramine T (powder or tablet, 25% active chlorine) is another chlorine-releasing compound used
above all as an antiseptic.
Trichloro-isocyanuric acid (T CCA), in powder or granules (90% active chlorine), is very similar to
NaDCC, but its use is limited due to its poor solubility.

Storage
– – In airtight, non-metallic containers, protected from light, heat (and humidity for dry
products).
Chlorinated lime, bleach and concentrated bleach are unstable. HT H is more stable. NaDCC is by far
the most stable.

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Page 571/ 663

 CIPROFLOXACIN, ear drops
Prescription under medical supervision

Therapeutic action
Fluoroquinolone antibacterial

Indications
Acute otitis externa
Chronic suppurative otitis media

Forms and strengths

0.3% ear drops

Dosage
Child ≥ 1 year: 3 drops 2 times daily
Adult: 4 drops 2 times daily
To administer drops in the affected ear(s), pull back the auricle and maintain the head to one side for a
few minutes.

Duration
Acute otitis externa: 7 days
Chronic suppurative otitis media: until no more drainage is obtained (approximately 2 weeks, max.4
weeks)

Contra-indications, adverse effects, precautions

May cause: headache, local skin eruption or pruritus.
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Pregnancy:
required in order tono
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the website; functional cookies, which provide better easy of use when using the website;
Breast-feeding:
performance cookies, whichcontra-indication
no we use to generate aggregated data on website use and statistics; and marketing
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Do not touch let the dropper touch either hands or the ear.

Storage
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Page 572/ 663

 Below 25 °C
Once the bottle has been opened, solution keeps for 4 weeks.

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Page 573/ 663

 CLOTRIMAZOLE, vaginal tablet
Therapeutic action
Antifungal

Indications
Vaginal candidiasis

Forms and strengths, route of administration

500 mg vaginal tablet, with applicator

Dosage and duration

Adult: one vaginal tablet single dose, at bedtime, preferably lying down
Place the tablet on the applicator. Insert the applicator high into the vagina. Push the plunger then
remove the applicator.

Contra-indications, adverse effects, precautions

May cause: local irritation; allergic reactions.
Inform patients that the oil-based vaginal tablet may damage the latex in condoms and diaphragms
and reduce their effectiveness.
Pregnancy: no contra-indication (do not use the applicator to avoid damage to the cervix)
Breast-feeding: no contra-indication

Remarks
Also comes in 100 mg vaginal tablets, applied once daily at bedtime for 6 days. Do not interrupt
treatment during menstruation. Clean the applicator with water after each use.

Storage
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
– Below 25 °C
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Settings Decline Accept

Page 574/ 663

 DIMETICONE, lotion
Therapeutic action
Pediculicide by physical mode of action

Indications
Head pediculosis (lice)

Forms and strengths

4% lotion

Use
Child 6 months and over and adult: apply lotion to scalp and entire length of the hair shaft, paying
particular attention to the areas behind the ears and around the nape of the neck. Leave on hair for
8 hours (e.g. overnight), then rinse throughly with water.
Repeat the application after 7 days.

Contra-indications, adverse effects, precautions

May cause: scalp and eye irritation.
Keep away from flames and/or heat sources during application and until rinsing (risk of ignition).
Avoid contact with eyes. In case of accidental contact, flush immediately with plenty of water.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Examine everyone in contact with a patient and only treat those with live lice and/or live nits.
Preventive treatment of noninfected persons is ineffective.
Wash combs and decontaminate headwear, bedding: wash ≥ 60 °C, iron or dry in the sun or, if not
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feasible, seal in a plastic bag for 2 weeks.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Storage
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at– "Settings".
Below 25 °C

Settings Decline Accept

Page 575/ 663

 ETHANOL
See ET HYL ALCOHOL

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Page 576/ 663

 ETHYL ALCOHOL = ETHANOL
Therapeutic action
Antiseptic and disinfectant

Indications
Antisepsis of intact skin prior to injections and venopunctures
Disinfection of latex stopper of infusion bottles and drug vials (except vaccines), latex injection
sites of infusion sets

Forms and strengths

Mixtures of alcohol (ethanol) and water in different concentrations (e.g. 95% v/v ethanol),
sometimes containing additives to avoid their ingestion.
Alcoholic strength is expressed:
preferably as a percentage by volume of alcohol (% v/v); e.g. 1000 ml of 95% v/v alcohol
contains 950 ml of absolute alcohol.
sometimes as a percentage by weight of alcohol (% w/w). T he % w/w is not equal to the % v/v
because the mixture of water and alcohol produces a reduction in volume.
sometimes in degrees (°) but this should be discouraged as it is a source of error. T here are at
least 3 different definitions of degrees: the old UK definition (° British proof), the American (°
proof) and the one used in French speaking countries (1° = 1% v/v). For example: 40% v/v = 70°
proof (British system) = 80° proof (American system) = 40° in French speaking countries.

Preparation
Use 70% v/v ethanol, which is more effective than higher concentrations.
To obtain 1 litre of 70% v/v ethanol:
take 785 ml of 90% v/v ethanol, or 730 ml of 95% v/v ethanol, or 707 ml of 99% v/v ethanol;
add distilled or filtered water to make up a volume of 1 litre;
leave to cool and top up with water again to bring the volume back to 1 litre (mixing water and
We use aethanol
selectiontogether
of our own and third-party
produces cookies
a reaction on the volume
whereby pages ofisthis website: Essential cookies, which are
reduced).
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Precautions
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not apply to mucous membranes, wounds or burns: it is painful, irritating and slows the healing
at "Settings".
process.
Do not apply on neonatal skin.
Settings Decline Accept
Remarks
Page 577/ 663
 Ethanol can be used for disinfection of non-critical medical items (items that are in contact with
intact skin only) that are not soiled by blood or other body fluids.
Critical medical items (surgical instruments, etc.) cannot, under any circumstances, be “sterilized” by
alcohol flaming, immersion in ethanol or wiping with ethanol.

Storage
– Below 25 °C
Close bottles tightly to avoid evaporation. Keep away from sources of ignition (flame, spark,
incandescent material).

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 578/ 663

 FLUORESCEIN, eye drops
Last updated: September 2023

Therapeutic action
Ophthalmic diagnostic staining agent

Indications
Detection of corneal or conjunctival epithelial damage

Forms and strengths

0.5% eye drops in single use vial

Dosage and duration

Instill 1 or 2 drops into the conjunctival sac.
Ask patient to blink a few times to spread the dye around; remove excess fluorescein and proceed
with the examination.

Contra-indications, adverse effects, precautions

May cause: local allergic reaction (rare).
Wait 15 minutes before administering any other kind of eye drops.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
To facilitate the examination, use an ophthalmoscope with a blue filter (increases fluorescence).
Under normal light, large lesions are visible but small lesions cannot be detected.

Storage
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required in order25
– Below to °C
use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, for
Vials are designed which we use
single usetoonly;
generate
they aggregated data on website
must be discarded use and statistics; and marketing
after use.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 579/ 663

 HYDROCORTISONE, cream and ointment
Prescription under medical supervision

Therapeutic action
Topical corticosteroid

Indications
Atopic eczema, contact eczema, seborrhoeic dermatitis
Reactions to insect bites

Forms and strengths

1% cream and ointment

Dosage and duration

Child and adult: one application once daily or 2 times daily to the affected area only, in thin layer, for
7 days maximum

Contra-indications, adverse effects, precautions

Do not use:
for more than 7 days;
in case of acne, rosacea, perioral dermatoses, untreated bacterial (impetigo, etc.), fungal
(candidiasis and dermatophytosis) and viral (herpes) skin infections;
under occlusive dressing, on large areas of skin or on wounds, especially in infants and children
(increased local and systemic adverse effects).
May cause:
irritations, pruritus, burning sensations, skin eruptions, hypopigmentation, contact eczema and
urticaria;
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required skin atrophy,
in order to usedilation of small
the website; bloodcookies,
functional vesselswhich
(telangiectasia), stretch
provide better easy ofmarks, skinusing
use when fragility, delayed
the website;
wound
performance healing
cookies, in case
which of to
we use prolonged treatment.data on website use and statistics; and marketing
generate aggregated
cookies, which are used to
Apply with precaution to:display relevant content and advertising. If you choose "Accept all", you consent to the
use of allthe
cookies. You
eyelids canaround
and accept the
and eyes
reject (risk
individual cookie types
of glaucoma and revoke your consent for the future at any
and cataract);
time at "Settings".
the face (risk of rosacea and thinning of the skin);
the skin folds (increased adverse effects).
Pregnancy: no contra-indication
Settings Decline Accept
Breast-feeding: no contra-indication. Do not apply to the breasts.
Page 580/ 663
 Remarks
T he cream and ointment are interchangeable. However, preferably use the cream on moist lesions
and the ointment on dry and scaly lesions.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 581/ 663

 LEVONORGESTREL intrauterine device
Last updated: October 2021

Prescription under medical supervision

Therapeutic action
Hormonal contraceptive, progestogen

Indications
Long-acting contraception
Long-term treatment of functional uterine bleeding

Forms and strengths

Intrauterine device (IUD) containing 52 mg of levonorgestrel and releasing 20 micrograms daily on
insertion

Dosage
The IUD may be inserted at any moment of the cycle if it is reasonably certain the woman is not
pregnant, including when switching from another form of contraception.
For contraception, use condoms for 7 days after the insertion of the IUD if it is inserted:
over 7 days after the start of menstrual period;
over 28 days postpartum if not breastfeeding;
over 7 days after an abortion.

Duration
Contraception: as long as this method of contraception is desired and well tolerated, for max. 5
years, after which the IUD must be changed.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Long-term
required treatment
in order to of functional
use the website; uterine
functional bleeding:
cookies, which according to clinical
provide better easy of response.
use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
relevant content precautions
and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Do not use in patients with breast cancer, cervical cancer, severe or recent hepatic disease, genital
at "Settings".
infection, active thromboembolic disorders, hydatidiform mole or other gestational trophoblastic
disease.
Settings Decline Accept
May cause:

Page 582/ 663

 changes in bleeding patterns: amenorrhoea, irregular lighter bleeding; rarely: heavy prolonged
bleeding;
abdominal pain, headache, nausea, breast tenderness, acne, weight gain, mood change.
IUD insertion-related complications: expulsion of IUD, pelvic infection, risk of uterine perforation
during insertion.
T he contraceptive efficacy of levonorgestrel-releasing IUD does not seem to be reduced in
women taking enzyme-inducing drugs.
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: no contra-indication

Remarks
Fertility returns rapidly after removal of the IUD.
T he IUD can be inserted into the uterus within 48 hours after childbirth. If not inserted within 48
hours, delay insertion until after 28 days postpartum.
For details on insertion and removal of IUD, read manufacturer’s instructions carefully.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 583/ 663

 MICONAZOLE, cream
Therapeutic action
Antifungal

Indications
Cutaneous candidiasis (groin, abdominal folds, intergluteal fold, sub-mammary folds, interdigital
spaces of the toes or fingers)
Candidal balanitis
Mild dermatophyte infection of the glabrous skin and skin folds

Forms and strengths

2% cream, tube

Dosage
Child and adult: one application 2 times daily, in a thin layer, to clean and dry skin

Duration
Cutaneous candidiasis: 2 to 4 weeks
Candidal balanitis: one week
Dermatophyte infection: 2 to 3 weeks

Contra-indications, adverse effects, precautions

May cause: local irritation; allergic reactions.
In the event of genital candidiasis, inform patients that the oil-based cream may damage the latex
in condoms and diaphragms and reduce their effectiveness.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. In the event of mammary candidiasis, clean the breast
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
before nursing and apply cream after nursing.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Remarks
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time For the treatment of vulvovaginal candidiasis, miconazole cream may complement, but does not
at "Settings".
replace, treatment with clotrimazole vaginal tablets.

Storage
Settings Decline Accept

Page 584/ 663

 – Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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time at "Settings".

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Page 585/ 663

 MUPIROCIN, ointment
Prescription under medical supervision

Mupirocin should not be used in patients with extended impetigo (more than 5 lesions or more
than one skin area involved), bullous impetigo, ecthyma, impetigo with abscess, and in
immunodeficient patients: in such cases, oral antibiotic therapy is required.

Therapeutic action
Antibacterial

Indications
Localized non bullous impetigo (less than 5 lesions in a single area)

Forms and strengths

2% ointment, tube

Dosage and duration

Child and adult: one application 3 times daily, to clean and dry skin, for 7 days
T he patient should be reassessed after 3 days. If there is no response, switch to oral antibiotic
therapy.

Contra-indications, adverse effects, precautions

May cause: pruritus and burning sensation; allergic reactions.
If applying to the face, avoid contact with eyes.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. Do not apply to the breasts.
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
Remarks
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Do not mix with other ointments (effect of mupirocin decreased).
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Avoid touching the lesions; keep them covered with gauze if possible.
at "Settings".

Storage
Settings Decline Accept
– Below 25 °C
Page 586/ 663
 NaDCC
See SODIUM DICHLOROISOCYANURAT E

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 587/ 663

 NYSTATIN, vaginal tablet
Therapeutic action
Antifungal

Indications
Vaginal candidiasis

Forms and strengths, route of administration

100 000 IU vaginal tablet

Dosage and duration

Adult: one tablet once daily at bedtime for 14 days
Tablets must be moistened and inserted high into the vagina.

Contra-indications, adverse effects, precautions

May cause (rarely): local irritation, allergic reactions.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Do not interrupt treatment during menstruation.
Prefer clotrimazole 500 mg vaginal tablet as a single dose for this indication.

Storage
– Below 25 °C
Once a tablet is removed from the packaging, it must be used immediately.
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 588/ 663

 OXYBUPROCAINE, eye drops
Prescription under medical supervision

Therapeutic action
Local anaesthetic

Indications
Short-term anaesthesia of conjunctiva and cornea

Forms and strengths

0.4% eye drops in single use vial

Dosage and duration

Removal of foreign bodies
Up to 3 drops into the conjunctival sac, administered one to two minutes apart

Measurement of intraocular pressure

1 drop into the conjunctival sac

Contra-indications, adverse effects, precautions

Do not use repeatedly (risk of severe and permanent corneal damage).
May cause: stinging on instillation.
Wait 15 minutes before administering any other kind of eye drops.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order toisuse
Anaesthesia the website;
produced functional
within cookies,
one minute andwhich
lasts provide
10 to 20better easy of use when using the website;
minutes.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Anaesthetic eye drops (oxybuprocaine, tetracaine, etc.) are intended for specific therapeutic or
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofdiagnostic
all cookies.procedures. T hey
You can accept andmust
rejectnot be given
individual to the
cookie patient
types for home
and revoke youruse. In the
consent forevent of intense
the future at any
time ocular pain, prescribe an appropriate oral analgesic.
at "Settings".

Storage
Settings Decline Accept

Page 589/ 663

 Below 25 °C
Vials are designed for single use only; they must be discarded after use.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time at "Settings".

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Page 590/ 663

 PERMETHRIN 1%, lotion
Therapeutic action
Pediculicide (pyrethroid insecticide)

Indications
Head pediculosis (lice)

Forms and strengths

1% lotion

Use
Child 2 months and over and adult: apply lotion to scalp and entire length of the hair shaft, paying
particular attention to the areas behind the ears and around the nape of the neck. Leave on hair for
10 minutes, then rinse throughly with water.
Repeat the application after 7 days.

Contra-indications, adverse effects, precautions

Use with caution and under medical supervision in children under 6 months.
May cause: scalp irritation, pruritus, skin rash and redness; rarely: oedema, hypersensitivity
reactions.
Avoid contact with eyes. In case of accidental contact, flush immediately with plenty of water.
Pregnancy and breast-feeding: prefer dimeticone

Remarks
Examine everyone in contact with a patient and only treat those with live lice and/or live
nits. Preventive treatment of noninfected persons is ineffective and increases the risk of
resistance.
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
Wash combs and decontaminate headwear and bedding: wash ≥ 60 °C, iron or dry in the sun or, if
required in order to use the website; functional cookies, which provide better easy of use when using the website;
not feasible,
performance seal
cookies, in a we
which plastic bag
use to for 2 weeks.
generate aggregated data on website use and statistics; and marketing
Usewhich
cookies, the lotion rather
are used than the
to display shampoo
relevant contentthat
andisadvertising.
less effective aschoose
If you the contact
"Accepttime
all",isyou
usually shorter.
consent to the
use ofPermethrin
all cookies.5%
Youcream is used
can accept and for theindividual
reject treatment of scabies
cookie types andin children 2 months
revoke your consentand over
for the and at
future adults.
any
time at "Settings".
Remarks Storage
Settings
– Below 25 °C Decline Accept

Page 591/ 663

 PERMETHRIN 5%, cream
Therapeutic action
Scabicide (pyrethroid insecticide)

Indications
Scabies

Forms and strengths

5% cream

Use
Child 2 months and over and adult: apply the cream to the whole body, including scalp, postauricular
areas, palms of the hands and soles of the feet, paying particular attention to skin creases and
interdigital web spaces. Leave on for at least 8 hours (e.g. overnight) then rinse thoroughly with
water.
In child under 2 years: wrap hands to avoid accidental ingestion and contact with eyes.
Repeat the application after 7 days.

Contra-indications, adverse effects, precautions

Do not use in children under 2 months.
Do not apply to the face and mucous membranes, nor on broken skin.
May cause: paraesthesia, pruritus, redness, burning sensation, skin dryness; rarely: oedema,
hypersensitivity reactions.
Avoid contact with eyes. In case of accidental contact, flush immediately with plenty of water.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. Do not apply to the breasts.

WeRemarks
use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Close contacts
performance shouldwebeuse
cookies, which treated at the
to generate same time
aggregated regardless
data on websiteofuse
whether there have
and statistics; symptoms or
and marketing
not.which
cookies, Decontaminate, after each
are used to display relevanttreatment, clothes
content and and bed
advertising. linen
If you of patients
choose "Acceptandall",close
you consent to the
use ofcontacts:
all cookies. You ≥can
wash 60accept
°C and and
dryreject individual
in the cookie types
sun, or expose and revoke
to sunlight yourinconsent
or seal forbag
a plastic the future
for 72at any
time hours.
at "Settings".
Itching may persist for up to 4 weeks after the end of treatment (allergic reaction to dead
parasites): do not re-treat during this period. T he treatment may be repeated if specific scabies
Settings Decline Accept
lesions (scabious burrows) are still present after this period.

Page 592/ 663

 1% permethrin lotion is used for the treatment of head lice in children 2 months and over and
adults.

Storage
– Below 25 °C

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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Page 593/ 663

 PILOCARPINE, eye drops
Prescription under medical supervision

Therapeutic action
Cholinergic anti-glaucoma agent, miotic

Indications
Chronic open-angle glaucoma

Forms and strengths

2% eye drops
Also comes in 4% eye drops.

Dosage
Adult: 1 drop into the conjunctival sac 4 times daily

Duration
Life-long treatment

Contra-indications, adverse effects, precautions

Do not administer to children.
Do not administer to patients with iridocyclitis and some forms of secondary glaucoma.
Do not administer to patients with history of retinal detachment (trauma or family history) nor to
myopic patients, except if it is possible to examine the peripheral retina (fundus examination) prior
to the initiation of therapy and routinely thereafter.
May cause:
We use atransient
selection blurred vision,
of our own and visual fieldcookies
third-party modification, difficulty
on the pages with
of this dark adaptation
website: (informwhich
Essential cookies, patients,
are
required especially drivers);
in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies,
retinal which we
detachment in use to generate
patients aggregated data on website use and statistics; and marketing
with myopia;
cookies, ocular
which are used to display relevant content
irritation, headache (decreasing after and advertising. If yourarely,
2 to 4 weeks); chooseallergic
"Acceptreactions.
all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
In case of treatment with another eye drop, wait 5 minutes before instilling the second eye drop
time at "Settings".
treatment.
Patients should have regular monitoring of intraocular pressure during therapy.
Settings
Pregnancy: no contra-indication Decline Accept
Breastfeeding: no contra-indication
Page 594/ 663
 Remarks
Do not touch the dropper with the hands.

Storage
Below 25 °C
Once the bottle has been opened, solution keeps for 2 weeks.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
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Page 595/ 663

 PODOPHYLLOTOXIN 0.5%, solution or gel
Prescription under medical supervision

Therapeutic action
Antiviral, antimitotic, cytolytic agent active against human papillomaviruses (HPVs)

Indications
External genital warts, perianal warts and vaginal warts

Forms and strengths

0.5% solution or gel, with applicator tips

Dosage
One application to warts 2 times daily
For vaginal warts, allow to dry before removing the speculum.

Duration
3 consecutive days per week, for a maximum of 4 weeks

Contra-indications, adverse effects, precautions

Do not use to treat genital warts in children.
Do not apply to warts > 3 cm.
Do not apply to cervical, urethral, anorectal or oral warts.
Do not apply to healthy skin.
May cause local reactions: erythema, ulceration, pain in area where applied.
Use a new applicator tip for each application.
We use a selection
Avoid contact of with
our own andInthird-party
eyes. case of eyecookies on the
contact pages
flush of this website:
immediately with Essential
plenty ofcookies,
water. which are
required in order to use the website;
Pregnancy: CONT RA-INDICAT ED functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Breast-feeding: CONT RA-INDICAT ED
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

When treatment is contra-indicated or has failed after 4 weeks, change treatment method
(cryosurgery, electrosurgery, surgical removal).
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Page 596/ 663

 Storage
– Below 25 °C

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Page 597/ 663

 PODOPHYLLUM resin, solution
Prescription under medical supervision

Therapeutic action
Antiviral, antimitotic, cytolytic agent active against human papillomaviruses (HPVs)

Indications
External genital warts, perianal warts and vaginal warts

Forms and strengths

Podophyllum resin in alcohol or compound benzoin tincture, 10%, 15% and 25% solution for
topical application

Use
Always apply a protective layer of vaseline or zinc oxide ointment on the surrounding skin prior to
treatment.
Apply podophyllum resin to warts:
For external warts, leave on the warts for 1 to 4 hours then wash with soap and water.
For vaginal warts, allow to dry before removing the speculum.

Duration
Apply once weekly if necessary, for a maximum of 4 weeks.

Contra-indications, adverse effects, precautions

Do not use to treat genital warts in children.
Do not apply to healthy skin or mucous membranes, or to warts > 3 cm, or to cervical, urethral,
We use a selection
anorectal or of ourwarts.
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May cause: to use the website; functional cookies, which provide better easy of use when using the website;
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local reactions: erythema, ulceration, pain in area where applied;
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can accept and gastrointestinal disturbances,
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revoke your consent neurological
the future at any
disorders (possibly severe) in the event of prolonged or excessive application, or when applied
time at "Settings".
to bleeding lesions.
Avoid contact with eyes. In case of eye contact flush immediately with plenty of water.
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Pregnancy: CONT RA-INDICAT ED

Page 598/ 663

 Breast-feeding: CONT RA-INDICAT ED

Remarks
Use by preference 0.5% podophyllotoxin solution: it is as effective as podophyllum resin, but less
irritant and toxic. Another advantage is that the patient may apply the solution to the warts himself;
whereas the resin must always be applied by medical staff.
When treatment is contra-indicated or has failed after 4 weeks, change treatment method
(cryosurgery, electrosurgery, surgical removal).

Storage
– Below 25 °C

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Page 599/ 663

 POVIDONE IODINE = POLYVIDONE IODINE =
PVI, aqueous solution
Therapeutic action
Antiseptic and disinfectant

Indications
Antisepsis of intact or broken skin and mucous membranes
Disinfection of latex stopper of infusion bottles and drug vials (except vaccines), latex injection
sites of infusion sets

Forms and strengths

10% aqueous solution

Use
Antisepsis of intact skin (injections, punctures)
Apply 10% solution to the puncture/injection site and allow to dry before inserting the needle. T he
skin should be cleaned beforehand if soiled or if the procedure is invasive (lumbar puncture,
epidural/spinal anaesthesia, etc.).

Preoperative skin antisepsis

Apply 10% solution twice. Allow to dry between each application (do not dab to accelerate drying).
Incise once the 2nd application has dried. T he surgical site should be cleaned beforehand with PVI
scrub solution.

Wound antisepsis
Apply 10% solution to small superficial wounds.
Fora large
We use wounds
selection of ourand
ownburns, wound irrigation,
and third-party etc.,
cookies on the dilute PVI
pages of (¼website:
this of 10%Essential
PVI andcookies,
¾ of 0.9% NaCl
which are or
sterile
required water)
in order thenthe
to use rinse with 0.9%
website; NaCl
functional or sterile
cookies, water.
which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Contra-indications,
cookies, adverse
which are used to display effects,
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and advertising. If you choose "Accept all", you consent to the
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at "Settings".
not use with other antiseptics such as chlorhexidine (incompatibility) or mercury compounds (risk
of necrosis).
Do not use in preterm neonates and neonates < 1.5 kg.
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Page 600/ 663

 Due to the risk of transcutaneous resorption of iodine, do not use repeatedly nor on large areas,
especially in pregnant and lactating women and infants < 1 month.
May cause: local skin reactions; exceptionally, allergic reactions.

Remarks
T he antiseptic effect of PVI begins after 30 seconds of contact. However, a minimum contact
time of 1 minute is recommended to eliminate bacteria.

Storage
– Below 25 °C
Once the bottle has been opened, solution keeps 30 days.

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Page 601/ 663

 POVIDONE IODINE = POLYVIDONE IODINE =
PVI, scrub solution
Therapeutic action
Antiseptic

Indications
Antiseptic hand wash and surgical hand antisepsis
Preoperative skin preparation (patient preoperative showering, antiseptic cleansing of the surgical
site)
Cleansing of contaminated wounds

Forms and strengths

7.5% scrub solution
Also comes in 4% scrub solution.

Use
Antiseptic hand wash
Wet hands; pour 5 ml of solution, rub hands for 1 min; rinse thoroughly; dry with a clean towel.

Surgical hand antisepsis

T here are different protocols, for information:
Wet hands and forearms; spread 5 ml of solution on hands and forearms and rub for 1 or 2 min
(i.e. 30 seconds or 1 min for each side); brush the nails of each hand for 30 seconds; rinse.
Spread again 5 ml of solution on hands and forearms and rub for 2 min; rinse thoroughly; dry with
a sterile towel.

WePatient preoperative
use a selection showering
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Wetinthe
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order body
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clothes.
time at "Settings".

Antiseptic cleansing of surgical site

Rub for 1 min the surgical site, using sterile gauze soaked with sterile water and solution;
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Accept
sterile water; dry with sterile gauze.
Page 602/ 663
 Cleansing of contaminated wounds
Prepare a diluted solution:
With 7.5% solution: 1 part of solution + 4 parts of sterile 0.9% NaCl or water
With 4% solution: 1 part of solution + 2 parts of sterile 0.9% NaCl or water
Clean the wound; rinse thoroughly.

Contra-indications, adverse effects, precautions

Do not use with others antiseptics such as chlorhexidine (incompatibility) or mercury compounds
(risk of necrosis). Given the possible interactions between different groups of antiseptics, PVI scrub
solution must only be used with products of the same group (i.e. PVI aqueous or alcoholic
solutions).
Do not use in preterm neonates and neonates < 1.5 kg (use ordinary soap).
May cause: local skin reactions (contact dermatitis); exceptionally: allergic reactions.
Pregnancy and breast-feeding: no contra-indication for brief application; no prolonged use.

Remarks
For preoperative skin preparation, cleansing of the surgical site is followed by the application of
10% PVI solution.

Storage
– Below 25 °C

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Page 603/ 663

 SILVER SULFADIAZINE, cream
Prescription under medical supervision

Therapeutic action
Antibacterial (sulfonamide group)

Indications
Prophylaxis and treatment of infections of in severe burns
Treatment of infections in leg ulcers

Forms and strengths

1% sterile cream, tube or jar

Use
Child 2 months and over and adult: clean the wound then apply a 3 to 5 mm layer of silver
sulfadiazine cream to the wound once daily and cover with sterile compresses.

Duration
Until wound has healed or until skin graft, when required.

Contra-indications, adverse effects, precautions

Do not use in patients with allergy to sulfonamides; in children under 2 months.
Do not apply other topical treatments to wounds where silver sulfadiazine is applied.
Use with caution in children under 2 years (risk of systemic absorption); in patients with severe renal
or hepatic impairment.
May cause:
We use askin
selection of our grey
reactions, own and
skinthird-party cookies
discoloration, onphotosensitivity;
skin the pages of this website: Essential
rarely: allergic cookies, which
reactions, are
sometimes
required severe
in order (Lyell’s
to use the website; functional cookies,
and Stevens-Johnson syndromes). which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
systemic adverse effects related to sulfonamides (haematological, renal, cutaneous disorders,
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use of alletc.) when
cookies. Youapplied to a and
can accept largereject
surface area, cookie
individual mucous membranes
types and revokeoryour
prolonged
consent use.
for the future at any
rd
time Pregnancy:
at "Settings". avoid if possible during the 3 trimester of pregnancy (risk of jaundice in the neonate)
Breast-feeding: CONT RA-INDICAT ED if the child is under one month

Storage
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Page 604/ 663

 – Between 8 °C and 25 °C
After use, keep the tube or jar tightly closed to avoid exposure to light.

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Page 605/ 663

 SODIUM DICHLOROISOCYANURATE = NaDCC

Therapeutic action
Disinfectant (chlorine-releasing compound)

Indications
Disinfection of medical devices, instruments, linen, floors and surfaces

Forms and strengths

1.67 g NaDCC effervescent tablet, releasing 1 g active chlorine when dissolved in water.
Also comes in different strengths and in granules and powder.

Preparation and use

Pre-disinfection of soiled instruments
0.1% active chlorine solution (1000 ppm): 1 tablet of 1 g active chlorine per litre
Immediately after use, soak instruments for 15 minutes, then clean instruments.

Disinfection of clean instruments

0.1% active chlorine solution (1000 ppm): 1 tablet of 1 g active chlorine per litre
Soak previously cleaned instruments for 20 minutes, rinse thoroughly and dry.

Disinfection of linen
0.1% active chlorine solution (1000 ppm): 1 tablet of 1 g active chlorine per litre
Soak for 15 minutes, rinse thoroughly (at least 3 times).

General disinfection (surfaces, floors, sinks, equipment, etc.)

WeSee
useChlorine-releasing compounds
a selection of our own and Antiseptics
and third-party andpages
cookies on the disinfectants, Part Essential
of this website: two. cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Precautions
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
use ofPrepare
all cookies. You can
solutions accept
with coldand rejectinindividual
water, cookie
non metallic types and revoke your consent for the future at any
containers.
time NaDCC
at "Settings".
can corrode metal. T he risk is limited for good quality stainless steel instruments if
concentration, contact time (20 minutes maximum) and thorough rinsing recommendations are
respected.
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For disinfection of linen: use only for white cotton or linen (risk of discolouration).
Page 606/ 663
 Do not expose the product to flames. Do not incinerate.
DO NOT SWALLOW. Do not store NaDCC tablets near oral tablets.
Avoid inhaling vapours and dust when opening or handling the containers.
Do not mix with acid solutions such as urine, etc. (release of toxic chlorine gas) and detergents.

Remarks
NaDCC may be used for wound antisepsis but only if the formulation is intended for this purpose:
0.1% active chlorine solution (1000 ppm): 1 tablet of 1 g active chlorine per litre. For prolonged use,
protect the healthy skin around the wound with vaseline.
Caution: some formulations used for disinfecting floors contain additives (detergents, colouring,
etc.) and cannot be used on wounds. Check label or leaflet.
Some formulations can be used for the disinfection of drinking water (Aquatabs®, etc.). Follow
manufacturer's instructions.
NaDCC is also called sodium troclosene, sodium dichloro-s-triazinetrione.

Storage
– – In airtight container, protected from light, heat and humidity, in a well ventilated room

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Page 607/ 663

 TETRACYCLINE, eye ointment
Therapeutic action
Antibacterial

Indications
Treatment of bacterial conjunctivitis
Treatment of trachoma (by preference use oral azithromycin for this indication)
Prevention of neonatal conjunctivitis

Forms and strengths

1% ointment, tube

Dosage and duration

Wash the eyes with boiled and cooled water before each application. Use sterile sodium chloride
0.9% for newborns.
Apply tetracycline 1% into the conjunctival sac of both eyes:
Conjunctivitis: one application 2 times daily for 7 days
Trachoma: one application 2 times daily for 6 weeks
Prevention of neonatal conjunctivitis: one single application immediately after birth

Contra-indications, adverse effects, precautions

Do not use in patients with hypersensitivity to tetracyclines.
May cause allergic reactions; stop treatment in the event of serious reaction.

Remarks
Neonatal conjunctivitis must be treated with systemic antibiotic therapy. When it is not immediately
available, apply tetracycline eye ointment to both eyes every hour until systemic treatment is
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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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performance and chlortetracycline
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aggregated datasame way as
on website usetetracycline.
and statistics; and marketing
In the
cookies, event
which areof eyetoinfection,
used use only
display relevant eye and
content ointment; dermal
advertising. ointment
If you choosemust never
"Accept all",beyou
applied totothe
consent the
use ofeyes.
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Storage
Settings
– Below 25 °C Decline Accept
Do not use after expiry date.
Page 608/ 663
 ZINC OXIDE, ointment
Therapeutic action
Skin protector

Indications
Dermatosis of kwashiorkor
Nappy rash
Eczema
First-degree burns
Protection of healthy skin when caustic products such as podophyllum resin or podophyllotoxin are
to be applied

Forms and strengths

10% zinc oxide ointment, tube or jar

Dosage
Child and adult: one application 1 to 3 times daily

Duration
According to clinical response

Contra-indications, adverse effects, precautions

Clean the skin before applying the ointment.
Do not apply to exudative and/or superinfected lesions.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication. Do not apply to the breasts.

WeStorage
use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
performance
– Below cookies,
25 °Cwhich we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
Once the ointment has been exposed to a high temperature the active ingredients are no longer evenly
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distributed:
time the ointment must be homogenized before using.
at "Settings".

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Page 609/ 663

 Drugs potentially dangerous or obsolete
or ineffective
AMODIAQUINE = AQ oral

ART EMET HER injectable

ART ESUNAT E = AS oral

ART ESUNAT E + SULFADOXINE/PYRIMET HAMINE = AS + SP oral

Long-acting oily CHLORAMPHENICOL injectable

MEFLOQUINE = MQ oral

MET HYLROSANILINIUM CHLORIDE = GENT IAN VIOLET = GV = CRYSTAL VIOLET

METAMIZOLE = DIPYRONE = NORAMIDOPYRINE oral

METAMIZOLE = DIPYRONE = NORAMIDOPYRINE injectable

POTASSIUM CHLORIDE 10% = KCl 10% injectable

QUININE injectable

SALBUTAMOL injectable

T ETANUS ANT IT OXIN ( EQUINE)

DIPHT ERIA-T ETANUS-PERT USSIS VACCINE (DT P)

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Page 610/ 663

 AMODIAQUINE = AQ oral
Prescription under medical supervision

Do not administer the combination artesunate-amodiaquine as separate tablets (i.e. artesunate

tablets + amodiaquine tablets). Use co-formulated tablets.

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria, in combination with artesunate
Treatment of uncomplicated malaria due to other Plasmodium species, in combination with
artesunate, when chloroquine cannot be used
Completion treatment following parenteral therapy for severe malaria, in combination with
artesunate

Forms and strengths

200 mg amodiaquine hydrochloride tablet, containing 153 mg amodiaquine base

Dosage and duration

Child and adult: 10 mg base/kg once daily for 3 days, in combination with artesunate

Contra-indications, adverse effects, precautions

Do not administer in the event of previous severe adverse reaction to treatment with amodiaquine
(e.g. hypersensitivity reaction, hepatitis, leucopenia, agranulocytosis).
Do not administer to patients taking efavirenz.
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May cause: gastrointestinal disturbances, pruritus, cough, insomnia.
required in order to use the website; functional cookies, which provide better easy of use when using the website;
Pregnancy:
performance no contra-indication
cookies, which we use to generate aggregated data on website use and statistics; and marketing
Breast-feeding:
cookies, which are usednoto contra-indication
display relevant content and advertising. If you choose "Accept all", you consent to the
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Remarks
time at "Settings".

Also comes as co-packaged dispersible tablets for seasonal malaria chemoprevention in children:
Settings
amodiaquine 153 mg + sulfadoxine/pyrimethamine 500 mg/25 mg and amodiaquineDecline
76.5 mg +Accept
sulfadoxine/pyrimethamine 250 mg/12.5mg.
Page 611/ 663
 Storage
– Below 25 °C

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Page 612/ 663

 ARTEMETHER injectable
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Alternative to injectable artesunate (when it is not available) in the:
Treatment of severe malaria
Initial treatment of uncomplicated malaria, when persistent vomiting precludes oral therapy

Forms and strengths, route of administration

80 mg in 1 ml ampoule (80 mg/ml), oily solution for IM injection. NEVER ADMINIST ER BY IV
ROUT E.
When the dose required is less than 1 ml, use a 1 ml syringe graduated in 0.01 ml.

Dosage and duration

Child and adult:
3.2 mg/kg by IM injection on the first day followed by 1.6 mg/kg once daily

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Page 613/ 663

 80 mg ampoule
Weight
Loading dose Maintenance dose

3-4 kg 0.2 ml 0.1 ml

5-6 kg 0.3 ml 0.15 ml

7-9 kg 0.4 ml 0.2 ml

10-14 kg 0.6 ml 0.3 ml

15-19 kg 0.8 ml 0.4 ml

20-29 kg 1.2 ml 0.6 ml

30-39 kg 1.6 ml 0.8 ml

40-49 kg 2 ml 1 ml

50-59 kg 2.5 ml 1.2 ml

Treat parenterally for at least 24 hours (2 doses), then, if the patient can tolerate the oral route,
change to a complete 3-day course of an artemisinin-based combination. If not, continue
parenteral treatment once daily until the patient can change to oral route (without exceeding 7 days
of parenteral treatment).

Contra-indications, adverse effects, precautions

May cause: gastrointestinal disturbances, dizziness.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Storage
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order25to°C
– Below use the website; functional cookies, which provide better easy of use when using the website;
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Page 614/ 663

 ARTESUNATE = AS oral
Prescription under medical supervision

Oral artesunate must always be administered in combination with another antimalarial in

coformulated tablets: artesunate/amodiaquine or artesunate/mefloquine.

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria, in combination with another antimalarial
Treatment of uncomplicated malaria due to other Plasmodium species, in combination with another
antimalarial, when chloroquine cannot be used
Completion treatment following parenteral therapy for severe malaria, in combination with another
antimalarial

Forms and strengths

50 mg tablet

Dosage and duration

Child and adult: 4 mg/kg once daily for 3 days in combination with another antimalarial

Contra-indications, adverse effects, precautions

May cause: gastrointestinal disturbances, dizziness.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
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Storage
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
– – Below 25 °C
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Page 615/ 663

 ARTESUNATE +
SULFADOXINE/PYRIMETHAMINE = AS + SP
oral
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria
Completion treatment following parenteral therapy for severe falciparum malaria

Forms and strengths

Artesunate (AS) tablets and sulfadoxine/pyrimethamine (SP) tablets, in blister packs, for a complete
treatment for one individual
T here are 4 different blister packs:
Child < 25 kg:
blister pack with 3 tab AS 50 mg and 1 tab SP 500/25 mg
Child 25 to < 50 kg:
blister pack with 6 tab AS 50 mg and 2 tab SP 500/25 mg
Child ≥ 50 kg and adult:
blister pack with 12 tab AS 50 mg and 3 tab SP 500/25 mg
or blister pack with 6 tab AS 100 mg and 3 tab SP 500/25 mg

Dosage and duration

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administered functional cookies,
daily for which provide better easy of use when using the website;
3 days.
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Sulfadoxine/pyrimethamine generate aggregated data on
as a single website
dose use with
on D1, and statistics; and marketing
the first dose of
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Page 616/ 663

 Weight Blister pack D1 D2 D3

5 to < 10 kg 3 tab AS50 + 1 tab SP ½ tab AS + ½ tab SP ½ tab AS ½ tab AS

10 to < 25 kg 3 tab AS50 + 1 tab SP 1 tab AS + 1 tab SP 1 tab AS 1 tab AS

25 to < 50 kg 6 tab AS50 + 2 tab SP 2 tab AS + 2 tab SP 2 tab AS 2 tab AS

12 tab AS50 + 3 tab SP 4 tab AS + 3 tab SP 4 tab AS 4 tab AS

≥ 50 kg and adult
6 tab AS100 + 3 tab SP 2 tab AS + 3 tab SP 2 tab AS 2 tab AS

Contra-indications, adverse effects, precautions

Do not administer to patients with allergy to sulfonamides.
May cause: see artesunate and sulfadoxine/pyrimethamine.
Do not use in combination with co-trimoxazole.
Do not give folic acid on the same day SP is administered, or within 2 weeks thereafter.
Pregnancy: CONT RA-INDICAT ED during the first trimester (risk of neural tube defects); no contra-
indication during the 2nd and 3rd trimester
Breast-feeding: no contra-indication

Storage
– – Below 30 °C
Leave tablets in blisters until use. Once a tablet is removed from its blister, it must be administered
immediately.
If half tablets are used, remaining half tablets may be given to another patient if administered within 24
hours.

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Page 617/ 663

 Long-acting oily CHLORAMPHENICOL
injectable
Prescription under medical supervision

Therapeutic action
Phenicol antibacterial, with prolonged effect

Indications
Treatment of meningococcal meningitis during epidemics

Forms and strengths, route of administration

500 mg oily suspension in 2 ml ampoule (250 mg/ml) for IM injection only. NEVER FOR IV
INJECT ION.

Dosage
Child over 2 years and adult: 100 mg/kg single dose (max. 3 g per dose)

Age Weight Dose Volume

2 to < 6 years 13 to < 21 kg 1.5 g 6 ml

6 to < 10 years 21 to < 31 kg 2g 8 ml

10 to < 15 years 31 to < 54 kg 2.5 g 10 ml

≥ 15 years and adult ≥ 54 kg 3g 12 ml

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Duration
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Single dose. If there is no improvement after 24 hours, a second dose may be administered.
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Contra-indications, adverse effects, precautions
Page 618/ 663
 Do not administer to patients with:
history of allergic reaction or bone marrow depression during a previous treatment with
chloramphenicol;
G6PD deficiency.
May cause:
dose-related haematological toxicity (bone marrow depression, anaemia, leucopenia,
thrombocytopenia), allergic reactions. In these events, stop treatment immediately;
gastrointestinal disturbances, peripheral and optic neuropathies.
Avoid or monitor combination with potentially haematotoxic drugs (carbamazepine, co-
trimoxazole, flucytocine, pyrimethamine, zidovudine, etc.).
Pregnancy: CONT RA-INDICAT ED
Breast-feeding: CONT RA-INDICAT ED

Remarks
Oily chloramphenicol is not recommended as chemoprophylaxis for meningitis contacts during
epidemics.
Shake the injection suspension before administration.

Storage
– Below 25 °C

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Page 619/ 663

 MEFLOQUINE = MQ oral
Prescription under medical supervision

Do not administer the combination artesunate-mefloquine as separate tablets (i.e.

artesunate tablets + mefloquine tablets). Use co-formulated tablets.

Therapeutic action
Antimalarial

Indications
Treatment of uncomplicated falciparum malaria
Treatment of uncomplicated malaria due to other Plasmodium species, when chloroquine cannot
be used
Completion treatment following parenteral therapy for severe malaria

Forms and strengths

250 mg scored tablet

Dosage and duration

Child 6 months and over (≥ 5 kg) and adult: 8 mg/kg once daily for 3 days (in combination with
artesunate)

Contra-indications, adverse effects, precautions

Do not administer to patients with neuropsychiatric disorders (or history of), seizures,
hypersensitivity to mefloquine or quinine; mefloquine treatment in the previous 4 weeks.
For completion treatment following parenteral therapy for severe malaria: do not administer if the
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allergies.
If the patient vomits less than 30 minutes after administration, repeat the full dose. If the patient
vomits within 30 to 60 minutes, re-administer a half the dose.
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Page 620/ 663

 Do not combine with anti-epileptics (risk of seizures), co-artemether, chloroquine (risk of seizures,
cardiac toxicity).
Do not administer simultaneously with quinine (risk of seizures, cardiac toxicity). If mefloquine is
used after quinine IV, administer mefloquine 12 hours after the last dose of quinine.
Administer with caution to patients taking antiarrhythmics, beta-blockers, calcium-channel blockers
or digitalis (risk of heart rhythm disorders).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Also comes in co-formulated tablets containing artesunate 25 mg/mefloquine 50 mg and
artesunate 100 mg/mefloquine 200 mg.

Storage
– Below 25 °C

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Page 621/ 663

 METHYLROSANILINIUM CHLORIDE =
GENTIAN VIOLET = GV = CRYSTAL VIOLET
Carcinogenic effects have been demonstrated in animals. As a precaution, this product should not
be used in humans if an alternative is available.

Therapeutic action
Antifungal, weak antiseptic, drying agent

Indications
Oropharyngeal candidiasis, mammary candidiasis in nursing mothers
Certain wet skin lesions (impetigo, dermatophytosis oozing lesions)

Forms and strengths

Powder to be dissolved

Preparation
Dissolve 2.5 g of powder (= one half-teaspoon) in 1 litre of clear water (boiled a few minutes and
cooled) to obtain a 0.25% solution.
Shake well and leave to settle. Pour carefully into another bottle to eliminate any possible
sediment.
Before preparation, carefully wash both the bottle for dilution and the storage bottle with hot
water and leave to dry.

Use
One application 2 times daily for a few days
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May cause:
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T he solution should not be swallowed.
Page 622/ 663
 T he use of cooking oil or vaseline around lips before swabbing can limit the risk of skin coloration.
Stop treatment in the event of allergic reactions or if new ulcerations develop.
In the event of product entering the eye, rinse with plenty of water.
Avoid contact with clothes (causes permanent staining of fabrics).

Remarks
Gentian violet is no longer included in the WHO list of essential medicines.

Storage

Powder to be dissolved: unlimited

Diluted solution: maximum 1 week

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Page 623/ 663

 METAMIZOLE = DIPYRONE =
NORAMIDOPYRINE oral
Prescription under medical supervision

Given the potentially serious adverse effects and that safer alternatives exist, this drug
should not be prescribed as first choice treatment.

Therapeutic action
Analgesic, antipyretic

Indications
Pain, fever

Forms and strengths

500 mg tablet

Dosage
Adult: 500 mg to 1 g 2 to 3 times daily

Duration
As short as possible.

Contra-indications, adverse effects, precautions

May cause:
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Remarks
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Page 624/ 663

 Storage
Below 25 °C

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Page 625/ 663

 METAMIZOLE = DIPYRONE =
NORAMIDOPYRINE injectable
Prescription under medical supervision

Given the potentially serious adverse effects and that safer alternatives exist, this drug
should not be prescribed as first choice treatment.

Therapeutic action
Analgesic, antipyretic

Indications
Pain, fever

Forms and strengths, route of administration

1 g in 2 ml ampoule (500 mg/ml) for IM, SC or slow IV injection or infusion

Dosage
Adult: 500 mg every 8 hours if necessary

Duration
As short as possible.

Contra-indications, adverse effects, precautions

May cause:
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Remarks
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Page 626/ 663

 Storage
Below 25 °C

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Page 627/ 663

 POTASSIUM CHLORIDE 10% = KCl 10%
injectable
Prescription under medical supervision

Indications
Treatment of severe hypokalaemia (arrhythmia, marked muscular weakness, rhabdomyolysis or
serum potassium level ≤ 2.5 mmol/litre)

Forms and strengths, route of administration

Ampoule containing 10% potassium chloride hypertonic solution (100 mg/ml, 10 ml), i.e. 1 g of
potassium chloride (KCl) per 10 ml ampoule
Ionic composition:
potassium (K+): 13.4 mmol per 10 ml ampoule (13.4 mEq)
chloride (Cl–): 13.4 mmol per 10 ml ampoule (13.4 mEq)
Check concentration before use: potassium chloride also comes in ampoules containing 7.5%,
11.2%, 15% and 20% solutions.
NEVER USE BY IV OR IM OR SC INJECT ION. Potassium chloride must always be administered by
slow IV infusion, diluted in 0.9% sodium chloride.
For dilution:
T he potassium concentration in the infusion fluid should not exceed 40 mmol/litre.
Mix thoroughly the potassium and the 0.9% sodium chloride solution by inverting at least 5
times the infusion bottle or bag.

Dosage and duration

Dosage depends on the severity of hypokalaemia and the patient’s underlying condition. For
information:
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Each mmol of potassium is diluted in 25 ml of 0.9% sodium chloride.
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Page 628/ 663

 0.2 (mmol) x 10 (kg) = 2 mmol/hour x 3 hours = 6 mmol
10 kg 6 mmol (= 4.5 ml of 10% KCl solution) diluted in 150 ml of NaCl 0.9% and administered
over 3 hours

0.2 (mmol) x 15 (kg) = 3 mmol/hour x 3 hours = 9 mmol

15 kg 9 mmol (= 6.5 ml of 10% KCl solution) diluted in 225 ml of NaCl 0.9% and administered
over 3 hours

Adult: 40 mmol (= 3 ampoules of 10 ml of 10% KCl) in one litre of 0.9% sodium chloride, to be
administered over 4 hours. Do not exceed 10 mmol/hour.

T he infusion may be repeated if severe symptoms persist or if the serum potassium level remains < 3
mmol/litre.

Contra-indications, adverse effects, precautions

Administer with caution to elderly patients.
Administer with caution and reduce the dose in patients with renal impairment (increased risk of
hyperkalaemia).
May cause:
in the event of rapid or excessive administration: hyperkalaemia, cardiac conduction and rhythm
disorders, potentially fatal;
in the event of extravasation: necrosis.
Infusion must be constantly monitored.

Remarks
A 7.5% potassium solution contains 1 mmol of K+/ml; a 11.2% solution contains 1.5 mmol of K+/ml;
a 15% solution contains 2 mmol of K+/ml; a 20% solution contains 2.68 mmol of K+/ml.
Moderate hypokalaemia is defined as a potassium level < 3.5 mmol/litre; severe hypo kalaemia as a
potassium level ≤ 2.5 mmol/litre.

Storage
Below 25 °C
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Page 629/ 663

 QUININE injectable
Prescription under medical supervision

Therapeutic action
Antimalarial

Indications
Alternative to injectable artesunate, when it is not available, in the treatment of severe malaria

Forms and strengths, route of administration

600 mg of quinine dihydrochloride in 2 ml ampoule (300 mg/ml), to be diluted in 5% glucose, for slow
infusion.
NEVER ADMINIST ER BY IV INJECT ION.

Dosage
T he dosage is expressed in terms of salt:

Child and adult:

loading dose: 20 mg/kg administered over 4 hours, then keep the vein open with an infusion of
5% glucose over 4 hours
maintenance dose: 8 hours after the start of the loading dose, 10 mg/kg every 8 hours
(alternate quinine over 4 hours and 5% glucose over 4 hours)

For adults, administer each dose of quinine in 250 ml. For children under 20 kg, administer each dose of
quinine in a volume of 10 ml/kg.

Do not administer a loading dose to patients who have received oral quinine or mefloquine within the
previous 24 hours: start with maintenance dose.
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complete 7 days of quinine treatment).
If not, continue parenteral treatment until the patient can change to oral route (without exceeding 7
days of parenteral treatment).
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Page 630/ 663

 Contra-indications, adverse effects, precautions
May cause: hypoglycaemia; auditory and visual disturbances, cardiac disorders (especially in the
event of overdose), hypersensitivity reactions, cardiac depression if injected undiluted by IV route.
In patients with acute renal failure, reduce the dose by one-third if the parenteral treatment lasts
more than 48 hours.
Monitor blood glucose (reagent strip test).
Do not administer simultaneously with mefloquine (risk of seizures, cardiac toxicity). Administer
mefloquine 12 hours after the last dose of quinine.
Pregnancy: no contra-indication. T he risk of quinine-related hypoglycaemia is very high in pregnant
women.
Breast-feeding: no contra-indication

Remarks
10 mg quinine dihydrochloride = 8 mg quinine base.
Administration by IM deep injection (into the anterior thigh only) is possible when infusion cannot be
performed (e.g. before transferring a patient). However this may cause numerous complications.
Doses are the same as for the IV route. Quinine should be diluted (1/2 or 1/5). For the loading dose,
administer half the dose into each thigh.

Storage
– Below 25 °C

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Page 631/ 663

 SALBUTAMOL injectable
Prescription under medical supervision

Therapeutic action
Uterine relaxant

Indications
T hreatened premature labour (preferably use nifedipine for this indication)

Forms and strengths, route of administration

0.5 mg in 1 ml ampoule (0.5 mg/ml) for IV infusion

Dosage
Dilute 5 mg (10 ampoules of 0.5 mg) in 500 ml of 5% glucose or 0.9% sodium chloride to obtain a
solution of 10 micrograms/ml.
Start infusion at the rate of 15 to 20 micrograms/minute (30 to 40 drops/minute).
If contractions persist, increase the rate by 10 to 20 drops/minute every 30 minutes until uterine
contractions cease. Do not exceed 45 micrograms/minute (90 drops/minute).
Continue for one hour after contractions have ceased, then reduce the rate by half every 6 hours.

Duration
48 hours maximum

Contra-indications, adverse effects, precautions

Do not administer to patients with pre-eclampsia, eclampsia, uterine haemorrhage, intra-uterine
infection, intra-uterine foetal death, placenta praevia, placental abruption, rupture of membranes,
We use a selection
multiple of our own
pregnancy, and cardiopathy.
severe third-party cookies on the pages of this website: Essential cookies, which are
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Administer with caution to patients cookies,
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hyperthyroidism.
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
Do not combine with nifedipine.
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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and reject ischemia,
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revoke tachycardia,
your consent for the future at any
time hypotension,
at "Settings". tremor, headache, hypokalaemia, hyperglycaemia.
Monitor maternal pulse regularly. Reduce the infusion rate in the event of maternal tachycardia (>
120/minute).
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Pregnancy: no contra-indication

Page 632/ 663

 Breast-feeding: avoid

Remarks
Use salbutamol within 24 hours of mixing with infusion fluid.
Do not mix with other drugs in the same infusion fluid.
Also comes in 5 ml ampoule containing 0.25 mg (0.05 mg/ml).

Storage
– Below 25 °C

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Page 633/ 663

 TETANUS ANTITOXIN ( EQUINE)
Equine tetanus antitoxin should no longer be used, as there is a risk of hypersensitivity and
serum sickness.
It should be replaced by human tetanus immunoglobulin.

Therapeutic action
Neutralisation of tetanus toxin. Tetanus antiserum provides temporary passive immunity against
tetanus for 2 weeks.

Indications
Prevention of tetanus in wound management, in patients non immunised or incompletely immunised
or in patients whose immunisation status is unknown, in combination with tetanus vaccine
Treatment of clinical tetanus

Composition, forms and strengths, route of administration

Solution prepared from the serum of horses immunised against tetanus toxin
1500 IU in 1 ml ampoule, for IM injection. DO NOT ADMINIST ER BY IV ROUT E.

Dosage and duration

Prevention of tetanus
Tetanus antiserum is administered in the event of tetanus-prone wounds, e.g. wounds with fracture,
deep penetrating wounds, bite wounds, wounds containing foreign bodies, wounds contaminated
with soil, infected wounds, extensive tissue damage (contusions, burns).
Child and adult: 1500 IU single dose; 3000 IU if more than 24 hours has elapsed
It is administered as soon as possible after injury, along with the tetanus vaccine, in a separate
syringe and injection site.

We use a selection
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Neonate: 1500 to useIUthe website;
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Child and adult: 10 000 IU single dose
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
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Contra-indications,
time at "Settings". adverse effects, precautions
Do not administer to patients with known allergy to tetanus antiserum.
May cause: hypersensitivity reactions, anaphylactic shock, Quinke oedema; serumDecline
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Accept
10 days after injection.
Page 634/ 663
 Administer following Besredka's method: inject 0.1 ml by SC route and wait 15 minutes; if no local
or general allergic reactions occur, inject 0.25 ml by SC route and wait 15 minutes; if no reactions,
administer the injection by IM route.
Ensure that the injection does not enter a blood vessel (risk of shock): aspirate prior to injection to
confirm that the needle is not in a vein.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks
Equine tetanus antitoxin is not included in the WHO list of essential medicines.

Storage
– Between 2 °C and 8 °C. Do not freeze.

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Page 635/ 663

 DIPHTERIA-TETANUS-PERTUSSIS VACCINE
(DTP)
Last updated: December 2024

T his vaccine has been replaced by the pentavalent DT P/Hepatitis B/Hib vaccine.

Indications
Prevention of diphtheria, tetanus and pertussis in children under 7 years (primary vaccination and
booster dose)

Composition, forms, route of administration

Trivalent vaccine combining diphtheria toxoid, tetanus toxoid and whole-cell (DTwP) or acellular
(DTaP) pertussis vaccine
Suspension for injection in multidose vial, for IM injection into the anterolateral part of the thigh in
children < 2 years and in the deltoid muscle in children ≥ 2 years
DO NOT ADMINIST ER INT O T HE GLUT EAL MUSCLE.

Dosage and vaccination schedule

Child: 0.5 ml per dose
Primary vaccination: 3 doses 4 weeks apart, preferably before the age of 6 months. It is
recommended to administer the 1st dose at 6 weeks of age, the 2nd dose at 10 weeks of age and
the 3rd dose at 14 weeks of age. If a child has not been vaccinated at 6 weeks of age, start
vaccination as soon as possible.
Booster: one dose between 12 and 23 months

Contra-indications, adverse effects, precautions

Do not administer in the event of allergic reactions to a previous dose of DT P vaccine or evolving
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neurological disease (encephalopathy, uncontrolled epilepsy).
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site), consent
fever, for the future at any
fatigue,
time malaise;
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rarely: anaphylactic reactions, seizures.
Respect an interval of 4 weeks between each dose of primary vaccination.
If administered simultaneously with other vaccines, use different syringes and injection
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 Remarks
If the vaccination is interrupted before the complete series has been administered, it is not
necessary to start again from the beginning. Continue the vaccination schedule from where it was
interrupted and complete the series as normal.
Also comes in:
tetravalent vaccine (diphtheria, tetanus, pertussis, hepatitis B) and pentavalent vaccine
(diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae) used for primary
vaccination in children < 7 years;
bivalent T d vaccine containing a reduced dose of diphtheria toxoid (tetanus-diphtheria), used in
children ≥ 4 years, adolescents and adults.
Shake before use to homogenise the vaccine.

Storage
– Between 2 °C and 8 °C. Do not freeze.

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 Part two
Organization and management of a pharmacy

Drug quality and storage

Prescription, cost, compliance

Antiseptics and disinfectants

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 Organization and management of a
pharmacy
Organization and rigorous management of the pharmacy are crucial in all health facilities in order to:
maintain a permanent stock of essential medicines and supplies of quality;
reduce costs;
save time and optimise the work of the staff;
facilitate management and continuous consumption evaluation.

In any case, national pharmaceutical policies and regulations must be taken into account when
implementing pharmaceutical activities.

Preliminary information
Drug designation
All active ingredients have an international nonproprietary name (INN). Drugs are designated by their
INN in all standardised lists. T he INN should also be used in standard therapeutic regimens and
management documents, in order to avoid confusion, since drugs are sold under their INN or a variety
of brand names, depending on the manufacturer (e.g. ampicillin may be sold as Britapen®, Penbritin®,
Pentrexyl®, Totapen®, etc.).

Generic drugs are copies of drugs whose patents have expired. T hey can therefore be made by any
pharmaceutical laboratory and are most often sold under their INN or occasionally under a new brand
name.

Selection of essential medicines

Most countries have a national list of essential medicines. If there is no national list, refer to the latest
WHO list.

T he use of such a list presents several advantages:

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obtains approvaluse from
and statistics; and marketing
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subsidise projects (United Nations, European Union, etc.).
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T he list of selected drugs is drawn in accordance with pre-established standardised therapeutic
regimens. T his offers two major advantages:
better treatments due to more rational use of a restricted number of essential drugs;
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Page 639/ 663

 economic and administrative improvements concerning purchasing, storage, distribution and
control.

Proposing the same drug in many different strengths or forms should be avoided. In most cases, one
form/strength for adults and one paediatric form/strength are sufficient. T his facilitates management
and avoids confusion in prescriptions.

At times, local prescription usages should be taken into account, e.g. in French-speaking Africa, 500
mg aspirin tablets are used; in English-speaking Africa, 300 mg tablets.

Note: medical supplies (dressing, injections, sutures, etc.) should be limited to essentials and the object
of a standardised list.

Drug classification
In the WHO list, drugs are classified according to their therapeutic action. T his classification presents
a certain pedagogical advantage but cannot be used as the basis of a storage arrangement system
(e.g. a drug may appear in several classes).

Médecins Sans Frontières recommends a storage arrangement system according to the route of
administration and in alphabetical order.
Drugs are divided into 6 classes and listed in alphabetical order within each class:
oral drugs
injectable drugs
infusion fluids
vaccines, immunoglobulins and antisera
drugs for external use and antiseptics
disinfectants

T his classification should be used at every level of a management system (order forms, stock cards,
inventory lists, etc.) in order to facilitate all procedures.

Levels of use
More limited lists should be established according to the level of health structures and competencies
of prescribers. Restricted lists and the designation of prescription and distribution levels should be
adapted to the terminology and context of each country.

Quantitative evaluation of needs when launching a programme

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possible to calculate the respective quantities of each product needed from the expected number of
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 Several methods have been suggested (see Estimating drug requirements, WHO). Quantities
calculated may differ from those corresponding to true needs or demands (this can be the case when
the number of consultations increases or when prescribers do not respect proposed therapeutic
regimens).

In an emergency situation (especially with displaced population), the Emergency Health Kit, developed
in collaboration with the WHO, UNHCR, MSF, etc., is designed to meet the care needs of a displaced
population of 10,000 people for 3 months. Afterwards, specific local needs should be evaluated in
order to establish a suitable supply.

Routine evaluation of needs and consumption allows verification of how well prescription schemes are
respected and prevents possible stock shortages.

Layout of a pharmacy
Whether constructing a building, converting an existing building, central pharmacy or health facility
pharmacy, the objectives are the same only the means differ.

Premises
Functional premises should be designed in order to ensure:
the safe keeping of stocks;
correct storage of drugs and supplies;
rational and easy management.

Characteristics of a warehouse
Dimensions of warehouse are determined by storage needs, which depend on:
the number of drugs and supplies to be stocked;
the number and activities of facilities;
distribution and receiving frequency: the lesser the frequency the greater the volume needed, thus
the greater the space needed.

It is better to have too much space than not enough: a cramped warehouse is difficult to work, and
any increases in stock or activity are also difficult. For 1 m2 of storage space count 3 m2 of floor
space.

We use a selection
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Correct preservation we usedepends
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Correct ventilation is necessary; fans mainly reduce humidity, air-conditioning reduces heat and
time at "Settings".
humidity.
A ceiling underneath the roof is essential in order to reduce the ambient temperature; the space
between the ceiling and roof must be ventilated.
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Windows and openings should be shaded to avoid exposure of drugs to direct sunlight.
Page 641/ 663
 Floors should be covered in cement (slightly inclined, if possible, to facilitate cleaning).

Interior layout of a warehouse

T he organization should be logical and correspond to the circuit "reception, storage, distribution".

Shelves and pallets

Solid and stable shelves are indispensable. In tropical countries where termites attack wood, metal
structures are preferred. As they can be dismantled, it is easy to adjust spaces between shelves and
alleys to better accommodate goods to be stored.
Space between shelves and walls improves ventilation.
No products or packaging, even large-sized, should be stored on the floor, but on pallets which permit
air circulation and protect against humidity.

Stocking areas
Within a warehouse, or close by, stocking areas should be provided.
Receiving area: for stocking parcels before unpacking and checking freight and quality control.
Distribution area: for stocking peripheral orders before distribution. Each destination should have a
designated area where parcels may be stocked before distribution.

Receiving and distribution areas should be near access doors in order to facilitate handling.

It is also recommended to plan a stocking area for empty boxes, used to prepare orders for peripheral
health facilities.

Workspace(s)
A workspace should be set up in the receiving area and in the distribution area to verify deliveries and
prepare orders.

Desk
For the person in charge of the pharmacy, a desk near a light source should be set up for
administrative work and for keeping documents.

Examples of pharmacy layout

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 T he arrangement of shelves, tables or other furniture, varies according to the layout of the premises.

For larger stocks or central pharmacies, use several rooms and apply the same principles by adapting
layouts to needs: administration, cold room, refrigerators, etc.

Arrangement of drugs and supplies

Storage of drugs not requiring a cold chain
Drugs are arranged according to the classification adopted:
oral drugs
injectable drugs
infusions
drugs for external use and antiseptics
disinfectants

In each category of products (oral, injectable, etc.) are classified alphabetically.

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Each product to use the website;
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performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
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Provide for sufficient space between and for each product.

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Page 643/ 663

 Clearly indicate expiry dates on boxes (large marker). Arrange products with the earliest expiry date at
the front of the shelves and those with the latest at the back. T his is essential to avoid drugs expiring
during storage.

So that persons not familiar with the INN system can find their way around in case of emergency or
replacement, a list of commercial names and the corresponding INN can be put up, e.g.:
Bactrim® see co-trimoxazole
Clamoxyl® see amoxicillin
Flagyl® see metronidazole
Valium® see diazepam

Storage of controlled substances

Narcotics and other controlled substances should be placed under lock and key.

Storage of products requiring a cold chain

Products needing a cold chain should be stored in a refrigerator (between 2-8 °C): vaccines,
immunoglobulins, serums, insulin, ergometrine, oxytocin, dinoprostone, certain laboratory tests, etc.

Storing medical materials/supplies

Given the diversity of items, do not to use alphabetical ordering, but group articles by category:
injections, dressings, sutures, reagents and laboratory material, etc.

Storing bulky materials

Put a few boxes in their normal place and, on a label, indicate where the rest of the stock is kept. Do
not disperse the rest of the stock in several places.

T he storage arrangement should allow a ‘visual stock check’:

It should be possible to quickly count the number of boxes for each product and evaluate, in
a few minutes, the number of weeks or months that can be covered with the stock available.
An empty space behind a label immediately shows that the product is out of stock.
Only a few hours should be needed to perform a complete inventory.

Management of a pharmacy
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should cookie to
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training. T his person is the only person possessing keys to the pharmacy and narcotics cupboard and
is helped by one or more assistants, depending on the workload.
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Page 644/ 663

 Tasks and responsibilities should be clearly defined. One assistant should be able to replace the person
in charge if necessary.

It is important to draw up a work calendar (orders, distributions, inventories, management of expired

drugs, etc.) in order to spread out the workload.

Stock management
Stock cards
T he stock card is the principle instrument for stock control. A stock card is established for each
product (drugs and supplies) and updated at each movement. Stock cards are used to:
identify all stock movements: in and out;
determine at any moment the theoretical level of stocks;
follow–up the consumption of different facilities;
correctly plan and prepare orders;
determine losses (differences between theoretical stock and actual stock).

Example of a stock card

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T he following
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movements (in, out, origin, destination, loss due to expiration, damages) and dates;
inventories and dates.
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T he following may also be included:

Page 645/ 663

 average monthly consumption;
stock levels: buffer stock, running stock;
other stock areas for a product;
unit price;
current orders and dates.

Quantities in and out are always recorded in units (e.g. 5,000 tablets, 80 ampoules) and never in number
of boxes.

Write a single operation per line, even if several operations take place the same day.

Note: stock cards are always equired, even when computer assisted stock management is used.

Quantities to retain and order (stock level)

Average monthly consumption (AMC)
Calculated from outgoing stock recorded on stock cards: add the quantities of several months (3, 6 or
12) in the out column and divide the total by the number of months considered.

Running stock = consumption between two supply deliveries

Running stock corresponds to the quantity of each drug consumed between two supply deliveries (e.g.
if deliveries are quarterly, running stock = AMC x 3).

Buffer stock
T his stock is planned to compensate for possible late deliveries, losses, and increases in consumption.
It is calculated according to the delivery delay of orders.
Buffer stock quantities are generally evaluated as half of the consumption during the period between
two deliveries. It depends on risks that a programme may run: stock shortages or drug expiration in
specific situations (resources, seasonal supply problems, etc.).
For example, if the delivery delay is two months, the buffer stock corresponds to the quantity
consumed in one month.

Quantities to be ordered
Quantities to order are based on data from stock cards:
actual stock level (inventory) on the day of the order
running stock
buffer stock
delay period between order and delivery
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Order = (running
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Order
time and delivery forms
at "Settings".

Concerning orders from peripheral facilities to the central pharmacy, it is recommended to use pre-
printed order forms which indicate the INN, form (tablet, capsule, vial, ampoule, etc.) and
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Page 646/ 663

 T he following may also be included:
stock levels,
AMC.

Orders should be in triplicate, dated and countersigned by the person in charge of the health facility.
Two copies are sent to the central pharmacy: one serves as a way bill and may also be used for
invoicing, the second stays with the central pharmacy. T he third copy stays at the health facility.

Example:
Health facility order form, 6-month supply period, minimum stock of 3 months (2 month delivery delay +
1 month buffer stock )

Receiving orders
All orders should be accompanied by a way bill or invoice and packing list.

On reception, the number of parcels should be checked, then their contents should be verified:
ensure that products delivered correspond to products ordered, and that the quantities conform to
those on the packing list;
packaging, labelling and expiry dates of each product should be checked, as well as the aspect of
the product;
look for special storage conditions (cold chain).

T he supplier should be notified of all irregularities.

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
T hen, drugs and material are integrated into stocks at their designated places. Incoming quantities are
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recorded
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which cards.
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years or more according to current regulations.

Inventory
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Page 647/ 663

 An inventory of current stock quantities and expiry dates should be done before each order.
Stock cards give a theoretical figure of stock quantities, but actual quantities of each product should
be verified (physical stock). Differences may arise due to errors in recording or due theft. T hese
differences should be clarified.
An inventory may only be easily done if the pharmacy is correctly arranged. It is an indispensable task.
During an inventory there should be no stock movements, i.e. incoming or outgoing stock.

Distribution
Distribution to health facilities
Each health facility sends the central pharmacy two copies of the order form.
On both copies, actual quantities supplied by the central pharmacy are recorded in the “Qty delivered”
column.
One on these copies is sent with the delivery.
After verifying that all products have been correctly recorded on their respective stock cards, the
second copy is placed in a file established for health facility. T he exit date on the stock card should be
the same as the date on the order form.

Dispensing drugs to patients

Drug packaging should be presentable. Use plastic bags that can be resealed by pressure (Minigrip®).
Prepare labels for each drug, clearly showing:
the name of the drug (INN), form and strength;
the dosage written out in full or in symbols.
Put the number of tablets corresponding to a complete treatment and the label into the bag.
In busy centres it is better to have two people responsible for dispensing drugs in order to double
check prescription deliveries; the first collects the drugs prescribed, the second verifies and gives them
to patients with all necessary explanations, slightly away from other patients.
So that patients correctly follow treatment, adequate explanations should be given:
how to take the drug,
for how long,
possible adverse effects (e.g. drowsiness caused by anti-histamines),
precautions to be taken (e.g. avoid alcohol with metronidazole).

Persons dispensing drugs should be able to give patients the information they need.
Interpreters are needed if several languages exist in the same region.

WeDonations of ofrecuperated
use a selection medicines
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T heyat "Settings".
are very often specialised drugs unknown to prescribers and unsuitable for local pathologies. T he
multiplication of different drugs supplied interfere with the implementation of standardised therapeutic
regimens and makes any form of management impossible.
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Page 648/ 663

 Drug quality and storage
Drug quality influences treatment efficacy and safety. Quality depends on correct manufacturing and
storage: high-quality drugs are available when using rational buying procedures and when suppliers are
reliable. It is also essential to ensure optimum transportation and storage conditions.

Quality standards
Each drug is characterised by particular norms written in pharmacopoeia or files presented by
manufacturers and recognised by competent authorities in each country. T hese norms concern
aspects (colour, odour, etc.), physicochemical properties, analysis procedures, shelf life and storage
conditions.
Analysis certificates guarantee that products from one batch (products from the same production
cycle) conform to official quality standards in the country of manufacture. T hese certificates are
provided for each product by manufacturers.
Every unit (box and bottle) should be clearly labelled; each label should clearly indicate the:
INN,
form and dosage,
number of units (tablets, ampoule, etc.) or the volume (syrup, etc.),
name and address of the manufacturer,
batch number,
expiry date.

Storage conditions
Stability of drugs depends on both environmental factors such as temperature, air, light and humidity,
and drug-related factors such as the active ingredient itself, the dosage form (tablet, solution, etc.)
and the manufacturing process. It is therefore necessary to respect storage instructions given in this
guide or by manufacturers (on notices and labels) if the recommendations are not identical.

Temperature
T he temperature in the store should not be above 25 °C.
We use a selection
Storage of our own
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aswebsite:
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 freezer – 15 to 0 °C

refrigerator + 2 to + 8 °C

cool + 8 to + 15 °C

ambient temperature + 15 to + 25 °C

During transit and transportation temperatures may attain 50 to 60 °C inside vehicles, shipping
containers or on docks and, in this case, shelf life and expiry dates may no longer be guaranteed.
Freezing may be detrimental, particularly for solutions, leading to the deterioration or precipitation of
active ingredients as well as the breaking of ampoules and vials.
Vaccines, immunoglobulins and antisera are products that are sensitive to heat and light. Even though
new techniques produce vaccines that are less sensitive to heat (called "thermostable"), they still have
to be stored in the refrigerator between 2 °C and 8 °C, and the cold chain must be strictly respected
during transport.

T he vaccine vials may have a heat-sensitive monitor (VVM). T he square on the monitor changes colour
when exposed to heat over a period of time: if the square is lighter than the circle, the vaccine can be
used. If the square is the same colour or darker than the circle, the vial must be destroyed. T he monitor
registers cumulative exposure to heat.

Controlled temperature chain (CTC)

In certain mass vaccination campaigns only, certain vaccines licensed for use in a CT C can be
transported and used out of the cold chain within a specified time limit.

To qualify for use in a CT C the vaccine must be able, once out of the cold chain (2 °C to 8 °C), to
tolerate temperatures of up to 40 °C for at least 3 days. T he maximum temperature of 40 °C is
monitored by a peak threshold indicator in each vaccine carrier used for transport and vaccination in
the field.

Air and humidity

In a store, relative humidity should not be above 65% (there are several devices for humidity
measurement).
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Air is a in orderof
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should remain
performance cookies, which we use to generate aggregated data on website use and statistics; and marketing
closed. In airtight and opaque containers (hospital type), drugs are protected against air and light.
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Patients should be informed that tablets should not be removed from blisters until immediately before
administration.
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Light
Page 650/ 663
 Drugs should be protected from light, particularly solutions. Parenteral forms should be preserved in
their packaging. Coloured glass may give illusory protection against light.

Deterioration
It is important to be familiar with the normal aspects of each drug (colour, odour, solubility,
consistency) in order to detect changes, which may indicate its deterioration. It is important to know
that deterioration does not always lead to a detectable external modification.
T he principal consequence of deterioration is a reduction of therapeutic activity, which leads to more
or less grave consequences for the individual and/or community.
For example, the use of expired antibacterials does not cure an infection and also favours the
emergence of resistant strains.
It is not recommended to compensate for a possible reduction of activity by a random increase in the
usual dose, as there is a real danger of overdose when using toxic drugs.

Over time, certain drugs undergo a deterioration leading to the development of substances much more
dangerous, thus an increase in toxicity. Tetracycline is the main example: the pale, yellow powder
becomes brownish and viscous, its use therefore being dangerous even if before the expiry date.
An increase in allergen strength has been observed in certain drugs such as penicillins and
cephalosporins.
Suppositories, pessaries, creams and ointments that have been melted under heat should not be used.
T he active ingredient is no longer distributed in a homogenous manner.
Oral rehydration salts may be used as long as they keep their aspect of white powder. Humidity
transforms them into a compact mass, more or less brownish and insoluble. T hey are therefore unfit
for consumption, whatever their expiry date.

Expiration
Drugs deteriorate progressively and according to various processes, even if stored in adequate
conditions. In most countries, regulations impose an obligation on manufacturers to study the stability
of their products in standardised conditions and to guarantee a minimum shelf life period. T he expiry
date indicated by manufacturers designates the date up to and including which the therapeutic effect
remains unchanged (at least 90% of the active ingredient should be present and with no substantial
increase in toxicity).
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container. Shelf life period currently usually guaranteed is 3 and 5 years. Less stable substanceswhen using the website;
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Expired drugs

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 Expiry dates are to be respected due to legal obligations and considerations of therapeutic
responsibility
In cases where the only available drugs have expired, a doctor may be led to take on the responsibility
of using these drugs.
It is evident that a drug does not become unfit for consumption the day after its expiry date. If a
product has been stored in adequate conditions (protected from humidity and light, packaging intact
and at a medium temperature) and if modification of aspects or solubility have not been detected, it is
often preferable to use the expired drug than to leave a gravely ill patient without treatment.

Expiry dates for drugs that require very precise dosage should be strictly respected due to a risk of
under-dosage. T his is the case for cardiotonic and antiepilectic drugs, and for drugs that risk becoming
toxic, such as cyclines.

Destruction of expired or unusable drugs and material

It is dangerous to throw out expired or unusable drugs or to bury them without precaution. For more
information about destruction of drugs and material see Interagency Guidelines For Safe Disposal of
Unwanted Pharmaceuticals in and after emergencies, WHO/99.2.

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 Prescription, cost, compliance
SOME SUGGEST IONS FOR
Reducing risks - Reducing costs - Facilitating compliance

It is possible to promote a more rational use of medicines, as much for safety as for cost, by a
judicious choice of therapeutic regimens and the resulting lists of medicines.

Limiting the use of injectable drugs

Numerous patients demand treatment with injectable drugs, which they imagine to be more effective.
Certain prescribers also believe that injections and infusions are more technical acts and thus increase
their credibility.

Parenteral treatment is always more costly than oral treatment. T he price of the drug itself is higher for
an equal dose of active ingredient. It requires costly disposable material. It exposes patients to
complications due to poorly tolerated products (abscesses, necrosis due to IM quinine injections or
antibacterials, etc.) or badly performed injection techniques (symptoms of overdose after a IV injection
given too rapidly, sciatic nerve damage, etc.). If disposable injection supplies are re-used, there is a risk
of bacterial or viral contamination (tetanus, hepatitis, HIV, etc.).

When both oral and injectable drugs are equally effective, parenteral administration is only justified in
case of emergency, digestive intolerance or when a patient is unable to take oral medication. Oral
drugs should replace injectable drugs as soon as possible during the course of treatment.

Limiting the use of syrups and oral suspensions

Taking liquid drugs is often easier, especially for young children and more so if they are sweetened or
flavoured. It is, however, recommended to limit their use for numerous reasons:

Risk of incorrect usage

Outside of hospitals, determining the correct dosage is hazardous: spoons never contain standard
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few days, and with syrups there is a risk of fermentation.
In numerous countries syrups are thought of as "cough medicine". Confusion between cough mixtures
and antibacterial suspensions or syrups is common.
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Economic considerations
Page 653/ 663
 Compared to the price of tablets or capsules, the price of syrups and oral suspensions is considerably
higher. Even using a powder for subsequent reconstitution, the costs may be 2 to 7 times higher than
an equivalent dose due to the cost of the bottle itself and higher transportation costs due to weight
and volume.

Studying the choice of treatment regimens

T he choice of a treatment regimen often influences compliance and cost. T he shortest and least
divided (1 to 2 doses per day) treatments are most often recommended. Single dose treatments are
ideal, when indicated.

For the treatment of malaria, tuberculosis and HIV infection, fixed-dose combinations (coformulated
tablets) should preferably be used in order to improve compliance.

Considering non-essential medicines and placebos

In developing countries as in industrialised countries, patients with psychosomatic complaints are
numerous. T he problems that motivate their consultations may not necessarily be remedied with a drug
prescription. Is it always possible or desirable to send these patients home without a prescription for a
symptomatic drugs or placebo? If so, what placebo should be prescribed?

When national drug policy is strict and allows neither the use of placebos nor non-essential
symptomatic drugs, other products are often used in an abusive manner, such as chloroquine, aspirin,
and even antibacterials.

Conversely, a placebo may take the place of an effective and needed drug. T his risk is real, but seems
less frequent, which makes the introduction of placebos on a list of essential drugs relevant.
Multivitamins may present a type of harmless and inexpensive placebo. T heir composition generally
corresponds to preventive treatment of vitamin deficiency and they have no contra–indications.

Numerous non-prescription drug products (tonics, oral liver treatments presented in ampoules) have no
therapeutic value and, due to their price, cannot be used as placebos.

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 Antiseptics and disinfectants
Definitions
Antiseptics are used to kill or eliminate microorganisms and/or inactivate viruses on living tissues (intact
or broken skin and mucous membranes).
Disinfectants are used to kill or eliminate microorganisms and/or inactivate viruses on inanimate
objects and surfaces (medical devices, instruments, equipment, walls, floors).
Certain products are used both as an antiseptic and as a disinfectant (see specific information for
each product).

Selection
Recommended products
1) Core list
No single product can meet all needs with respect to cleaning, disinfection and antisepsis. However,
use of a limited selection of products allows greater familiarity by users with the products in question
and facilitates stock management:
ordinary soap;
a detergent and, if available, a detergent-disinfectant for instruments and a detergent-disinfectant
for floors and surfaces;
a disinfectant: chlorine-releasing compound (e.g. NaDCC);
an antiseptic: 10% povidone iodine or chlorhexidine.

2) Complementary list
Other products can be used, according to the activities carried out, resources, and options for
obtaining the product, locally or otherwise:

Ethanol and isopropanol

By virtue of its rapid action (< 30 seconds), alcohol, if available locally, is useful to disinfect:
intact skin, before taking a blood sample or performing an injection (except vaccines),
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and third-party
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used on broken skin in the event of accidental exposure to blood.
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time Alcohol is more effective at 60-70% concentration than at 90-95%.
at "Settings".

Alcohol-based hand rub solutions

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Page 655/ 663

 Alcohol-based hand rubs (ABH) are used for standard hand antisepsis. Some, but not all, ABH may
also be used for surgical hand antisepsis.
Not all ABH preparations are equivalent. For example, for antiseptic hand rub, depending on the
product specifications:
Bactericidal effect may be achieved with a single application of 30 seconds duration, or 2
consecutive applications of 30 seconds each, or a single application of 60 seconds duration.
T he volume of rub required per application may be 3 or 5 ml.
T hus, when purchasing locally, it is important to verify the quality of the product and specific
instructions for use (number of applications, duration of application, and volume to be used per
application).
For surgical activity, ensure that the product is suitable for use as a surgical hand rub. Follow
manufacturer’s instructions for use.
All alcohols and alcohol-based products are flammable. Precautions should be taken during
storage and use to avoid contact with a heat source (flame, electrocautery, etc.).

Povidone iodine (PVI) scrub solution

7.5% or 4% PVI scrub solution is used for antiseptic cleansing of healthy skin, contaminated
wounds and surgical site, as well as antiseptic hand wash and surgical hand wash.
Given the possible interactions between different groups of antiseptics, antiseptic cleansing and
antisepsis should only be carried out using products from the same class. For example, for pre-
operative skin preparation, PVI scrub solution is used for cleansing, then PVI 10% dermal solution is
used for antisepsis.

Glutaraldehyde (2% solution)

Glutaraldehyde is used for high-level disinfection of heat-sensitive items, which cannot withstand
heat sterilisation, notably endoscopes/endoscopy equipment.
Instructions for glutaraldehyde use must be followed scrupulously:
1. two preliminary washes of the equipment through immersion in a detergent-disinfectant solution
for instruments, followed each time by rinsing;
2. complete immersion of the equipment in a 2% glutataldehyde solution for 20 minutes;
3. thorough final rinsing, with filtered water (or sterile water for endoscopes introduced into a sterile
cavity) to eliminate any residue;
4. thorough drying with a sterile towel;
5. sterile wrapping and use within 24 hours.
Glutaraldehyde is available as 2% ready-to-use solution (e.g. Korsolex RT U®, Steranios 2%®);
concentrated
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Glutaraldehyde solution is irritating to skin and and advertising. If you choose
mucous membranes, and"Accept all",toxic
releases you consent to the
vapours.
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
Personnel exposed to glutaraldehyde should take precautions to protect skin and eyes and avoid
time at "Settings".
inhalation of vapours (risk of nausea, headache, breathing disorders, rhinitis, eye irritation,
dermatitis).
Glutaraldehyde solutions are flammable. Precautions should be taken during storage
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Page 656/ 663
 Non-recommended products
Hydrogen peroxide (3% or 10 volumes) has limited efficacy as antiseptic agent but can be useful to
clean contaminated wounds. In addition, concentrated solutions are dangerous to transport and
handle.
Mercury compounds such as phenylmercuric borate, merbromin (Mercurochrome®), mercurobutol
(Mercryl®), thimerosal (Merthiolate®, T imerosal®) have limited efficacy, may cause serious
adverse effects (toxic for kidneys, central nervous system and digestive tract; allergies) and pollute
the environment. T heir use must be abandoned.
Hexachlorophene is toxic for the central nervous system and its efficacy is limited.
Ether is often wrongly used as an antiseptic; it removes sticky residues of plaster.
Eosin is often wrongly used as an antiseptic; it is a colouring agent used for staining as well as a
drying agent.

None of these products is included in the WHO list of essential medicines.

Preparation and use of antiseptic solutions

Preparation
Aqueous solutions of many antiseptics can be contaminated by pathogens (especially Pseudomonas
aeruginosa) during handling. To avoid this, the following precautions must be taken:
Prepare all aqueous antiseptic solutions with clean water that has been boiled for a few minutes
and cooled.
Prepare solutions immediately before use.
Only prepare small amounts at a time to avoid wastage and the temptation to keep expired and/or
contaminated solutions.
Wash bottles with hot water and leave to dry before each refill.
Never use a cork stopper (it promotes contamination; cork inactivates certain antiseptics such as
chlorhexidine).
Mark on the bottles:
the name of the product,
its concentration,
the date and time of preparation.

Every medical facility should define a clear policy concerning the renewal of antiseptic solutions.
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Use
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Do not use antiseptic solutions belonging to different classes for the same procedure:
use of all cookies. You can accept and reject individual cookie types and revoke your consent for the future at any
time incompatibilities
at "Settings". between different compounds exist.
Antiseptics should be used when wounds are contaminated or infected. Clean, non-infected
wounds may be cleaned with 0.9% sodium chloride; it is not necessary to apply an antiseptic.
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Page 657/ 663
 transmission, however, their use – after thorough cleaning – is not contraindicated. Use 2.6%
bleach diluted 1/5 or 1/10, or 70% alcohol, or 10% povidone iodine solution and leave in contact
for 5 minutes.
Disinfection of skin when administrating a vaccine is not recommended; rather, simply clean the
injection site with clean water. Certain vaccines (for example, BCG) may be inactivated in the
presence of an antiseptic. If an antiseptic is used despite this recommendation, it must be allowed
to dry before vaccine injection.

Preparation and use of disinfectant solutions

T he effectiveness of disinfection can be impaired by error in preparation (concentration, temperature),
failure to follow recommended contact times, or deterioration of the product due to poor storages
conditions.

Personnel carrying out disinfection should wear protective clothing when preparing or using
disinfectant solutions: gown, rubber apron, gloves with long cuffs, goggles and mask.

Preparation
Solutions should be prepared with clean water (chlorine solutions should be prepared with cold water
only, in non-metal containers).
Solution for disinfecting floors and surfaces: prepare just before use, and discard any unused
solution.
Solution for pre-disinfection of medical devices and instruments: replace daily. T he solution may be
used for a maximum of 24 hours; if visibly soiled, discard and replace with fresh soaking solution
before 24 hours are up.
Solution for disinfection of medical devices and instruments: prepare just before and discard after
use.

Do not add any product (e.g. a detergent, descaling agent) to disinfectant solutions.

Disinfection of floors and surfaces

Apply detergent-disinfectant intended for floors and surfaces a , without rinsing. Follow
manufacturer’s instructions for dilution and specific preparation procedures.
Or
After
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of organic materialuse and statistics;
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blood and other body fluids), and the detergent used may be incompatible with chlorine. Contact all", you consent to the
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chlorine solution.

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Page 658/ 663

 T he use of detergent-disinfectant products reduces workload (cleaning and disinfection are carried
out as a single procedure), but they have the disadvantage of being weak detergents and leaving a film,
which causes dirt to build up on the floors. It is thus necessary to alternate their use with that of a
detergent alone. Each medical facility should establish a clear policy addressing this issue.

Disinfection of linen
After hand washing, followed by rinsing: soak the clean linen in a solution of 0.1% active chlorine for 15
minutes and rinse thoroughly (3 rinses).

After machine-washing at 60 °C: soak the linen in a 0.1% active chlorine solution for 2 to 3 minutes and
rinse thoroughly (3 rinses).

Pre-disinfection of reusable medical devices/instruments

After use, soak medical devices (disassembled, forceps and scissors opened):
a
In a detergent-disinfectant solution intended for medical devices and instruments . Use a
syringe to irrigate the cavities of hollow devices with the same solution.
For correct dilution and soak times, follow manufacturer ’s instructions; use a timer.
Or
In 0.1% available chlorine solution for 15 minutes (use a timer). Use a syringe to irrigate the
cavities of hollow devices with the solution.
Comply with recommended soaking times and concentrations (risk of corrosion of metal
instruments). Soaking for too long (> 15 minutes) and/or in a solution that is too concentrated
will increase the risk of corrosion.
Rinse with clean water, using a syringe for hollow cavities.
Dry with a clean, dry, lint-free cloth.

Washing-disinfection of reusable medical devices/instruments

After the pre-disinfection step:
Immerse the material in a detergent-disinfectant solution intended for medical devices and
a
instruments (for correct dilution and soak times, follow manufacturer’s directions). Scrub with a
soft, non abrasive brush. Use a bottle brush for hollow devices, or irrigate with a syringe. Rinse with
clean water, drain and dry with a clean, dry, lint-free cloth.
Or
Wash
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Footnotes
Page 659/ 663
 (a) For example a quat ernary ammonium det ergent -disinf ect ant .

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required in order to use the website; functional cookies, which provide better easy of use when using the website;
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 Main references
Websites consulted between June 2019 and December 2022
British National Formulary (BNF) and British National Formulary for Children (BNFc)
MedicinesComplete

Martindale. The Complete Drug Reference

MedicinesComplete

UpToDate. Evidence-based clinical decision support resource

BMJ best practice

Centre de référence sur les agents tératogènes (CRAT )

http://lecrat.fr/

Agence nationale de sécurité du médicament et des produits de santé (Ansm)

http://agence-prd.ansm.sante.fr/php/ecodex/index.php

Medicines and Healthcare products Regulatory Agency (MHRA)

http://www.mhra.gov.uk/spc-pil/

Drug Safety Update

https://www.gov.uk/drug-safety-update

Centre belge d’information pharmacothérapeutique (CBIP)

http://www.cbip.be/fr/chapters

Clinical Info HIV Guidelines

https://clinicalinfo.hiv.gov/en/guidelines

American Academy of Pediatrics - Red Book (2021): Report of the Committee on Infectious Diseases
(32nd edition)
https://publications.aap.org/aapbooks/book/663/Red-Book-2021-Report-of-the-Committee-on
We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
WHO publications
performance cookies,available online
which we use and used
to generate in this edition
aggregated data on website use and statistics; and marketing
cookies, which are used to display relevant content and advertising. If you choose "Accept all", you consent to the
WHO.
use of allmhGAP
cookies.Intervention Guide
You can accept and Mental Health Gap
reject individual Action
cookie typesProgramme Version
and revoke your 2.0 for
consent forthe
mental,
future at any
neurological
time and substance use disorders in non-specialized health settings. Geneva, 2016.
at "Settings".
https://www.who.int/publications/i/item/9789241549790

Settings Decline
WHO. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and Accept
monitoring:
recommendations for a public health approach. Geneva, 2021.
Page 661/ 663
 https://www.who.int/publications/i/item/9789240031593

WHO. Guidelines for diagnosing, preventing and managing cryptococcal disease among adults,
adolescents and children living with HIV. Geneva, 2022.
https://www.who.int/publications/i/item/9789240052178

WHO. Pocket book of hospital care for children, second edition. Geneva, 2013.
http://apps.who.int/iris/bitstream/10665/81170/1/9789241548373_eng.pdf?ua=1

WHO. Vaccine Position Papers

https://www.who.int/immunization/documents/positionpapers/en/

WHO. WHO recommendations for routine immunization - summary tables

https://www.who.int/immunization/policy/immunization_tables/en/

WHO. Family planning - a global handbook for providers. Geneva, 2018.

https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-
eng.pdf;jsessionid=7B9B140B645D3F9FEA3C91A379C5B8EE?sequence=1

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We use a selection of our own and third-party cookies on the pages of this website: Essential cookies, which are
required in order to use the website; functional cookies, which provide better easy of use when using the website;
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