ESSENTIAL MEDICINES LIST - Federal Ministry of Health

1 FEDERALREPUBLICOFNIGERIAESSENTIALMEDICIN ESLIST5 THREVISION2010 PUBLISHED BY THE Federal Ministry OF Health ABUJA, NIGERIAIN COLLABORATION WITH WORLD Health ORGANIZATION AND EUROPEAN COMMISSION 2010 Federal Ministry of Health , NigeriaAll rights reserved. No part of this publication may be reproduced, stored in retrieval system ortransmitted in any form or by any means, electronic, mechanical, photocopying, recording and/orotherwise, without prior written permission of the Federal Ministry of Health , : 978-978-49531-4-6 For all enquiries or comments, write to the publishers:The Honourable Minister, Federal Ministry of Health , Federal Secretariat Complex,Shehu Shagari Way, 080 Garki,Abuja, NigeriaE-mail:Printed in Ibrahim [MB;BS (Ib.), (ABU), FMCP (Nig.)]Clinical Pharmacology UnitDepartment of MedicineAhmadu Bello University Teaching , Ambrose O. (MB;BS, FMCP, FWACP, MD)Department of MedicineUniversity of Benin/Teaching HospitalBenin City, , Augustine ( , PhD.)

2 Faculty of PharmacyUniversity of BeninBenin City, , ( )Deputy , Emma O. (FPSN)MD/CEOA rchy Pharmaceutical of the Pharmaceutical Manafacturers Group (PMG-MAN)5 .Pharm., Danjuma [ (Ahmadu Bello University), MPSN]Director, Pharmaceutical ServicesMinistry of HealthTaraba , Egbuna Olakunle [MB;BS, FMCPaed., PGD(Fin.)]Director, Institute of Child HealthUniversity of Nigeria Teaching Hospital, of the Minister of HealthAbdu-AguyeIsahOkhamafeAnyakoraEber eGanaObidikeEssential MEDICINES List (Fifth Revision 2010) (Mrs.), Adepeju A. [ (Ahmadu Bello University), FPSN]Director of Pharmaceutical Services,Osun , Christiana M. [ , MBA (University of Nigeria)]Director of Pharmaceutical ServicesEbonyi State Ministry of HealthAbakaliki, Ebonyi , Yaro Sa'idu [ (Jos)]Medical DirectorTiga Clinics and Maternity Hospital7, Civic Centre Road, KanoMedical Practitioner appointed by the (Mrs.), Joyce Director, Food and Drugs Services DepartmentFederal Ministry of , Obehi A.

3 [MB;BS., FMCP(Nig.), MPH]Dept. of MedicineUniversity of Benin/University of Benin Teaching HospitalBenin City, , Gbesimi [MB., BS. (University of Benin), Mother and Child Health ,(London)]Mother and Child Health ConsultantLagos, [Dip. Pharm., BSc. (Pharm.), FPSN, FPCP harm.]Consultant PharmacistPharmeng Nig. 370 Nnewi, Anambra , PharmacistOjoOkoOmatigaUgwuAkoriaMero-As agbaObiagaFagbemiroTECHNICAL SUB-COMMITTEEIN ATTENDANCEE ssential MEDICINES List (Fifth Revision 2010)Department of Food and DrugFederal Ministry of , M. ( )Senior PharmacistDepartment of Food and DrugFederal Ministry of (Mrs.), [ (Jos), MPSN]Department of Food and Drug, Federal Ministry of HealthAbujaDr., Ogori ( , MPH, PhD.)Pharmaceutical AdvisorWHO, NigeriaIbrahimWaribokoTaylorWORLD Health ORGANIZATIONE ssential MEDICINES List (Fifth Revision 2010) TO THE FIFTH , ANTIPYRETICS AND NON-STEROIDAL ANTIINFLAMMATORY (ANTI-EPILEPTICS).

4 AND IMMUNOSUPPRESSIVE AND PRODUCTS AND PLASMA anaesthetics and drugs and analgesic muscle relaxants and antagonist (drug for treatment of opioid dependence).. analgesics and anti-inflammatory drugs and drugs used for (general) and antileishmaniasis (ARV) antifungal fraction for specific MEDICINES List (Fifth Revision 2010) ACTING ON RESPIRATORY AFFECTING THE FOR PARKINSONISM AND OTHER NEUROLOGICAL USED IN , NOSE AND THROAT used in heart dental and antipruritic and keratoplastic and and MEDICINES for chronic obstructive pulmonary and for myasthenia anti-infective and anti-inflammatory of ear MEDICINES List (Fifth Revision 2010) and nasal drugs and smooth muscle used in rehydration for diarrhoea in for diarrhoea in pylori hormones and synthetic (human).. antidiabetic hormonal hormonal acting on pituitary-ovarian hormones and antithyroid and for specific for universal immunization.

5 , OTHER ENDOCRINE DRUGS AND VIVO DIAGNOSTIC MEDICINES List (Fifth Revision 2010) and anti-allergic and antiglaucoma eye eye to antipsychotic used in generalized used in mood used in depressive used in bipolar used for obsessive compulsive disorders and panic used in psychotic used in substance dependence AND FOR CORRECTING WATER ELECTROLYTEAND ACID-BASE AND PRIMARY Health CARE OF PRODUCTS TO BE STOCKED AND SOLD BY PATENT 1: APPROVED DOSES FOR 2: RESTRICTED DRUGS MEDICINES List (Fifth Revision 2010)FOREWARDIt gives me pleasure to write the foreword of this fifth edition of the national EssentialDrugs List (EDL) of which the first edition was published in 1989 in accordance withDecree 43 of importance of the EDL in the Health care delivery system of Nigeria cannot be overemphasized hence government's efforts towards the sustenance of the programme.

6 TheExpert Committee on EDL programme has continued to ensure revision of the EDL has no doubt continued to streamline the drugs deployed in the healthcaredelivery system of the country. This makes for the enhancement of quality of Health careservices. It provides a reference standard for all levels of Health care towards ensuring gooddrug supply management as all drugs to be procured by the public Health facilities shouldbe drawn from the review exercise made use of several references including the national StandardTreatment Guidelines (STG) which was not in existence during previous reviews. By sodoing more drugs which are beneficial in treatment of various disease conditions wereidentified and included in this EDL. In particular, given the prevailing concern andcommitment of the President Goodluck Jonathan administration towards the reduction ofhigh maternal mortality ratio in the country, misoprostol which has been found useful in thecontrol of post-partum haemorrhage has for the first time been included on the list.

7 In viewof this, it is assured that this edition is enriched and has advantage over previous EDL is an ESSENTIAL companion for doctors, pharmacists and nurses. I enjoin all ourhealth care providers to get a copy of the fifth edition of the EDL and ensure its use for theprovision of affordable quality Health care to our this connection, the Ministry will ensure that dissemination workshops at the facilitylevels are organized to educate the Health care providers on the provisions of the EDL. TheMinistry will put in place effective monitoring and evaluation mechanism to ensure itssuccessful C. O. Onyebuchi ChukwuHonourable Minister of HealthOctober, 2010 ESSENTIAL MEDICINES List (Fifth Revision 2010)9 PREFACE TO THE FIFTH REVISIONE ssentialMedicines ListStandard Treatment Guidelines (STG)It is once more my honour and privilege to write the preface to the fifth revision of thefor the Nigerian Health Care System.

8 This edition coming almost seven years after the2003 fourth revision is a welcome leap from the past because there is need for the country to catch upwith practices world-wide. Health practitioners and their students can now heave a sigh of relief with thehope that the next review will not be as delayed as this developments in the country suggest that the Health of Nigerians is being put on the front burnerof policies and these leave room for optimism: guinea worm eradication has been achieved. Nigeria ison the verge of being declared polio-free. There are indications that the high maternal and infantmortality may be truly on the decline due to the recent strategies devised to meet the targets of theMillennium Development Goals. A National Health Insurance Scheme (NHIS) has been launched andits practice is now widespread and gaining greater acceptance. Finally, about two years ago, the countrypublished its firstwhich, from all indications, has been wellcirculated and fifth review was primarily directed at ensuring that the MEDICINES in the Standard TreatmentGuidelines and the ESSENTIAL MEDICINES List are harmonized.

9 I believe this objective would have beenachieved with the release of this review. In addition this review takes care of the new antimalarial drugpolicy as well as current practices with regards to HIV/AIDS, Tuberculosis/Leprosy treatment policiesand other special services. The hope therefore is that this edition will reflect positively on the efforts tomake Nigerians healthier at the minimum cost to individuals and governments at all fifth review and the STG are the products of the hard work put in by the National Drugs Formulary& ESSENTIAL Drugs Review Committee under the directives of the Foods & Drugs Division of the FederalMinistry of Health and the invaluable contribution of the Country Office of the World HealthOrganization. Regrettable however, is our inability to finish the review of the National DrugsFormulary. No doubt this would be needed to complement this review and I do hope that the FederalMinistry of Health will facilitate this activity in the nearest Drugs have been defined as those drugs that satisfy the Health care needs of the majority of thepopulation.

10 They should therefore be available at all times in adequate amounts and in appropriatedosage forms at all levels of the Health care delivery system of the country. The expected advantages ofan ESSENTIAL Drugs Programme include:- Limiting the number of drugs deployed in the Health care system Creating opportunity for the provision of concise, accurate and comprehensiveinformation in the form of a National Drugs Formulary on all the drugs in the essentialdrugs list Improving the knowledge of prescribers regarding the pharmacological properties of theEssential MEDICINES List (Fifth Revision 2010)10prescribed drugs Improving drug utilization by the various sectors of the Health care system through bettermonitoring and Reducing the cost of Health care deliveryWe cannot claim that this fifth review is perfect but all effort has been made to ensure that it meets theaspirations of the Essentials Drugs Programme of Nigeria.