KeyCare acute medicine formulary

2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category medicines same sub-category
medicine

Broad medicine category Analgesics

Medicine subcategory Analgesics and antipyretics

Dosage form

NAPPI code

Medicine name

Medicine strength

Syrup 792101 704093 894281 703820 863742 895199 889772 704450 707583 758558 Tablet 745707 745723 757403 700742 805467 704645 798533 704643 787043 837652 700909 704465 704719 710211 Adco-Napacod Adco-Napamol Adco-Prolief Amstil Antalgic Aspirin Be-Tabs Aspirin (white) Cetapon Codorol Dino-Cod Gulf Aspirin Painogesic Paracet Zydus-Paracetamol Allergex Lenazine Prohist 500mg 500mg 500mg 300mg 300mg 500mg Actamol red (boxed) Actamol red (un-boxed) Adco-Paracetamol Feverpain Feverpain (boxed) Go-Pain P Painblok (plastic bottle) Painogesic Paracetamol elixir SAD (alcohol free) Pyralen 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml 120mg/5ml

Maximum allowable quantity 200

Per number of days 120

30

120

300mg 500mg 500mg 500mg 100 180 2mg/5ml 5mg/5ml 5mg/5ml

Antihistamines

Oral antihistamines

Syrup 702145 736244 757373

Page 2 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Antihistamines Antimicrobials Medicine subcategory Oral antihistamines Anti-protozoals Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 30 200 726338 Tablet 792284 792292 742872 702148 715866 821705 788708 707241 707242 784710 793159 793167 779822 783544 792136 772216 Beta-lactams Capsule 704443 704444 706950 704401 784583 714184 707499 705637 783188 706327 788155 788546 897880 897887 815268 806579 Allmox Allmox Amocas Amoxicap Ampipen Amyn Austell-Amoxicillin Austell-Amoxicillin Be-Ampicil Belex Betamox Betamox CPL Alliance Cephalexin CPL Alliance Cephalexin Ipcamox Moxymax 250mg 500mg 250mg 250mg 250mg 500mg 250mg 500mg 250mg 500mg 250mg 500mg 250mg 500mg 250mg 250mg Acuzole Acuzole Adco-Metronidazole Amzole Anaerobyl Bemetrazole Bemetrazole Bio-Metronidazole Bio-Metronidazole Medamet Metazol Metazol Metrazole Metrostat Suprazole Trichazole 200mg 400mg 200mg 400mg 400mg 200mg 400mg 200mg 400mg 200mg 200mg 400mg 400mg 400mg 400mg 200mg 30 120 Flagyl 200mg/5ml 60 120 Per number of days 180 120

Tablet 703162 Suspension Rhineton 4mg

Page 3 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Antimicrobials Medicine subcategory Beta-lactams Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 30 Per number of days 120

Capsule 806587 808741 808768 830909 837253 824879 708397 Suspension 893409 899097 829099 714179 714180 707186 707187 714182 714183 707666 716611 861952 861960 713358 829307 829358 751111 865540 842524 897892 830488 830496 860603 860611 894123 894125 701380 830534 830542 A-Lennon Amoxycillin Adco-Amoclav S Adco-Amoxycillin Allmox S Allmox SF Amoclan S Amoclan SF Amyn S Amyn SF Apex-Clavutin SF Athlone Phenoxymethylpenicillin Augmaxcil S Augmaxcil SF Auro-Amoxiclav Be-Ampicil Betamox S Betapen Bio-Amoksiklav S Clamentin S CPL Alliance Cephalexin Promoxil S Promoxil SF Ranceph Ranceph Ranclav Ranclav forte Ranmoxy Saltermox S Saltermox SF 250mg/5ml 156mg/5ml 125mg/5ml 125mg/5ml 250mg/5ml 156mg/5ml 312mg/5ml 125mg/5ml 250mg/5ml 312mg/5ml 125mg/5ml 156mg/5ml 312mg/5ml 156mg/5ml 125mg/5ml 125mg/5ml 125mg/5ml 156mg/5ml 156mg/5ml 125mg/5ml 125mg/5ml 250mg/5ml 125mg/5ml 250mg/5ml 156mg/5ml 312mg/5ml 125mg/5ml 125mg/5ml 250mg/5ml Moxymax Promoxil Promoxil Ranceph Ranceph Ranmoxy Zaloxy 500mg 250mg 500mg 250mg 500mg 500mg 500mg

200

120

Page 4 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Antimicrobials Medicine subcategory Beta-lactams Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 200 Per number of days 120

Suspension 878782 878774 708396 708395 830739 Tablet 893218 707184 707185 707663 707665 861936 861944 713381 713382 707407 707408 706326 780081 716124 716125 878766 701736 Adco-Amoclav Amoclan Amoclan Forte Apex-Clavutin Apex-Clavutin Augmaxcil Augmaxcil Auro-Amoxiclav Auro-Amoxiclav Austell-Co-Amoxiclav Austell-Co-Amoxiclav Belex Betapen Bindoclav Bindoclav Sandoz Co-Amoxyclav Sandoz Co-Amoxyclav Clindahexal Dalacin C Adco-Erythromycin Purmycin Spectrasone Xeramel Adco-Erythromycin Betamycin Erymycin P Erymycin PF Purmycin 375mg 375mg 625mg 375mg 625mg 375mg 625mg 375mg 625mg 375mg 625mg 250mg 250mg 375mg 625mg 375mg 625mg Sandoz Co-Amoclav SF Sandoz Co-Amoxyclav S Zaloxy Zaloxy Zoxil S 312mg/5ml 156mg/5ml 125mg/5ml 250mg/5ml 125mg/5ml

30

120

Lincosamides

Capsule 849960 717347 150mg 150mg

40

120

Macrolides

Capsule 780561 758388 765651 824682 Suspension 786608 793329 787108 787086 758396 125mg/5ml 125mg/5ml 125mg/5ml 250mg/5ml 125mg/5ml 250mg 250mg 250mg 250mg

40

120

100

120

Page 5 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Antimicrobials Medicine subcategory Macrolides Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 100 Per number of days 120

Suspension 758418 765678 783277 823570 848409 Purmycin Spectrasone Spectrasone Xeramel S Xeramel SF Candacide Canstat oral Nystacid Austell Ciprofloxacin Austell Ciprofloxacin Biocip Biotech Ciprofloxacin Biotech Ciprofloxacin Cifran Cilofloc Cilofloc Ciprofloxacin Actor Ciprogen Ciprol Ciprol CPL Alliance Ciprofloxacin CPL Alliance Ciprofloxacin Dynafloc Loxip Loxip Orpic Simayla Ciprofloxacin Casicot suspension Co-Trim Cozole Doctrim Ilvitrim Purbac Xerazole 250mg/5ml 125mg/5ml 250mg/5ml 125mg/5ml 250mg/5ml

Oral antifungals

Suspension 701100 835056 835285 100 000u/1ml 100 000u/1ml

40

120

Quinolones

Tablet 704353 704351 704459 713792 713793 892147 707886 707887 716518 703045 704777 704775 700284 700287 700516 713361 713362 701210 708015 250mg 500mg 250mg 250mg 500mg 500mg 250mg 500mg 250mg 500mg 250mg 500mg 250mg 500mg 250mg 250mg 500mg 500mg 250mg

20

120

Sulphonamides

Suspension 703865 779881 793310 894842 705259 758221 816337 240mg/5ml 240mg/5ml 240mg/5ml 240mg/5ml 240mg/5ml 240mg/5ml 240mg/5ml

200

120

Page 6 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Antimicrobials Medicine subcategory Sulphonamides Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 40 Per number of days 120

Tablet 780464 716731 704095 735698 701754 867977 758248 789836 715609 Adco-Co-Trimoxazole Cozole Ilvitrim Lagatrim Pharma-q Co-Trimoxazole Nucotrim Purbac adult Trimethox Trixazole A-Lennon Doxycycline HCL Be-Oxytet Cyclidox Doxytet Nucotet Pharmatet (yellow/orange) Migril 480MG 480mg 480mg 480mg 480mg 480mg 480mg 480mg 480mg

Tetracyclines

Capsule 893402 787434 716944 714192 884167 703224 100mg 250mg 100mg 100mg 250mg 250mg

40

120

Central nervous system

Anti-migraine preparations Anxiolytics

Tablet 743283 Tablet 708062 721174 753173 Betapam Doval Pax Adco Prednisolone Aspelone Be-Tabs Prednisone Panafcort Trolic 5mg 5mg 5mg

30 30

180 180

Corticosteroids

Glucocorticocoids

Syrup 716381 714552 Tablet 788783 752304 818267 5mg 5mg 5mg 15mg/5ml 15mg/5ml

100

120

40

90

Page 7 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Corticosteroids Medicine subcategory Topical corticosteroids Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 20 Per number of days 120

Cream 827290 807834 800163 826642 754064 882934 833037 701138 700445 Cream 824011 846422 Canex topical Fungispor Betadine cream Cetriklor 1% 1% Adco-Betamethasone Biocort (stx) Lenovate Link Mezzoderm Persivate Repivate Topivate Vari-Betamethasone Vari-Hydrocortisone 0,1% 1% 0,1% 0,1% 0,1% 0,1% 0,1% 1%

Dermatologicals

Antifungals

20

180

Antimicrobial/ Antiseptics

Cream 708178 836516 Ointment 821713 Septadine antiseptic Calamine - Alchemist Calamine lotion BP Calamine lotion - darol Clicks Calamine Lacto Calamine Link lot Calamine Lot Calamine (xpressmed) 0,1%

25

180

25 200 717243 705561 715602 712969 735647 861758 839027

180 180

Antipruritics

Lotion

Page 8 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Dermatologicals Medicine subcategory Scabicides Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 100 Per number of days 180

Lotion 700205 707716 717242 Scalp lotion 885588 841080 App Benzyl benz - Allied App Benzyl benz (xpressmed) Adco-Acyclovir Beta-Vira Lovire Alum Hydroxide gel Alumag D Aluminium Hydroxide gel Amgel Betaclomin gel Dicyclomine Co gel Magasil Mayogel Medigel Neutragel D Propan Gel S Spasmogel 25% 25% Alpha Benzyl benzoate application App Benzyl benz bpc Benzyl Benzoate application bp 25% 25%

100

180

Topical antivirals

Cream 824674 713942 701035 Suspension 702447 703640 891345 700771 707899 702725 892654 740551 740683 786810 757675 765538 5% 5%

180

Gastrointestinal system

Antacids

500

30

Anthelminthics

Suspension 845698 Tablet 703063 Adco-wormex 100mg Wormstop 100mg/5ml

60 12

180 180

Page 9 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Gastrointestinal system Medicine subcategory Anti emetics Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 100 Per number of days 120

Syrup 783064 723037 784346 792845 820571 796700 Tablet 715875 787817 717891 700712 799424 762849 Adco-Contromet Betaclopramide Bio Metoclopramide Clomax Nauzine Scripto-Metic Adco-Prodium Norimode Anusol Anusol pain relief (was Anugesic) 10mg 10mg 10mg 10mg 50mg 5mg Adco-Contromet Emetrol Emex Medazine-S Nauzine S Triazine paediatric (was Norizine) 5mg/5ml

12,5mg/5ml 12,5mg/5ml

20

120

Antidiarrhoeals Antihaemorrhoidals

Tablet 791768 796697 Ointment 826375 704083 Syrup 707213 783331 703383 Tablet 731951 743348 762717 Hyospasmol Millerspas Scopex Co Cysticide Ceralyte oral rehydration solution Lectro solution Purity oral rehydration solution Scriptolyte 10mg Hyospasmol Medicyclomine Scopex syrup 5mg/5ml 10mg/5ml 5mg/5ml 2mg 2mg

12

90

25

120

Antispasmodics

100

120

20

120

Biltricides Electrolyte replacement

Tablet 717169 Syrup 703357 787191 701466 762873 500mg

100 25

360 180

Page 10 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Gastrointestinal system Medicine subcategory H2-Receptor blockers Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 90 Per number of days 180

Tablet 811459 800252 886978 887003 854247 854255 736260 797464 797472 Syrup 708722 713232 717972 797723 Tablet 709275 868078 Adco-Senna Soflax Gencit simplex Mist Pot Cit simplex Sb Urinary tract alkalising mixture Crystacit solution 13,5mg Aculax Agarol Lactulose Anlac Lacson 3300mg/5ml 3300mg/5ml 3300mg/5ml 3300mg/5ml Adco-Cimetidine Adco-Cimetidine Bio-Cimetidine Bio-Cimetidine Cimlok Cimlok Lenamet Secadine Secadine 200mg 400mg 200mg 400mg 200mg 400mg 400mg 200mg 400mg

Laxatives

150

120

48

120

Genito-urinary system

Urinary alkalinisers

Suspension 839760 805130 859869 Syrup 883535 416,6mg/5ml

500

30

500 50 831913 839620 Canex Vag Gyno-Trimaze Adco-Mefenamic Acid Fenamin Ibucine (was Ibumax) Ibugesic Ponac 1% 1% 200 875643 797014 700315 704781 793264 50mg/5ml 50mg/5ml 100mg/5ml 100mg/5ml 50mg/5ml

30 120

Vaginal antifungals Musculoskeletal Non-steroidal antiinflammatories (NSAIDs)

Vaginal cream

Suspension

120

Page 11 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Musculoskeletal Medicine subcategory Non-steroidal antiinflammatories (NSAIDs) Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 30 Per number of days 120

Tablet 788597 893390 893391 787426 701975 708290 853240 705940 700316 700318 868221 708536 733741 733768 786012 786020 752398 824852 701654 719811 Eye Ointment 713759 817201 767360 769967 Chlorcol 3.5g Chlorphen 3.5g Sulphacetamide 3.5g Terramycin 5g Adco-Mucolinct Alcophyllex Alcophyllin Betaphlem Bronchette Co-Flem 1% 1% Adco-Diclofenac A-Lennon Diclofenac A-Lennon Diclofenac Betaprofen Betaprofen FC Bren Diclohexal Ibu Ibucine (was Ibumax) Ibucine (was Ibumax) Ibunate Ibusor Inza Inza Mylan Diclofenac Mylan Diclofenac Panamor AT Ranfen Ranfen Sandoz Diclofenac 50mg 25mg 50mg 200mg 400mg 400mg 25mg 200mg 200mg 400mg 200mg 200mg 200mg 400mg 25mg 50mg 50mg 200mg 400mg 25mg

Ophthalmics

Eye ointment

120

Respiratory system

Flu preparations

Cough syrup 787078 701742 701750 708151 710520 779814 250mg/5ml 26,67mg/5ml 250mg/5ml 250mg/5ml 250mg/5ml

200

180

Page 12 of 13

07/2013

KeyCare acute medicine

This formulary contains medicines for acute (short term) use only We have set the quantity of medicine for each medicine sub-category (medicines with similar therapeutic effects) according to a specified number of days. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days Please note: You may prescribe only one medicine from each medicine sub-category in the specified time period. For example you may not prescribe Aspirin and Paracetamol within 120 days of each other, because both medicines are in the same medicine sub-category
Broad medicine category Respiratory system Medicine subcategory Flu preparations Dosage form NAPPI code Medicine name Medicine strength Maximum allowable quantity 200 Per number of days 180

Cough syrup 789739 742414 770388 700238 Decongestant syrup Nasal spray 746126 Tablet 822744 Sinuend Nazene Z 20ml Flemgo Metaxol cough Theophen Theophen Compound elixir Adco-Flupain 250mg/5ml 80mg/15ml

200 806218 1 20

180 180 120

Page 13 of 13

07/2013