abu dhabi plan drug list

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Shaded Drugs are available only in Public Providers Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price 1279-4500-008 Xylocaine 2% Lidocaine 2.0% Jelly 30g 1 17.50 17.50 1622-3795-001 Rialocaine Lidocaine 2.0% Gel 20gm 1 5.50 5.50 1392-4356-010 Valium Diazepam 5 mg Tablet 25's 25 17.00 0.68 1472-1900-006 Diazepam Diazepam 5 mg Tablet 20's 20 6.50 0.33 1392-3830-005 Rivotril Clonazepam 0.5 mg Tablets 50's 50 16.00 0.32 1392-3830-009 Rivotril Clonazepam 2mg Tablets 30's 30 20.00 0.67 1392-3830-001 Rivotril Clonazepam 2.5 mg/ml Drops 10ml 1 17.00 17.00 1595-4490-002 Xanax Alprazolam 0.25 mg Tablet 30's 30 11.50 0.38 1595-4490-004 Xanax Alprazolam 0.5 mg Tablet 30's 30 19.50 0.65 1256-4286-001 Tryptizol Amitriptyline 25 mg Tablet 30's 30 9.50 0.32 1438-3909-001 Saroten Retard Amitriptyline 25 mg Capsules 100's 100 51.00 0.51 1671-3953-001 Seroxat Paroxetine 20 mg Tablets 30's 30 176.00 5.87 1676-2180-002 Faverin Fluvoxamine Maleate 50mg Film Coated Tablets 60's 60 103.50 1.73 1438-1613-001 Cipram Citalopram 20 mg Tablet 28's 28 173.50 6.20 1567-4598-001 Lopram Citalopram 20mg Film Coated Tablets 28's 28 110.00 3.93 1742-1282-002 Ativan Lorazepam 1 mg Tablet 20's 20 9.00 0.45 1556-4224-002 Tofranil Imipramine 25 mg Tablet 50's 50 26.50 0.53 2015-5252-002 Buspirone Buspirone 5mg Tablet 100's 100 25.00 0.25 2015-5252-003 Buspirone Buspirone 10mg Tablet 100's 100 42.00 0.42 1783-5102-004 Prochlorperazine Prochlorperazine 5mg Tablet 100's 100 25.00 0.25 1988-4625-004 Chlorpromazine Chlorpromazine 25mg Tablet 100's 100 97.00 0.97 1369-4625-005 Chlorpromazine Chlorpromazine 50mg Tablet 100's 100 102.00 1.02 1768-4625-006 Chlorpromazine Chlorpromazine 100mg Tablet 100's 100 114.00 1.14 2016-4626-005 Phenobarbital Phenobarbital 15mg Tablet 28's 28 29.58 1.06 1263-4626-004 Phenobarbital Phenobarbital 30mg Tablet 28's 28 25.36 1.48 1. CNS AGENTS 1.1 Sedative & Antidepressant 2. ANTICONVULSANTS/ ANTIEPILEPTICS National Health Insurance Company - Daman P.O. Box 128888 Abu Dhabi, U.A.E Phone: + 971 2 6149555 Fax: +971 2 6149550 Abu Dhabi Plan Drug List Version 4 - Effective from 1st of June 2009 Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 1 of 45

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Page 1: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

1279-4500-008 Xylocaine 2% Lidocaine 2.0% Jelly 30g 1 17.50 17.50

1622-3795-001 Rialocaine Lidocaine 2.0% Gel 20gm 1 5.50 5.50

1392-4356-010 Valium Diazepam 5 mg Tablet 25's 25 17.00 0.68

1472-1900-006 Diazepam Diazepam 5 mg Tablet 20's 20 6.50 0.33

1392-3830-005 Rivotril Clonazepam 0.5 mg Tablets 50's 5016.00 0.32

1392-3830-009 Rivotril Clonazepam 2mg Tablets 30's 3020.00 0.67

1392-3830-001 Rivotril Clonazepam 2.5 mg/ml Drops 10ml 117.00 17.00

1595-4490-002 Xanax Alprazolam 0.25 mg Tablet 30's 30 11.50 0.38

1595-4490-004 Xanax Alprazolam 0.5 mg Tablet 30's 30 19.50 0.65

1256-4286-001 Tryptizol Amitriptyline 25 mg Tablet 30's 30 9.50 0.32

1438-3909-001 Saroten Retard Amitriptyline 25 mg Capsules 100's 100 51.00 0.51

1671-3953-001 Seroxat Paroxetine 20 mg Tablets 30's 30 176.00 5.87

1676-2180-002 Faverin Fluvoxamine Maleate 50mg Film Coated Tablets 60's 60 103.50 1.73

1438-1613-001 Cipram Citalopram 20 mg Tablet 28's 28 173.50 6.20

1567-4598-001 Lopram Citalopram 20mg Film Coated Tablets 28's 28 110.00 3.93

1742-1282-002 Ativan Lorazepam 1 mg Tablet 20's 20 9.00 0.45

1556-4224-002 Tofranil Imipramine 25 mg Tablet 50's 50 26.50 0.53

2015-5252-002 Buspirone Buspirone 5mg Tablet 100's 100 25.00 0.25

2015-5252-003 Buspirone Buspirone 10mg Tablet 100's 100 42.00 0.42

1783-5102-004 Prochlorperazine Prochlorperazine 5mg Tablet 100's 100 25.00 0.25

1988-4625-004 Chlorpromazine Chlorpromazine 25mg Tablet 100's 100 97.00 0.97

1369-4625-005 Chlorpromazine Chlorpromazine 50mg Tablet 100's 100 102.00 1.02

1768-4625-006 Chlorpromazine Chlorpromazine 100mg Tablet 100's 100 114.00 1.14

2016-4626-005 Phenobarbital Phenobarbital 15mg Tablet 28's 28 29.58 1.06

1263-4626-004 Phenobarbital Phenobarbital 30mg Tablet 28's 28 25.36 1.48

1. CNS AGENTS

1.1 Sedative & Antidepressant

2. ANTICONVULSANTS/ ANTIEPILEPTICS

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 1 of 45

Page 2: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1263-4626-008 Phenobarbital Phenobarbital 60mg Tablet 28's 28 33.80 1.90

1581-2891-005 Lyrica Pregabalin 75mg Capsules 14's 14 69.50 4.96

1713-2716-002 Keppra Levetiracetam 250 mg Film Coated Tablet 100's 100 426.00 4.26

1713-2716-003 Keppra Levetiracetam 500 mg Film Coated Tablet 100's 100 770.50 7.71

1713-2716-001 Keppra Levetiracetam 1000 mg Film Coated Tablet 100's 100 1504.50 15.05

1556-4154-004 Tegretol Carbamazepine 200 mg Tablet 50's 50 50.50 1.01

1556-4155-001 Tegretol CR Carbamazepine 200 mg Tablet 50's 50 55.50 1.11

1556-4154-003 Tegretol Syrup Carbamazepine 0.02 mg Syrup 100 ml 1 16.00 16.00

1576-2091-001 Epanutin Phenytoin Na 100 mg Capsules 100's 100 22.00 0.22

1635-1839-002 Depakine Valproate Na 200 mg Tablet 40's 40 31.00 0.78

1635-1839-004 Depakine Valproate Na 500 mg Tablet 40's 40 65.50 1.64

1635-1840-001 Depakine Chrono Valproic acid+Valproate Na 500 mg Film Coated Tablet 30's 30 61.00 2.03

1635-1839-001 Depakine Valproate Na 200mg/ml Solution40ml Glass Bottle

+ Graduated 1 31.00 31.00

1346-4230-003 Topamax Topiramate 25 mg Tablet 60's 60 181.00 3.02

1346-4230-004 Topamax Topiramate 50 mg Tablet 60's 60 326.00 5.43

1346-4230-001 Topamax Topiramate 100 mg Tablet 60's 60 599.50 9.99

1346-4230-002 Topamax Topiramate 200 mg Tablet 60's 60 1034.50 17.24

1705-2760-001 Lamictal Liqui-Tabs Lamotrigine 100mg Chewable Dispersible Tablets 30's 30 255.00 8.50

1705-2760-004 Lamictal Liqui-Tabs Lamotrigine 50mg Chewable Dispersible Tablets 30's 30 148.00 4.93

1705-2760-003 Lamictal Liqui-Tabs Lamotrigine 25mg Chewable Dispersible Tablets 30's 30 83.50 2.78

1503-1772-001 Cymbalta Duloxetine 30mg Capsules 28's 28 219.00 7.82

1503-1772-002 Cymbalta Duloxetine 60mg Capsules 28's 28 271.00 9.68

1704-1265-001 Aspimed Acetylsalicylic acid 75 mg Enteric Coated Tablet 56's 56 27.00 0.48

1276-1258-001 Asiaprine Acetylsalicylic acid 81mg Enteric Coated Tablet 20's 20 6.00 0.30

1747-1271-001 Aspirin Protect Acetylsalicylic acid 100 mg Enteric Coated Tablet 20's 20 10.00 0.50

1368-2083-001 Enelfa Paracetamol 100mg/5ml Syrup 100ml 1 8.00 8.00

3.1 Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)

3. ANALGESICS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 2 of 45

Page 3: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1544-3197-001 Neomol Paracetamol 120 mg/5 ml Suspension 100ml 1 5.00 5.00

1431-2063-001 Emidol Paracetamol 120mg/5ml Suspension 100ml 1 5.00 5.00

1431-2063-003 Emidol Paracetamol 250mg/5ml Suspension 100ml 1 6.50 6.50

1472-1058-001 Adol Paracetamol 100mg/5ml Drops 15ml 1 7.00 7.00

1472-1058-016 Adol Paracetamol 500 mg Tablet(Caplet) 96's 96 12.00 0.13

1523-2938-003Medamol Paracetamol 500mg

Tablets (Caplets)

30's (10's Blister x

3)30

5.00 0.17

1516-4293-002 Tylenol Arthritis Pain ER Relief Paracetamol 650mg Extended Release Caplets 24's 24 14.50 0.60

1516-2156-002 Extra Strength Tylenol Paracetamol 500mg Caplets 24's 24 7.00 0.29

1431-2063-005 Emidol Paracetamol 500mg Tablet 24's 24 4.00 0.17

1544-3197-003 Neomol Paracetamol 500mg Caplets 20's 20 4.50 0.23

1368-2083-009 Enelfa Paracetamol 500mg Tablet 20's 20 5.50 0.28

1368-2083-002 Enelfa Paracetamol 125mg Rectal Suppository 10's 10 6.50 0.65

1472-1058-007 Adol Paracetamol 125 mg Rectal Suppository 10's 10 7.00 0.70

1368-2083-004 Enelfa Paracetamol 250mg Rectal Suppository 10's 10 8.00 0.80

1472-1058-010 Adol Paracetamol 250mg Suppository 10's 10 7.50 0.75

1346-4292-002 Tylenol Paracetamol 200mg Rectal Suppository 10's 10 12.00 1.20

1346-4292-003 Tylenol Paracetamol 350mg Rectal Suppository 10's 10 13.00 1.30

1368-2083-006 Enelfa Paracetamol 500 mg Rectal Suppository 10's 10 8.50 0.85

1472-1058-018 Adol Paracetamol 500 mg Suppository 10's 10 10.00 1.00

1431-2065-003 Emifen Ibuprofen 600mg Film Coated Tablets 20's 20 13.50 0.68

1368-1961-010 Dolgit Ibuprofen 600mg Tablet 20's 20 18.00 0.90

1636-3638-004 Profenid Ketoprofen 100mg Film Coated Tablets 30's 30 29.50 0.98

1735-1075-001 Advil Ibuprofen 200mg Coated Tablet 24's 24 8.00 0.33

'1735-1077-003 Advil Liqui-Gels Ibuprofen 200mg Capsules (Soft Gelatin) 32's 32 18.50 0.58

1544-3204-003 Neoprofen Ibuprofen 200mg Tablet 20's 20 7.00 0.35

1472-3640-005 Profinal Ibuprofen 200mg Tablet 20's 20 7.00 0.50

1250-3757-003 Remofen Ibuprofen 400 mg Tablet 30's 30 12.00 0.40

1680-3904-002 Sapofen Ibuprofen 400 mg Tablet 20's 20 10.00 0.50

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 3 of 45

Page 4: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1525-2648-002 Irfen Lactabs Ibuprofen 400 mg Tablet 20's 20 13.50 0.68

1544-3204-006 Neoprofen Ibuprofen 400 mg Tablet 20's 20 11.00 0.55

1241-1457-007 Brufen Ibuprofen 400mg Tablet 25's 25 19.00 0.76

1544-3204-006 Neoprofen Ibuprofen 400mg Tablet 20's 20 11.00 0.55

1697-3636-002 Prof Ibuprofen 400mg Tablet 30's 30 11.50 0.38

1471-1966-001 Doloraz Ibuprofen 400mg Capsules 20's 25 17.00 0.85

1368-1961-004 Dolgit Ibuprofen 400mg Tablet 20's 20 15.50 0.78

1241-1458-001 Brufen Retard Ibuprofen 800mg Modified Release Tablets 20's 20 39.00 1.95

1472-3642-001 Profinal XP Ibuprofen, Caffeine 400mg, 65mg/Tablet Tablets 20's 20 15.50 0.78

1514-3437-001 Oruvail Ketoprofen 100mg Controlled Release Capsules 28's 28 48.00 1.71

1514-3437-005 Oruvail Ketoprofen 200 mg Controlled Release Capsules 28's 28 74.00 2.64

1368-2572-002 Ibutop Ibuprofen 5.0% Gel 20gm 1 7.50 7.50

1284-3638-003 Profenid Ketoprofen 2.5% Gel 60g 1 17.50 17.50

1431-2065-001 Emifen Ibuprofen 100mg /5 ml Suspension 100ml 1 11.00 11.00

1735-1586-001 Childrens Advil Ibuprofen 100 mg/5 mL Suspension(alcohol free) 100ml 1 15.00 15.00

1244-1457-001 Brufen Ibuprofen 100 mg/5 mL Syrup 100ml 1 14.50 14.50

1697-3636-001 Prof Ibuprofen 100mg/5 ml Suspension 100ml 1 6.50 6.50

1355-3327-001 Nurofen for children Ibuprofen 100mg/5mL Suspension 100ml 1 14.50 14.50

1472-3640-001 Profinal (Paediatric) Ibuprofen 100mg/5ml Suspension 110ml 1 13.50 13.50

1641-3866-001 Roxonin Loxoprofin 60mg Tablets 20's 20 31.00 1.55

1392-4211-005 Tilcotil Tenoxicam 20 mg Tablet 10's 10 43.50 4.35

1250-2197-001 Fendol DS Mefenamic acid 500 mg Tablet 20's 20 7.50 0.38

1544-4603-001 Mefex Mefenamic acid 500 mg Film Coated Tablets 20's 20 10.00 0.50

1574-3581-001 Ponstan Forte Mefenamic acid 500mg Tablets 20's 20 16.00 0.80

1544-3213-005 Neoxicam Meloxicam 7.5 mg Tablet 10's 10 10.00 1.00

1490-4592-005 Flexicam Meloxicam 7.5 mg Tablets 10's 10 10.00 1.00

1544-3213-003 Neoxicam Meloxicam 15 mg Tablet 30's 30 42.00 1.40

1249-3083-001 Moven Meloxicam 15 mg Capsules 10's 10 14.50 1.45

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 4 of 45

Page 5: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1967-3064-001 Mobic Meloxicam 15 mg Tablet 10's 10 27.50 2.75

1490-4592-001 Flexicam Meloxicam 15mg Tablets 10's 10 16.00 1.60

1622-1749-001 Coxicam Meloxicam 15mg Tablets 10's 10 19.00 1.90

1433-3679-001 Proxen Naproxen 250 mg Tablet 20's 20 26.50 1.33

1433-3679-002 Proxen Naproxen 500 mg Tablet 20's 20 45.00 2.25

1250-3275-001 Nopain DS Naproxen 500 mg Tablets 10's 10.00 12.50 1.25

1587-2187-004 Feldene Piroxicam 20 mg Dispersable Tablet 10's 10 30.00 3.00

1433-4246-004 Tramal Tramadol HCL 50mg Capsules 10's 10 16.00 1.60

1433-4247-001 Tramal Retard Tramadol HCL 100mg Film Coated Tablets 10's 10 26.50 2.65

1538-4248-001 Tramundin Retard Tramadol HCL 100mg Modified Release Tablets 10's 10 23.00 2.30

1538-4248-002 Tramundin Retard Tramadol HCL 150mg Modified Release Tablets 10's 10 33.00 3.30

1538-4248-003 Tramundin Retard Tramadol HCL 200mg Modified Release Tablets 10's 10 41.50 4.15

1754-4575-001 Arthrum H Sodium hyaluronate 40mg/2ml Injection2ml Pre-filled

Syringe 3 1497.00 499.00

1417-4566-002 Zyloric Allopurinol 100mg Tablet 50's 50 48.00 0.96

1567-4599-001 Loric Allopurinol 100mg Tablets 100's 100 74.00 0.74

1379-3304-001 No-Uric Allopurinol 100mg Tablet 50's 50 21.00 0.42

1379-3304-002 No-Uric Allopurinol 300 mg Tablet 20's 20 21.00 1.05

1567-4599-002 Loric Allopurinol 300mg Tablets 28's 28 53.00 1.89

1417-4566-003 Zyloric Allopurinol 300 mg Tablet 28's 28 66.50 2.38

1705-2590-003 Imuran Azathioprine 50 mg Tablet 100's 100 158.50 1.59

1596-3886-001 Salazopyrin EN Sulfasalazine 500 mg Tablet 100's 100 39.00 0.39

1508-3763-001 Reparil Aescin 20mg Tablets 40's 40 26.00 0.65

1472-3112-002 Muscadol450 mg paracetamol with orphenadrine

35 mg Tablet35mg+450mg Tablet 20's 20 5.00 0.25

1468-1909-007 Diclomax Diclofenac Sodium 50 mg Tablet 20's 20 21.00 1.05

1680-3839-007 Rofenac Diclofenac Sodium 50 mg Tablet 20's 20 23.50 1.18

3.2 Medicines used to treat gout

3.3 Disease modifying agents used in rheumatoid disorders (DMARDs)

4. NSAIDs (Anti-inflammatory), MUSCLE RELAXANTS (PERIPHERALLY-ACTING) AND CHOLINESTERASE INHIBITORS

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 5 of 45

Page 6: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1680-3840-001 Rofenac D Diclofenac Sodium 50mg Dispersible Tablets 20's 20 36.50 1.83

1622-3874-004 Rumafen Diclofenac Sodium 50mg Enteric Coated Tablets 20's 20 23.50 1.18

1556-4476-011 Voltaren Diclofenac Sodium (Enteric-Coated) 50 mg Tablet 20's 20 49.50 2.48

1544-3183-003 Neoflam Diclofenac Sodium (Enteric-Coated) 50 mg Enteric Coated Tablets 20's 20 23.50 1.18

1431-2066-001 Emifenac Diclofenac free radical dispersable 50mg Dispersable Tablet 20's 20 34.00 1.70

1360-1907-007 Diclogesic Diclofenac Sodium (Enteric-Coated) 50 mg Tablet 20's 20 17.00 0.85

1250-4485-003 Votrex Diclofenac Sodium (Enteric-Coated) 50 mg Tablet 20's 20 13.50 0.68

1470-2682-001 Joflam Diclofenac Potassium 50 mg Film Coated Tablets 20's 20 28.00 1.40

1697-3724-002 Rapidus Diclofenac Potassium 50 mg Coated Tablets 20's 20 32.50 1.63

1525-3368-004 Olfen Lactabs Diclofenac Sodium 50mg Tablet 20's 20 25.50 1.28

1344-1520-002 Cataflam Diclofenac Potassium 50 mg Sugar Coated Tablets 20's 20 47.00 2.35

1360-1907-006 Diclogesic Diclofenac Sodium 50 mg Rectal Suppository 10's 10 14.50 1.45

1472-1660-010 Clofen Diclofenac Sodium 50mg Rectal Suppositories 10's 10 24.50 2.45

1556-4476-007 Voltaren Diclofenac Sodium 50 mg Suppository 10's 10 37.00 3.70

1556-4622-003 Voltfast 50mg Diclofenac Potassium 50 mg Powder for Solution (Oral) 30 Sachets 30 56.00 1.87

1464-4481-001 Voltic Diclofenac Sodium 25 mg Tablet 30's 30 19.00 0.63

1525-3370-001 Olfen SR Depotabs Diclofenac Sodium 75 mg Sustained Release Tablets 10's 10 16.50 1.65

1360-1907-009 Diclogesic Diclofenac Sodium 75mg/3ml Injection 3ml Ampoule x 5 5 15.50 3.10

1556-4476-009 Voltaren Diclofenac Sodium 75mg/3ml Injection 3ml Ampoule x 5 5 43.00 8.60

1250-4485-005 Votrex Diclofenac Sodium 75mg/3ml Injection 3ml Ampoule x 5 5 16.00 3.20

1556-4479-002 Voltaren SR Diclofenac Sodium 75 mg Sugar Coated Tablets 10's 10 37.50 3.75

1697-1953-001 Divido Diclofenac Sodium 75mg Modified Release Capsules 20's 20 33.00 1.65

1699-2614-003 Infla-ban 100 S.R. Diclofenac Sodium 100mg Sustained Release Tablets 10's 10 12.50 1.25

1544-3184-003 Neoflam retard Diclofenac Sodium 100 mg Modified Release Tablets 10's 10 32.50 3.25

1360-1908-002 Diclogestic R 100 mg Diclofenac Sodium 100 mg Tablets 10's Blister 10 13.50 1.35

1344-4478-001 Voltaren Retard Diclofenac Sodium 100 mg Tablets 10's Blister 10 48.00 4.80

1468-1909-001 Diclomax Diclofenac Sodium 1.0% EmulGel50g Collapsible

Tube 1 11.00 11.00

1552-4476-001 Voltaren Diclofenac Sodium 1.0% Emulgel 20g Tube 1 15.00 15.00

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 6 of 45

Page 7: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1552-4476-002 Voltaren Diclofenac Sodium 1.0% Emulgel 50g 1 31.00 31.00

1622-3874-002 Rumafen Gel Diclofenac Sodium 1.0% Gel 50g 1 14.00 14.00

1523-1910-001 Diclon Diclofenac Sodium 1.0% EmulGel 45 gm 1 14.00 14.00

1697-4124-001 Tabiflex Cool Diclofenac Sodium 1.0% Gel 50gm 1 13.50 13.50

1525-3368-002 Olfen Diclofenac Sodium 1.0% Gel 50gm 1 19.00 19.00

1360-1907-002 Diclogesic Diclofenac Diethylamine 1.0% Gel 30gm 1 12.50 12.50

1368-1961-008 Dolgit Ibuprofen 5.0% Cream 20g Tube 1 7.50 7.50

1235-2176-003 FastumKetoprofen

2.50% Emulgel

50g Plastic

Dispenser 1 32.00 32.00

1368-1961-009 Dolgit Ibuprofen 5.0% Cream 50g 1 17.00 17.00

1583-1553-002 Celebrex Celcoxib 200mg Capsules 10's 10 63.50 6.35

1531-1235-001 Arcoxia Etoricoxib 120mg Film Coated Tablets 7's 7 49.00 7.00

1595-1841-001 Depo-Medrol Methylprednisolone 40mg/ml Injection 1ml Vial 1 14.00 14.00

1595-4024-003 Solu Medrol Methylprednisolone (as sodium

succinate)40mg/ml Injection

1 Act-o-Vial

(Powder + 1ml 1 15.50 15.50

1727-1864-001 Dexamethasone Phosphate Dexamethasone 4mg/ml Solution for Injection 1ml Ampoule x 10 10 42.50 4.25

1280-2594-002 Inderal Propranolol 10 mg Film Coated Tablets 50's 50 8.00 0.16

1280-2594-005 Inderal Propranolol 40 mg Film Coated Tablets 50's 50 19.50 0.39

1632-1471-002 Cafergot Ergotamine+cyclizine Hcl+caffeine 2mg+50mg+100mg Tablet 20's 20 17.50 0.88

1368-3014-001 Migranerton Metoclopramide+ paracetamol 5mg+500mg Capsules (Hard Gelatin) 20's 20 15.50 0.78

1422-2583-001 Imigran Sumatriptan 100 mg Tablet 2's 2 120.50 60.25

1280-4560-001 Zomig Zolmitriptan 2.5mg Coated Tablet 3's 3 106.50 35.50

1472-2430-002 Gupisone Prednisolone 20 mg Tablet 20's 20 24.00 1.20

1650-3569-001 Polaramine Chlorpheniramine Maleate 2 mg/5 mL Syrup 120ml 1 8.50 8.50

1472-1591-003 Chlorohistol Chlorpheniramine Maleate 2 mg/5 mL Syrup 100 ml 1 7.50 7.50

1472-1591-005 Chlorohistol Chlorpheniramine Maleate 4mg Tablets 20's 20 7.00 0.35

1699-1118-003 Allerfin Chlorpheniramine Maleate 4mg Tablets 30's 30 6.50 0.22

1542-3393-003 Omvil Chlorpheniramine Maleate 4mg Tablets 20's 20 4.50 0.23

5. ANTIMIGRAINE MEDICINES

6. ANTIALLERGICS AND MEDICINES USED IN ANAPHYLAXIS

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 7 of 45

Page 8: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1562-3597-001 Prednisolon Nycomed Prednisolone 5mg Tablet 100's 100 44.50 0.45

1603-3595-001 Predfoam Prednisolone 20 mg/100 mL Enema 100ml 14 79.00 5.64

1601-2942-002 Medrol Methylprednisolone 4mg Tablets 30's 30 19.50 0.65

1256-1817-001 Decadron Dexamethasone 0.5 mg/5 mL Syrup Elixir 100ml 1 14.50 14.50

1431-2396-003 Glotrizine Cetirizine HCL 5mg/5ml Syrup 100 ml 1 15.00 15.00

1712-4572-004 Zyrtec Cetirizine HCL 1 mg/1ml Syrup 75 mL 1 18.00 18.00

1592-2225-004 Finallerg Cetirizine HCL 1mg/ml Syrup 100ml 1 13.00 13.00

1472-1581-002 Cetralon Cetirizine HCL 5mg/5ml Syrup 75ml 1 12.50 12.50

1592-2225-002 Finallerg Cetirizine HCL 10mg Film Coated Tablets 20's 20 25.50 1.28

1712-4572-002 Zyrtec Cetirizine HCL 10mg Film Coated Tablets 20's 20 48.00 2.40

1250-3768-001 Restamine Loratadine 10 mg Tablet 10's 10 16.00 1.60

1650-1644-001 Claritine Loratadine 10 mg Tablet 10's 10 21.00 2.10

1544-3180-002 Neoday Loratadine 10mg Tablet 10's 10 15.00 1.50

1680-2877-002 Lorine Loratadine 10 mg Tablet 20's 20 29.50 1.48

1431-2069-002 Emilora Loratadine 10mg Tablets 20's 20 27.00 1.35

1464-1639-001 Clara Loratadine 10mg Tablets 10's 10 18.00 1.80

1490-2753-002 Lagadine Loratadine 10mg Tablets 10's 10 15.00 1.50

1360-2868-001 Loradad Loratadine 10 mg Tablets 10's 10 13.00 1.30

1542-2850-001 Lohist Loratadine 10mg Tablets 10's 10 13.50 1.35

1431-2396-002 Glotrizine Cetirizine HCL 10mg Film Coated Tablets 20's 20 34.50 1.73

1622-2870-001 Lorahist Loratadine 1mg/ml Syrup 100ml 1 12.00 12.00

1431-2069-003 Emilora Loratadine 1mg/ml Syrup 100ml 1 21.00 21.00

1592-4208-003 Tidilor Loratadine 5mg/5ml Syrup 100ml 1 18.50 18.50

1680-2877-003 Lorine Loratadine HCl 5mg/5ml Syrup (Alcohol Free) 100ml 1 21.00 21.00

1622-2870-002 Lorahist Loratadine 10mg Tablets 10's 10 15.00 1.50

1259-2022-002 Ebastel Ebasten 10mg Film Coated Tablets 20's 20 39.00 1.95

1523-1935-001 DiphelinDiphenhydramine HCl, Sodium Citrate,

MentholCombination Syrup 100ml 1 6.00 6.00

1650-1643-001 Clarinase Repetabs Pseudoephedrine+Loratadine 12mg+5mg Tablets 14's 14 30.00 2.14

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 8 of 45

Page 9: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1680-2876-001 Lorinase Loratidine+Pseudoephedrine 5mg+60mg/5ml Syrup 100ml 1 23.50 23.50

1648-1078-003 Aerius Desloratadine 5mg Film Coated Tablets 30's 30 61.50 2.05

1650-1078-001 Aerius Desloratadine 0.5mg/ml Syrup 150ml 1 37.00 37.00

1621-1932-001 Dimetapp Brompheneramine+Pseudophedrine Syrup Syrup 118ml 1 14.50 14.50

1465-4080-001 Stugeron Cinnarizine 25 mg Tablet 50's 50 14.00 0.28

1676-1388-001 Betaserc Betahistine Hydrochloride 16mg Tablet 60's 60 92.00 1.53

1472-2516-002 Histaloc Promethazine HCL 25 mg Tablet 20's 20 4.00 0.20

1256-3521-001 Periactin Cyproheptadine 4 mg Tablet 20's 20 6.00 0.30

1552-2198-004 Fenistil Dimethindene 1mg Tablet 20's 20 10.00 0.50

1552-2198-005 Fenistil Dimethindene 1mg/ml Oral Drops 20ml 1 13.00 13.00

1552-2198-002 Fenistil Dimethindene 0.1% Gel 30g 1 15.00 15.00

1710-4508-002 Xyzal Levocetrizine 5 mg Film Coated Tablets 30's 30 75.00 2.50

1542-3379-002 Omcet Cetrizine 10mg Film Coated Tablets 28's 28 46.50 1.66

1472-1581-001 Cetralon Cetrizine 10mg Film Coated Tablets 10's 10 18.00 1.80

1579-4157-001 Telfast Fexofenadine 120mg Film Coated Tablets 15's 15 27.00 1.80

1579-4157-002 Telfast Fexofenadine 180mg Film Coated Tablets 15's 15 34.50 2.30

1763-2013-001 Duxil Almitrine+Raubasmine 30mg+10mg Tablet 30's 30 36.50 1.22

1595-4024-001

Solu Medrol Methylprednisolone 125mg/2ml

Powder for Injection

1 Act-o-Vial

(Powder + 2ml

Solvent)

1

38.50 38.50

1595-4024-004

Solu Medrol Methylprednisolone 500 mg/8ml

Powder for Injection

1 Vial (Powder) + 1

Diluent Vial (7.8ml)

1

107.00 107.00

2008-5318-001 Hydrocortone Hydrocortisone 10mg Tablet 30's 30 70.00 2.33

2078-5299-002 EPI-Pen Epinephrine 0.3mg/0.3ml% Injection 1 pre-filled syring 1 339.00 339.00

1465-4407-001 Vermox Mebendazole 100mg Tablet 6's 6 8.00 1.33

1465-4407-002 Vermox Mebendazole 0.02mg Suspension 30ml 1 9.50 9.50

7.1.1 Intestinal anthelminthics

7. ANTI-INFECTIVE MEDICINES

7.1 Anthelminthics

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 9 of 45

Page 10: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1465-4407-003 Vermox Mebendazole 500 mg Tablet 1's 1 7.00 7.00

1475-4406-001 Vermonil Mebendazole 100mg Suspension 30ml 1 8.00 8.00

1663-4529-001 Zentel Albendazole susp. 100 mg/5 mL Suspension 20 ml 1 10.00 10.00

1419-4529-002 Zentel Albendazole 200 mg Film Coated Tablets 2's 2 8.00 4.00

1392-1731-001 Copegus Ribavirin 200 mg Tablets 168's 168 4003.50 23.83

1472-1096-001 Albenda Albendazole 200 mg Tablets 2's 2 6.50 3.25

1774-4630-001 Distamine Penicillamine 250mg Tablets 100's 100 237.00 2.37

1776-3116-002 Myambutol Ethambutol 400mg Tablets 100's 100 631.40 6.31

1791-4631-001 Pyrazimamide Pyrazimamide 500mg Tablets 100's 100 334.00 3.34

1435-3810-001 Rifadin Rifampicin 150mg Capsules 100's 100 105.50 1.06

1435-3810-002 Rifadin Rifampicin 300mg Capsules 100's 100 211.50 2.12

1777-4632-001 Resochin Chloroquine 250 mg Tablets 100's 100 694.00 6.94

1622-1593-001 Chloroquine Chloroquine 50mg / 5ml Syrup 100 ml 1 7.00 7.00

1525-2966-001 Mephaquin Lactabs Mefloquine 250 mg Tablets 6's 6 34.50 5.75

2043-4633-002 Dapsone Dapsone 100mg Tablets 100's 100 161.00 1.61

1776-4634-001 Isoniazid Isoniazide 100mg Tablets 100's 100 22.44 0.22

1276-1168-001 Ampicillin Aminopenicillin 1g Powder for Injection 1 Vial (Dry) 1 4.50 4.50

1276-1168-002 Ampicillin Aminopenicillin 2g Powder for Injection 1 Vial (Dry) 1 8.50 8.50

1276-1168-003 Ampicillin Aminopenicillin 500mg Powder for Injection 1 Vial (Dry) 1 3.50 3.50

1671-1161-004 Amoxil Amoxicillin 250 mg Capsules 20's 20 35.00 1.75

1544-3200-010 Neomox Amoxicillin 500 mg Capsules 20's 20 25.50 1.28

1431-2392-010 Glomox Amoxacillin 500mg Film Coated Tablets 20's 20 34.00 1.70

1544-3200-001 Neomox Amoxicillin 125 mg /5 ml Powder of Suspension 100ml 1 12.00 12.00

1309-3438-002 Ospamox Amoxicillin 125 mg /5 ml Granules for Suspension 100ml 1 16.50 16.50

1250-3388-001 Omnicef Cefdilir 125mg/5ml Powder for Suspension 40ml 1 67.50 67.50

1544-3200-005 Neomox Amoxicillin 250 mg /5 ml Powder of Suspension 100ml 1 18.50 18.50

1309-3438-004 Ospamox Amoxicillin 250 mg /5 ml Granules for Suspension 100ml 1 27.00 27.00

7.2 Antibacterials

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 10 of 45

Page 11: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1431-2392-007 Glomox Amoxacillin 250mg/5ml Powder for Suspension 100ml 1 21.00 21.00

1250-3509-005 Penamox Amoxicillin 250 mg Capsule 500's 500 264.00 0.53

1472-2688-007 Julphamox Amoxicillin 250 mg Capsule 20's 20 25.50 1.28

1250-3509-006 Penamox Amoxacillin 250mg/5ml Syrup 100ml 1 14.50 14.50

1472-2688-008 Julphamox Amoxacillin 250mg/5ml Syrup 100ml 1 24.50 24.50

1631-3438-010 Ospamox Amoxicillin 1g Tablets 16's 16 92.00 5.75

1631-3439-008 Ospen 400Penicillin V (Phenoxymethyl penicillin

potassium) 400mg Suspension 60 ml 1 21.00 21.00

1304-2249-001 Floxapen Flucloxacillin 125mg/5ml Suspension 100ml 1 27.50 27.50

1304-2249-003 Floxapen Flucloxacillin 250mg Capsule 20's 20 36.00 1.80

1243-2112-001 Erythrocin Erythromycin 200 mg/5 ml Granules for Suspension 100ml 1 20.00 20.00

1472-2106-007 Eromycin Erythromycin 500mg Tablet 10's 10 18.50 1.85

1417-3943-005 Septrin Sulfamethoxazole + trimethoprim 400 mg + 80 mg Tablet 20's 20 29.00 1.45

1705-3944-002 Septrin DS Sulfamethoxazole + trimethoprim 800mg + 160mg Tablet 10's 10 21.00 2.10

1392-1330-002 Bactrim Forte Sulfamethoxazole + trimethoprim 800mg + 160mg Tablet 10's 10 33.00 3.30

1490-2756-001 Lagatrim Forte Sulphamethoxazole+Trimethoprim 160+800mg Tablets 10's 10 20.50 2.05

1417-3943-002 Septrin(Pediatric) Sulfamethoxazole + trimethoprim 200 mg + 40 mg/5 ml Suspension 100ml 1 18.00 18.00

1392-1329-004 Bactrim Sulfamethoxazole + trimethoprim 200 mg + 40 mg/5 ml Syrup 100ml 1 24.00 24.00

1523-1539-003 Cefaxine Cephalexin 250 mg Capsules 20's 20 10.00 0.50

1250-2803-006 Lexin Cephalexin 250 mg/5 ml Suspension 100ml 1 12.00 12.00

1472-1546-006 Cefrin Cephalexin 250 mg/5 ml Suspension 100ml 1 29.00 29.00

1360-1567-001 Cephadar Forte Cephalexin 500 mg Capsules 20's 20 20.00 1.00

1309-3440-001 Ospexin Cephalexin 125 mg/5 ml Granules for Suspension 100ml 1 19.00 19.00

1309-3440-004 Ospexin Cephalexin 250 mg/5 mL Granules for Suspension 100ml 1 30.00 30.00

1309-3440-006 Ospexin Cephalexin 500mg Capsules 1000's 1000 1580.00 1.58

1472-1546-009 Cefrin Cephalexin 500mg Capsules 20's 20 51.00 2.55

1542-3372-003 Omaceph Cefalexin 500 mg Capsules 20's 20.0 28.00 1.40

1523-1539-006 Cefaxine Cephalexin 500 mg Capsules 20's 20 18.50 0.93

1250-3388-003 Omnicef Cefdinir 300mg Capsules 10's 10 138.50 13.85

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 11 of 45

Page 12: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1671-1293-010 Augmentin(Infant) Amoxicillin + Clavulanic acid 62.5 mg/ml Powder for Drops(Oral) 20ml 1 31.50 31.50

1309-1758-001 Curam Amoxicillin + Clavulanic acid 156.25mg/5ml Powder for Suspension 100ml 1 23.00 23.00

1250-1155-001 Amoclan Amoxicillin + Clavulanic acid 156mg/5ml Powder for Suspension 100ml 1 17.50 17.50

1544-3173-001 Neoclav amoxicillin + clavulanic acid 156.25mg /5ml Powder for Suspension 100ml 1 18.00 18.00

1671-1293-002 Augmentin Amoxicillin + Clavulanic acid 156mg /5ml Suspension 100ml 1 27.00 27.00

1671-1293-004 Augmentin Amoxicillin + Clavulanic acid 228mg/5ml Powder for Syrup 70ml 1 22.50 22.50

1468-2949-003 Megamox Amoxicillin + Clavulanic acid 228mg/5ml Powder for Suspension 70ml 1 17.50 17.50

1544-3173-002 Neoclav Amoxicillin + Clavulanic acid 228.5mg/5ml Powder for Suspension 70ml 1 17.00 17.00

1276-1292-001 Augmatic Amoxicillin + Clavulanic acid 312.5 mg/5ml Powder for Suspension 100ml 1 25.00 25.00

1544-3173-003 Neoclav Amoxicillin + Clavulanic acid 312.5mg/5ml Powder for Suspension 100ml 1 24.00 24.00

1431-2390-002 Gloclav Amoxicillin + Clavulanic acid 312mg/5ml Powder for Suspension 100ml 1 25.50 25.50

1472-2686-001 Julmentin Forte Amoxicillin + Clavulanic acid 312 mg/ 5 ml Powder for Suspension 100ml 1 25.50 25.50

1250-1156-003 Amoclan Bid Amoxicillin + Clavulanic acid 400mg/5ml Powder for Suspension 70ml 1 23.00 23.00

1544-3173-005 Neoclav Amoxicillin + Clavulanic acid 457mg/5ml Powder for Suspension 70ml 1 28.50 28.50

1468-2949-006 Megamox Amoxicillin + Clavulanic acid 457mg / 5 ml Powder for Suspension 70ml 1 30.00 30.00

1671-1293-008 Augmentin Amoxicillin + Clavulanic acid 457mg/5ml Powder for Syrup 70ml 1 41.50 41.50

1523-2936-001 Medaclav Amoxicillin + Clavulanic acid 375 mg Film Coated Tablets 20's 20 38.00 1.90

1431-2390-004 Gloclav 375 Amoxicillin + Clavulanic acid 375 mg Film Coated Tablets 20's 20 38.00 1.90

1544-3173-004 Neoclav Amoxicillin + Clavulanic acid 375mg Film Coated Tablets 20's 20 34.50 1.73

1680-2733-003 Klavox Amoxicillin + Clavulanate 375mg Tablets 20's 20 43.00 2.15

1468-2949-005 Megamox Amoxicillin + Clavulanic acid 375mg Tablets 20's 20 37.50 1.88

1250-1155-002 Amoclan Amoxicillin + Clavulanic acid 375mg Tablets 20's 20 36.50 1.83

1671-1293-007 Augmentin Amoxicillin + Clavulanic acid 375 mg Tablet 20's 20 58.50 2.93

1276-1292-002 Augmatic Amoxicillin + Clavulanic acid 625mg Tablet 10's 10 30.50 3.05

1523-2936-002 Medaclav Amoxicillin + Clavulanic acid 625 mg Tablet 20's 20 64.50 3.23

1671-1293-011 Augmentin Amoxicillin + Clavulanic acid 625 mg Tablet 20's 20 101.00 5.05

1472-2686-002 Julmentin Forte Amoxicillin + Clavulanic acid 625 mg Tablet 20's 20 63.50 3.18

1544-3173-007 Neoclav Amoxicillin + Clavulanic acid 625mg Film Coated Tablets 20's 20 53.00 2.65

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 12 of 45

Page 13: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1250-1157-002 Amoclan Forte Amoxicillin + Clavulanic acid 500 mg / 125 mg Tablet 15's 15 47.00 3.13

1431-2390-006 Gloclav Amoxicillin + Clavulanic acid 500mg / 125mg Film Coated Tablets 20's 20 64.50 3.23

1680-2733-004 Klavox Amoxicillin + Clavulanic acid 625 mg Tablet 20's 20 72.50 3.63

1631-1758-003 Curam Amoxicillin + Clavulanic acid 500 mg / 125 mg Film Coated Tablets 20's 20 84.00 4.20

1468-2949-008 Megamox Amoxicillin + Clavulanic acid 625mg Tablets 20's 20 61.00 3.05

1431-2390-007 Gloclav 1 gm Amoxicillin + Clavulanic acid 875 mg/125 mg Film Coated Tablets 14's 14 85.00 6.07

1631-1758-002 Curam Amoxicillin + Clavulanic acid 1g Tablets 14's 14 91.00 6.50

1472-2685-006 Julmentin Amoxicillin + Clavulanic acid 1 gm Film Coated Tablets 15's 15 85.00 5.67

1671-1293-003 Augmentin Amoxicillin + Clavulanic acid 1 gm Tablet 14's 14 123.50 8.82

1468-2949-002 Megamox Amoxicillin + Clavulanic acid 1gm Tablet 14's 14 78.00 5.57

1250-1156-001 Amoclan Bid Amoxicillin + Clavulanic acid 1 gm Tablets 14's 14 61.00 4.36

1544-3173-008 Neoclav Amoxicillin + Clavulanic acid 1 gm Film Coated Tablets 14's 14 78.00 5.57

1309-3772-002 Retarpen L.A. Penicillin G Benzathine 1.2 MIU Injection 1's 1 6.00 6.00

1309-3439-005 Ospen 500 Penicillin V (Phenoxymethyl penicillin

potassium) 312 mg Tablet 12's 12

9.00 0.75

1472-2689-007 Julphapen Ampicillin 500mg Capsules 12's 12 12.50 10.42

1431-2061-001 Emicipro Ciprofloxacin 250 mg Tablet 10's 10 36.00 3.60

1342-3695-001 Qcip Ciprofloxacin 250mg Film Coated Tablets 10's 10 27.50 2.75

1641-2248-001 Floxacin Ciprofloxacin 250mg Film Coated Tablets 10's 10 38.00 3.80

1300-1614-003 Ciprobay Ciprofloxacin 250 mg Tablet 10's 10 65.00 6.50

1544-3172-002 Neocipro Ciprofloxacin 250 mg Film Coated Tablets 10's 10 26.00 2.60

1369-1621-001 Ciprolet Ciprofloxacin 250 mg Film Coated Tablets 10's 10 25.50 2.55

1680-1623-001 Cipromax Ciprofloxacin 250mg Film Coated Tablets 10's 10 38.50 3.85

1542-3375-001 Omacip Ciprofloxacin 250mg tablets 10's 10 19.00 1.90

1369-1621-003 Ciprolet Ciprofloxacin 500 mg Film Coated Tablets 10's 10 41.50 4.15

1641-2248-002 Floxacin Ciprofloxacin 500mg Film Coated Tablets 10's 10 63.50 6.35

1472-3907-002 Sarf Ciprofloxacin 500mg Film Coated Tablets 10's 10 76.00 7.60

1542-3375-003 Omacip Ciprofloxacin 500mg Film Coated Tablets 10's 10 33.50 3.35

1475-1603-004 Ciflox Ciprofloxacin 500mg Tablets 10's 10 68.50 6.85

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 13 of 45

Page 14: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1342-3695-002 Qcip Ciprofloxacin 500mg Film Coated Tablets 10's 10 47.50 4.75

1544-3172-004 Neocipro Ciprofloxacin 500mg Film Coated Tablets 10's 10 42.00 4.20

1592-1624-002 Cipropharm Ciprofloxacin 500mg Film Coated Tablets 10's 10 47.50 4.75

1348-3723-002 Rapidflox Ciprofloxacin 500 mg Film Coated Tablets 10's 10 42.50 4.25

1431-2061-002 Emicipro Ciprofloxacin 500mg Tablet 10's 10 64.00 6.40

1490-3430-004 Orlin Ciprofloxacin 500 mg Film Coated Tablets 10's 10 42.00 4.20

1300-1614-004 Ciprobay Ciprofloxacin 500 mg Film Coated Tablets 10's 10 127.50 12.75

1673-1328-002 Bactiflox Lactabs Ciprofloxacin 500mg Tablet 10's 10 55.50 5.55

1680-1623-002 Cipromax Ciprofloxacin 500mg Film Coated Tablets 10's 10 63.50 6.35

1369-1621-002 Ciprolet Ciprofloxacin 500 mg Film Coated Tablets 100's 100 393.00 3.93

1673-1328-003 Bactiflox Lactabs Ciprofloxacin 750 mg Tablet 10's 10 78.00 7.80

1699-1618-003 Ciproflox Ciprofloxacin 750 mg Tablet 10's 10 86.00 8.60

1680-1623-003 Cipromax Ciprofloxacin 750 mg Film Coated Tablets 10's 10 65.50 6.55

1276-3980-001 Sipro Ciprofloxacin 750 mg Film Coated Tablets 10's 10 63.50 6.35

2087-4635-005 Minocycline Minocycline 50 mg Capsule 100's 100 174.21 1.74

2071-4635-004 Minocycline Minocycline 100 mg Capsule 28's 28 80.38 2.87

1697-2951-001 Meiact Cefditoren Pivoxil 200mg Tablets 20's 20 90.50 4.53

1489-2990-005 Metrolag Metronidazole 250 mg Tablets 20's 20 20.00 1.00

1471-2992-001 Metrozole Metronidazole 250mg Tablet 20's 20 4.50 0.23

1544-3187-002 Neogyl Metronidazole 500mg Tablet 20's 20 23.50 1.18

1489-2990-006 Metrolag Metronidazole 500mg Tablets 24's 24 31.50 1.31

1472-3166-005 Negazole Metronidazole 500mg Tablets 20's 20 27.00 1.35

1309-4092-002 Supplin Metronidazole 500mg Tablets 20's 20 16.00 0.80

1697-3045-002 Mirazol Metronidazole 500mg Tablets/Film-coated 20's 20 17.00 17.00

1472-3166-002 Negazole Metronidazole 200mg/5ml Suspension 100ml 1 16.50 16.50

1514-2229-001 Flagyl-S Metronidazole 200 mg /5 ml Suspension 100ml 1 21.00 21.00

1250-3241-002 Nidazole Metronidazole 125mg/5ml Suspension 100ml 1 5.00 5.00

1262-1999-003 Dumozol Metronidazole 25mg/ml Suspension 100ml 1 17.50 17.50

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 14 of 45

Page 15: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1589-2175-002 Fasigyn Tinidazole 500 mg Tablets 4's 4 17.50 4.38

1360-1642-003 Claridar Clarithromycin 125 mg Powder for Suspension 60ml 1 27.00 27.00

1697-1645-003 Claritt Clarithromycin 125mg Suspension 60ml 1 27.50 27.50

1244-2728-002 Klacid Clarithromycin 125mg/5ml Granules for Suspension 60ml 1 38.50 38.50

1697-1645-004 Claritt Clarithromycin 250mg Suspension 70ml 1 47.50 47.50

1697-1645-001 Claritt Clarithromycin 250 mg Tablet 14's 14 36.00 2.57

1544-3766-001 Resclar Clarithromycin 250 mg Film Coated Tablets 14's 14 61.00 4.36

1472-1638-001 Clamycin Clarithromycin 250mg Film Coated Tablets 14's 14 61.00 4.36

1244-2728-003 Klacid Clarithromycin 250mg Film Coated Tablets 14's 14 80.00 5.71

1431-2070-001 Emimycin Clarithromycin 250mg Film Coated Tablets 14's 14 50.00 3.57

1699-2731-001 Klaribac Clarithromycin 250 mg Film Coated Tablets 14's 14 39.50 2.82

1622-4586-002 Clarimac Clarithromycin 500 mg Film Coated Tablets 14's 14 52.00 3.71

1241-2729-001 Klacid XL Clarithromycin 500mg Modified Release Tablets 7's 7 77.50 11.07

1544-3766-002 Resclar Clarithromycin 500 mg Film Coated Tablets 14's 14 86.00 6.14

1699-2731-002 Klaribac Clarithromycin 500mg Film Coated Tablets 14's 14 56.00 4.00

1471-2103-002 Eracid Clarithromycin 500 mg Tablet 14's 14 56.00 4.00

1592-1646-002 Clarixin Clarithromycin 500 mg Tablet 14's 14 47.00 3.36

1360-1642-002 Claridar Clarithromycin 500 mg Film Coated Tablets 14's 14 56.00 4.00

1431-2070-002 Emimycin Clarithromycin 500mg Film Coated Tablets 20's 20 100.00 5.00

1472-1638-002 Clamycin Clarithromycin 500mg Film Coated Tablets 14's 14 86.00 6.14

1697-1645-002 Claritt Clarithromycin 500mg Film Coated Tablets 14's 14 58.00 4.14

1544-5216-001 Resclar MR Clarithromycin (modified release ) 500 mg Film Coated Tablets 7's 7 45.00 6.43

1628-3873-001 Rulid Roxithromycin 150mg Tablets 10's 10 57.50 5.75

1697-4538-002 Zetron Azithromycin 250 mg Capsules (Hard Gelatin) 6's 6 37.00 6.17

1641-1318-001 Azomax Azithromycin 250 mg Capsules (Hard Gelatin) 6's 6 33.50 5.58

1680-4541-003 Zimax Azithromycin 250 mg Capsules (Hard Gelatin) 6's 6 50.50 8.42

1442-4549-003 Zithromax Azithromycin 250 mg Capsules (Hard Gelatin) 6's 6 82.00 13.67

1464-1316-004 Azi-once Azithromycin 250 mg Capsules (Hard Gelatin) 6's 6 47.50 7.92

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 15 of 45

Page 16: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1544-2925-001 Mazit Azithromycin 250 mg Capsules (Hard Gelatin) 6's 6 50.50 8.42

1249-4551-001 Zocin Azithromycin 250mg Capsules (Hard Gelatin) 6's 6 40.50 6.75

1472-1319-003 Azomycin Azithromycin 250mg Capsules (Hard Gelatin) 6's 6 69.50 11.58

1590-4550-001 Zithromax SD Azithromycin 2g Powder for Suspension 2g 1 98.00 98.00

1584-4549-005 Zithromax Azithromycin 600mg Powder For Suspension 15ml 1 31.50 31.50

1584-4549-006 Zithromax Azithromycin 900mg Powder for Suspension 22.5ml 1 47.00 47.00

1472-1319-001 Azomycin Azithromycin 200 mg/5 mL Powder for Suspension 15ml 1 26.50 26.50

1697-4538-001 Zetron Azithromycin 200 mg/5 mL Powder for Suspension

15ml Plastic Bottle

+ 9ml Water

(Plastic Ampoule) 1 15.00 15.00

1680-4541-001 Zimax Azithromycin 200 mg/5 mL Powder for Suspension 15ml 1 18.50 18.50

1697-4538-003 Zetron Azithromycin 300 mg/7.5 ml

Powder for Suspension

22.5ml Plastic

Bottle + 12ml

Water (Plastic

Ampoule) + 10ml 1 22.50 22.50

1680-4541-004 Zimax Azithromycin 300 mg/7.5 ml Powder for Suspension 22.5 ml 1 27.50 27.50

1477-3859-001 Rovamycin Spiramycine 3 MIU Tablets 10's 10 37.00 3.70

1472-1550-003 Cefuzime Cefuroxime Axetil 250mg Film Coated Tablets 10's 10 38.00 3.80

1544-3215-001 Neoxime Cefuroxime Axetil 250mg Tablet 10's 10 38.00 3.80

1750-4545-009 Zinnat Cefuroxime Axetil 250mg Tablet 10's 10 55.00 5.50

1360-1813-001 Daroxime 250 Cefuroxime Axetil 250 mg Film Coated Tablets 10's 10 35.50 3.55

1249-4301-001 U-cef Cefuroxime Axetil 250 mg Film Coated Tablets 10's 10 38.00 3.80

1592-1549-002 Cefutil Cefuroxime Axetil 250 mg Film Coated Tablets 10's 10 38.50 3.85

1525-4519-001 Zamur Cefuroxime Axetil 250mg Film Coated Tablets 10's Blister 10 38.50 3.85

1525-4519-002 Zamur Cefuroxime Axetil 500mg Film Coated Tablets 10's 10 74.00 7.40

1472-1550-004 Cefuzime Cefuroxime 500mg Film Coated Tablets 10's 10 73.50 7.35

1507-1580-002 Cetil Cefuroxime Axetil 500mg Tablets 10's 10 60.50 6.05

1418-4545-008 Zinnat Cefuroxime Axetil 250 mg/ 5ml Susp 50ml 1 62.00 62.00

1360-1813-002 Daroxime Cefuroxime Axetil 500mg Film Coated Tablets 10's 10 63.50 6.35

1249-4301-002 U-cef Cefuroxime Axetil 500mg Film Coated Tablets 10's 10 68.00 6.80

1592-1549-003 Cefutil Cefuroxime Axetil 500mg Tablets 10's 10 63.50 6.35

1750-4545-012 Zinnat Cefuroxime Axetil 500mg Tablets 10's 10 105.50 10.55

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 16 of 45

Page 17: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1544-3215-003 Neoxime Cefuroxime Axetil 500 mg Tablets 10's 10 73.50 7.35

1595-1805-002 Dalacin-C Clindamycin 150mg Capsules 16's 16 23.00 1.44

1595-1805-003 Dalacin-C Clindamycin 300mg Capsules 16's 16 42.00 2.63

1595-1805-004 Dalacin-C Clindamycin 300mg/2ml Injection 2ml 1 15.00 15.00

1418-4545-004 Zinnat Cefuroxime Axetil 125mg/5ml Granules for Suspension 50ml 1 32.50 32.50

1523-4528-001 Zenon Cefuroxime Axetil 125 mg/ 5ml Powder for Suspension 100ml 1 44.00 44.00

1523-4528-002 Zenon Cefuroxime Axetil 250 mg/ 5ml Powder for Suspension 50ml 1 44.00 44.00

1472-1550-001 Cefuzime Cefuroxime Axetil 125mg Film Coated Tablets 10's 10 20.00 2.00

1541-1551-001 Cefzalin Cefazolin Sodium 1000mg Powder for Injection 1 Vial (Dry) 1 9.00 9.00

1541-1551-002 Cefzalin Cefazolin Sodium 500mg injection 1 vial 1 6.00 6.00

1250-1537-002 Cefamezin Cefazolin Sodium 500mg Injection 1 vial 1 7.00 7.00

1250-1537-001 Cefamezin Cefazolin Sodium 1000mg Injection 1 vial 1 10.00 10.00

1697-4548-002 Zinoximor Cefuroxime Axetil 250mg Film Coated Tablets 14's 14 50.00 3.57

1592-1311-001 Axone(I.V) Ceftriaxone (I.V) 1 gram Vial Injection1 Vial (Dry) + 1

Solvent Ampoule

(10 ml) 1 47.50 47.50

1276-3869-001 Rozifax Ceftriaxone 1 gram Vial Powder for Injection 1 Vial (Dry) 1 44.00 44.00

1697-1548-003 Ceftriaxone-Tabuk Ceftriaxone (I.V / I.M) 1 gram Vial Powder for Injection1 Vial (Dry) + 1

Solvent Ampoule

(10ml) 1 49.00 49.00

1392-3838-003 Rocephin Ceftriaxone (I.V / I.M) 1 gram Vial Powder for Injection 1 Vial (Dry) + 1

Solvent Ampoule 1 107.00 107.00

1472-4258-011 Triaxone (I.V.) Ceftriaxone

1gm

Powder for Injection

1 Vial (Dry) + 1

Solvent Ampoule

(10ml) 1 49.00 49.00

1250-3895-002 Samixon Ceftriaxone 1gm I.V. Powder for Injection 1 Vial (Dry) 1 53.50 53.50

1250-3895-004

Samixon

Ceftriaxone

1gm I.M.

Powder for Injection

1 Vial (Dry) + 1

Diluent Ampoule

(3.5ml) 1 53.50 53.50

1631-2950-003 Megion Ceftriaxone 1g Injection/Powder for

1 Glass Vial

(Powder) + 1

Plastic Ampoule 150.00 50.00

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 17 of 45

Page 18: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1524-2975-002 Mesporin(I.M) Ceftriaxone 1000 mg Vial Powder for Injection1 Vial (Dry) + 1

Solvent Ampoule

(3.5ml) 1 47.00 47.00

1697-1548-001 Ceftriaxone-Tabuk 0.5g Ceftriaxone (I.V / I.M) 500 mg Vial Powder for Injection1 Vial (Dry) + 1

Solvent Ampoule

(5ml) 1 26.00 26.00

1524-2975-006 Mesporin (I.M) Ceftriaxone 500mg Vial Powder for Injection1 Vial (Dry) + 1

Solvent Ampoule

(2ml) 1 25.50 25.50

1472-4258-007 Triaxone 0.5gm Ceftriaxone (I.V / I.M) 500 mg Vial Powder for Injection1 Vial (Dry) + 1

Solvent Ampoule

(5ml) 1 26.50 26.50

1392-3838-013 Rocephin Ceftriaxone (I.V / I.M) 500 mg Vial Powder for Injection 1 Vial (Dry) + 1

Solvent Ampoule 1 58.50 58.50

1276-3869-003 Rozifax Ceftriaxone 500mg Vial Powder for Injection 1 Vial (Dry) 1 23.50 23.50

1472-4258-001 Triaxone (I.M) Ceftriaxone 250mg Vial Powder For Injection1Vial + 1Amp

diluent1

14.50 14.50

1276-3869-002 Rozifax Ceftriaxone 250 mg Vial Powder for Injection 1 Vial (Dry) 1 13.00 13.00

1631-2950-002 Megion Ceftriaxone 0.5gm Powder for Injection

1 Glass Vial

(Powder) + 1

Plastic Ampoule

(5ml Solvent) 1

27.50 27.50

1250-4098-001 Suprax Cefixime 100 mg/5 mL Suspension 30mL 1 30.50 30.50

1250-4098-002 Suprax Cefixime 100 mg/5 mL Suspension 60mL 1 54.00 54.00

1592-1540-002 Cefix 100mg/5ml Cefixime 100mg/5ml Powder for Suspension 60mL 1 38.00 38.00

1592-1540-001 Cefix 100mg/5ml Cefixime 100mg/5ml Powder for Suspension 30mL 1 21.00 21.00

1507-2676-001 Ixime Cefixime100mg/ 5ml.

Powder for Suspension 50ml 1 35.50 35.50

1697-4432-002 Winex 200 Cefixime 200mg Capsules (Hard Gelatin) 8's 8 53.00 6.63

1697-4432-001 Winex 400 Cefixime 400mg Capsules (Hard Gelatin) 6's 6 79.00 13.17

1544-2016-003 Dynaceph Cefixime 400mg Tablets 6's 6 80.00 13.33

1592-1540-004 Cefix Cefixime 400 mg Capsules (Hard Gelatin) 5's 5 58.00 11.60

1250-4098-004 Suprax Cefixime 400 mg Capsules (Hard Gelatin) 6's 6 100.00 16.67

1592-1543-004 Cefodox Cefpodoxime Proxetil 50mg/5ml Powder for Suspension 50ml 1 31.00 31.00

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 18 of 45

Page 19: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1592-1543-002 Cefodox Cefpodoxime Proxetil 100mg/5ml Powder for Suspension 50ml 1 46.00 46.00

1360-1667-001 Cloracef 125 mg Cefaclor 125mg/5ml Granules for Suspension 75ml 1 21.00 21.00

1592-1543-001 Cefodox Cefpodoxime Proxetil 100mg Tablet 10's 10 49.50 4.95

1592-1543-003 Cefodox Cefpodoxime Proxetil 200mg Tablet 10's 10 74.50 7.45

1523-1545-003 Ceframed Cephradine 500mg Capsules (Hard Gelatin) 20's 20 42.50 2.13

1523-2932-005 Medacef Cefaclor 500mg Capsules (Hard Gelatin) 20's 20 82.00 4.10

1360-1669-001 Clofacef MR Cefaclor 500 mg Modified Release Tablets 10's 10 29.50 2.95

1360-1669-002 Clofacef MR Cefaclor 750 mg Modified Release Tablets 10's 10 41.00 4.10

1523-4583-001 Cefproz Cefprozil 125 mg / 5ml Suspension 50ml 1 25.00 25.00

1340-1552-002 Cefzil Cefprozil 125mg/5ml Powder For Suspension 50ml 1 31.50 31.50

1340-1552-004 Cefzil Cefprozil 250mg/5ml Powder For Suspension 100ml 1 101.50 101.50

1340-1552-005 Cefzil Cefprozil 250mg/5ml Powder For Suspension 50ml 1 53.50 53.50

1523-4583-002 Cefproz Cefprozil 250 mg Susp 50 ml 1 43.00 43.00

1340-1552-003 Cefzil 250mg Cefprozil 250mg Film Coated Tablets 10's 10 59.50 5.95

1340-1552-006 Cefzil 500mg Cefprozil 500mg Film Coated Tablets 10's 10 105.00 10.50

1703-4321-001 Unidox Doxycycline 100mg Capsules 10's 10 14.50 1.45

1360-1982-002 Doxydar Doxycycline 100 mg Capsules 8's 8 11.50 1.44

1544-3179-001 Neocycline Doxycycline 100 mg Capsule 1000's 1000 1037.00 1.04

1697-4125-001 Tabocine Doxycycline 100mg Capsules 10's 10 30.50 3.05

1448-4141-001 Tarivid Ofloxacin 200mg Tablet 10's 10 78.00 7.80

1300-1299-001 Avalox Moxifloxacin 400mg Tablet 5's 5 95.00 19.00

1300-1299-003 Avalox Moxifloxacin 400mg Tablet 7's 7 137.50 19.64

1417-4562-002 Zovirax Acyclovir 200 mg/ 5 ml Suspension 125ml 1 166.50 166.50

1420-4562-009 Zovirax Acyclovir 800 mg Capsule 35's 35 735.50 21.00

1960-4916-001 Acyclovir Wockhart Acyclovir 200 mg Tablets 25's 25 9.40 0.38

1747-1499-003 Canesten Clotrimazole 1.0% Cream 20g 1 22.00 22.00

1523-2944-001 Medsten Clotrimazole 1.0% Cream 30g 1 16.50 16.50

7.3 Antifungal medicines

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 19 of 45

Page 20: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1472-3017-003 Mikostat Nystatin 100 000 IU/ml Suspension 30ml 1 12.00 12.00

1268-3123-001 Mycosat Nystatin 100,000 IU/mL Suspension 30mL 1 9.50 9.50

1276-3333-001 Nystatin Nystatin 500,000 IU/5ml Powder for Suspension 60mL 1 19.50 19.50

1276-3333-002 Nystatin Nystatin '500000 IU Tablets 20's 20 21.00 1.05

1567-3398-001 Opizole Clotrimazole& Betamethasone 1% Cream Cream 20gm 1 9.50 9.50

1567-3399-001 Opizole-B Cream Clotrimazole& Betamethasone 1% Cream Cream 20 gm 1 11.50 11.50

1747-1499-006 Canesten Clotrimazole 500 mg Vaginal Tablet 1's 1 23.00 23.00

1465-3254-003 Nizoral Ketoconazole 200mg Tablet 10's 10 46.00 4.60

1465-2435-002 Gyno-Daktrin Miconazole 200mg Vaginal Ovules 7's 7 34.50 4.93

1256-2855-005 Lomexin Fenticonazole 200mg Vaginal Ovules 3's 3 22.00 7.33

1523-1497-001 Candizole Miconazole 2.0% Cream 30g 1 10.00 10.00

1523-1497-002Candizole Miconazole 2.0%

Vaginal Cream

45g Collapsible

Tube + Applicator1

15.50 15.50

1360-3121-004

Mycoheal Oral Gel Miconazole Nitrate 40 gm

Oral Gel

40g Metal

Collapsible Tube +

Spoon

1

14.00 14.00

1360-3122-001 Mycoheal HC Miconazole Nitrate 15 gm Cream 15g 1 8.00 8.00

1360-3121-003 Mycoheal 2% Miconazole Nitrate 30 gm Cream 30 gm 1 13.50 13.50

1360-3121-005 Mycoheal Miconazole 2.0% Vaginal Cream 50gm 1 20.50 20.50

1567-1404-002 Bevason 0.1% Betamethasone Valerate 0.1% Ointment 20gm 1 5.50 5.50

1471-2315-001 Funzol Fluconazole 150 mg Capsules (Hard Gelatin) 1's 1 25.50 25.50

1472-3422-001 Oramax Fluconazole 150 mg Capsule 1's 1 35.00 35.00

1249-1496-001 Candivast Fluconazole 150 mg Capsules (Hard Gelatin) 1's 1 20.50 20.50

1571-2440-001 Gynosant Fluconazole 150 mg Capsules (Hard Gelatin) 1's 1 27.00 27.00

1589-1914-001 Diflucan Fluconazole 150 mg Capsules (Hard Gelatin) 1's 1 44.00 44.00

1465-4053-002 Sporanox Itraconazole 100mg Capsules (Hard Gelatin) 4's 4 49.50 12.38

1283-4143-002 Tavanic Levofloxacin 500mg Film Coated Tablets 5's 5 117.50 23.50

1283-4143-003 Tavanic Levofloxacin 500mg Film Coated Tablets 7's 7 164.50 23.50

1597-1804-001 Dalacin Clindamycin 100mg Vaginal Ovule3's Strip +

Applicator3

77.50 25.83

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 20 of 45

Page 21: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1529-3972-001 Sinemet Carbidopa & Levodopa 100 mg + 25 mg Tablet 100's 100 122.00 1.22

2015-5340-001 Carbidopa / Levodopa Carbidopa & Levodopa 100 mg + 25 mg Tablet 100's 100 87.30 0.87

1529-3973-001 Sinemet CR Carbidopa & Levodopa 100/25 Tablet 100's 100 163.00 1.63

1529-3973-002 Sinemet CR Carbidopa & Levodopa 200/50 Tablet 100's 100 296.00 2.96

1256-3972-002 Sinemet Carbidopa & Levodopa 250 mg + 25 mg Tablet 20's 20 25.00 1.25

1499-4277-001 Trivastal Retard Piribedil 50mg Tablets 30's 30 42.00 1.40

1544-3182-002 Neoferon Iron (Carbonyl Iron), Folic Acid 100mg+0.5mg Capsules (Hard Gelatin) 30's 30 21.00 0.70

1472-2278-001 FolicronIron (as Ferrous sulfate), Folic acid

5 mg Sustained Release Capsules

(Hard Gelatin)30's 30

7.00 0.23

1785-4637-001 Haem Plus Ferrous salt + Folic acid 45 mg+400mg Capsule 30's 30 13.00 0.43

1472-2279-001 Folicum Folic Acid305mg (100mg elemental

iron)Tablets 20's 20 3.50 0.18

1342-4595-001 Haem-Up Ferric ammonium citrate Liquid (Oral) 200ml 1 18.50 18.50

1523-2649-001 Irokid Iron III Hydroxide Polymaltose 50mg/5ml Syrup 100ml 1 15.00 15.00

1622-2205-001Feromin Drops Ferrous Sulphate 25mg/ml

Drops (Oral)

30ml Bottle +

Dropper1

7.50 7.50

1241-2211-001 Ferrograd Folic Iron+Folic acid 105mg+350mcg Tablets 30's 30 15.50 0.52

1793-4638-001 Feroglobin Elemental Iron+Folic acid 24mg+0.5mg Capsules 30's 30 26.50 0.88

1732-2204-001 Feroglobin B12 Iron+Folic acid 7mg+0.1mg/5ml Syrup 200ml 1 28.00 28.00

1680-2207-001 Ferose Iron Polymaltose complex 100mg Chewable Tablets 30's 30 19.50 0.65

1680-2207-003 Ferose Iron Polymaltose complex 50mg/5ml Syrup 100ml 1 14.50 14.50

2086-5329-001 Iron complete syrupElemental iron (ferrous fumarate), Folic

acid40mg/150mg

Syrup 200ml1

35.00 35.00

1680-2208-001 Ferose-F Iron (as Iron III hydroxide polymaltose

complex), Folic acid 1 mg

Chewable Tablets30's 30

21.50 0.72

1667-2185-001 Fefol Spansules Ferrous Sulfate / Folic Acid 1 mg Capsules (Hard Gelatin) 30's 30 13.00 0.43

1392-3734-004 Recormon Erythropoetin 4000IU Solution for Injection 6 Prefilled syringe 6 2002.00 333.67

1635-3564-001 Plavix 75mg tabs Clopidrogel Disulfate 75 mg Film Coated Tablets 28's 28 311.00 11.11

1285-1648-003 Clexane Enoxaprin Na 4000 anti-Xa IU/0.4ml Solution for Injection 2's 2 72.50 36.25

9. MEDICINES AFFECTING THE BLOOD

8. ANTIPARKINSONISM MEDICINES

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 21 of 45

Page 22: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1779-1747-003 Coumadin Warfarin 1 mg Tablet 100's 100 63.01 0.63

1779-1747-004 Coumadin Warfarin 2 mg Tablet 100's 100 67.28 0.67

1338-1747-001 Coumadin Warfarin 2.5 mg Tablet 100's 100 49.00 0.49

1338-1747-002 Coumadin Warfarin Na 5 mg Tablet 100's 100 54.50 0.55

1556-2984-001 Methergin Methylergometrine H maleate 0.125 mg Sugar Coated Tablets 30's 30 13.50 0.45

1378-4609-001 Pletaal Cilostazol 100 mg Tablets 20's 20 93.50 4.68

1431-2394-002 Glormin Atenolol 25mg Tablet 28's 28 15.00 0.54

1431-2394-003 Glormin Atenolol 50mg Tablet 28's 28 23.50 0.84

1280-4166-005 Tenormin Atenolol 50 mg Tablet 28's 28 37.50 1.34

'1259-1425-003 Blokium Atenolol 50mg Tablet 30's 30 23.50 0.78

1567-1283-003 Atormin Atenolol 50mg Tablets 28's 28 20.50 0.73

1272-1219-004 Apo-atenol Atenolol 50 mg Tablets 30's 30 19.50 0.65

1475-4164-002 Tenol Atenolol 50 mg Tablets 20's 20 21.00 1.05

1431-2394-001 Glormin Atenolol 100 mg Tablet 28's 28 40.50 1.45

1280-4166-002 Tenormin Atenolol 100mg Tablet 28's 28 60.50 2.16

1259-1425-001 Blokium Atenolol 100mg Tablet 15's 15 20.50 1.37

1417-4249-004 Trandate Labetalol HCl 200mg tablets 25's 25 23.50 0.94

1499-1748-001 Coversyl Perindopril arginine 10mg Tablet 30's 30 198.00 6.60

1499-1748-003 Coversyl Perindopril arginine 5mg Tablet 30's 30 154.50 5.15

1982-5462-001 Bipreterax Arginine Perindopril arginine, Indapamide 5mg, 1.25mg Film Coated Tablets 30's 30 198.00 6.60

1982-5462-001 Bi Preterax Arginine Perindopril arginine, Indapamide 5mg/1.25mg Tablets 30's 30 198.00 6.60

1429-1188-001 Angised Glyceryl trinitrate 0.5 mg Tablet 100's 100 31.50 0.32

1499-3627-001 Procoralan Ivabradine 5mg Film Coated Tablets 56's 56 370.00 6.61

1280-4534-003 Zestril Lisinopril 5mg Tablet 28's 28 72.00 2.57

1544-3203-003 Neopril Lisinopril 5 mg Tablet 28's 28 42.50 1.52

1544-3203-001 Neopril Lisinopril 10 mg Tablet 28's 28 55.00 1.96

10. CARDIOVASCULAR MEDICINES

10.1 Antianginal medicines

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 22 of 45

Page 23: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1280-4534-001 Zestril Lisinopril 10mg Tablet 28's 28 95.50 3.41

1544-3203-002 Neopril Lisinopril 20 mg Tablet 28's 28 72.00 2.57

1280-4534-002 Zestril Lisinopril 20mg Tablet 28's 28 120.00 4.29

1280-4533-001 Zestoretic Lisinopril, Hydrochlorothiazide 20mg, 12.5mg Tablet 28's 28 131.00 4.68

1499-3627-002 Procoralan Ivabradine 7.5mg Tablet 56's 56 370.00 6.61

1334-1502-001 Capoten Captopril 25 mg Tablet 30's 30 34.50 1.15

1475-1015-001 Acetab Captopril 25 mg Tablet 20's 20 19.50 0.98

1334-1502-002 Capoten Captopril 50 mg Tablet 30's 30 66.50 2.22

1325-4062-001 Staril Fosinopril Na 10mg Tablets 28's 28 68.50 2.45

1325-4062-002 Staril Fosinopril 20mg Tablets 14's 14 55.50 3.96

1344-3250-002 Nitroderm TTS Nitroglycerin 0.4 mg/hour Transdermal patch 10's 10 46.00 4.60

1288-2415-001 Glytrin Glyceryl trinitrate 400 mcg/doseSpray (Sublingual)

200 Metered Dose

Pressurised Can 1 32.50 32.50

1544-3206-001 Neosorbide Isosorbide mononitrate 20 mg Tablet 30's 30 20.00 0.67

1654-2657-001 Isoket Retard Isosorbide dinitrate 20mg Tablet 50's 50 52.00 1.04

1544-3206-002 Neosorbide Isosorbide mononitrate 40 mg Tablet 30's 30 35.00 1.17

1279-2582-002 Imdur Isosrbide mononitarte 60 mg Tablet 30's 30 61.00 2.03

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 23 of 45

Page 24: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1415-2766-001 Lanoxin PG Digoxin 0.0625mg Tablet 100's 100 14.00 0.14

1705-2765-002 Lanoxin Digoxin 0.125mg Tablet 500's 500 28.50 0.06

1705-2765-005 Lanoxin Digoxin 0.25mg Tablet 25's 25 6.50 0.26

1417-2765-001 Lanoxin Paediatric Digoxin 0.05mg/ml Elixir 60ml 1 21.00 21.00

1472-1152-001 Amirone Amiodarone 200 mg Tablet 30's 30 31.50 1.05

1635-1733-002 Cordarone Amiodarone 200mg Tablet 30's 30 45.50 1.52

1556-2864-002 Lopresor Metoprolol 50 mg Tablet 40's 40 35.00 0.88

1556-2864-001 Lopresor Metoprolol 100 mg Tablet 40's 40 65.50 1.64

1256-1107-001 Aldomet Methyldopa 250 mg Tablet 30's 30 15.50 0.52

1677-3547-001 Physiotens Moxonidine 0.2mg Tablet 28's 28 61.50 2.20

1641-4375-003 Vasopril Enalapril 5mg Tablet 30's 30 19.50 0.65

1342-2089-002 Envas Enalapril 5mg Tablet 30's 30 31.50 1.05

1471-1187-003 Angiotec Enalapril 5 mg Tablet 30's 30 47.50 1.58

1276-2076-003 Enapress Enalapril 5 mg Tablet 20's 20 26.50 1.33

1472-3146-003 Narapril Enalapril 5mg Tablet 28's 28 40.50 1.45

1276-2076-001 Enapress Enalapril 10mg Tablet 20's 20 37.00 1.85

1342-2089-001 Envas Enalapril 10mg Tablet 30's 30 50.50 1.68

1641-4375-001 Vasopril Enalapril 10mg Tablet 30's 30 33.00 1.10

1471-1187-001 Angiotec Enalapril 10mg Tablets 30's 30 66.50 2.22

1276-2076-002 Enapress Enalapril 20 mg Tablet 20's 20 43.50 2.18

1471-1187-002 Angitec Enalapril 20 mg Tablet 20's 20 52.50 2.63

1641-4375-002 Vasopril Enalapril 20 mg Tablet 30's 30 43.50 1.45

1969-4274-007 Tritace Ramipril 2.5mg Capsules 28's 28 100.00 3.57

1969-4274-008 Tritace Ramipril 5mg Capsules 28's 28 106.50 3.80

1283-4274-002 Tritace Ramipril 10mg Capsules 28's 28 119.00 4.25

1279-3565-006 Plendil Felodipine 5mg Tablet 30's 30 66.00 2.20

10.3 Antihypertensive

10.2 Antiarrhythmic

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 24 of 45

Page 25: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1279-3565-002 Plendil Felodipine 10mg Tablet 30's 30 89.00 2.97

1256-2791-001 Lercadip Lercanidipine HCl 10mg Film Coated Tablet 30's 30 65.00 2.17

1464-1173-002 Amvasc Amlodipine 2.5mg Capsules 30's 30 26.00 0.87

1472-1154-001 Amlophar Amlodipine 5 mg Capsules 30's 30 64.50 2.15

1587-3302-001 Norvasc Amlodipine 5 mg Capsules 30's 30 106.50 3.55

1431-5197-001 Glodip Amlodipine 5mg Capsules 30 's 30 60.00 2.00

1369-5217-002 Stamlom Amlodipine 5mg Tablets 28's 28 41.00 1.46

1464-1173-003 Amvasc Amlodipine 5mg Capsules 30's 30 44.00 1.47

1464-1173-001 Amvasc Amlodipine 10 mg Capsules 30's 30 72.50 2.42

1580-3302-002 Norvasc Amlodipine 10 mg Tablet 30's 30 104.00 3.47

1369-5217-001 Stamlom Amlodipine 10mg Tablets 28's 28 67.50 2.41

1574-1925-001 Dilzem Diltiazem HCl 60mg Tablet 50's 50 35.50 0.71

1574-1926-002 Dilzem Retard Diltiazem HCl 90mg Tablet 30's 30 35.50 1.18

1300-1052-001 Adalat Nifidipine 10 mg Tablet 30's 30 38.50 1.00

1300-1053-001 Adalat LA Nifidipine 30mg Tablet 30's 30 66.50 2.22

1300-1053-002 Adalat LA Nifidipine 60mg Tablet 30's 30 80.50 2.68

1499-4379-001 Vastarel MR Trimetazidine 35mg Modified Release Tablets 60's 60 79.00 1.32

1240-2662-001 Isoptin SR 240 mg Verapamil 240mg Film Coated Tablet 20's 20 76.50 3.83

1240-2661-001 Isoptin 80 mg Verapamil 80 mg Film Coated Tablet 20's 20 23.00 1.15

1240-4142-001 Tarka Trandolapril+Verapamil 2mg/180mg Modified Release Tablets 28's 28 124.50 4.45

1527-1720-001 Concor 5 PlusBisoprolol fumarate, Hydrochlorothiazide

5/12.5mg Tablet 30's 3046.50 1.55

1527-1723-001 Concor Bisoprolol Fumarate 5mg Film Coated Tablet 30's 30 34.50 1.15

1527-1722-001 Concor Bisoprolol fumarate 10mg Film Coated Tablets 30's 30 51.00 1.70

1280-4165-001 Tenoretic Atenolol, Chlorthalidone 100mg/25mg Tablet 28's 28 65.00 2.32

1392-1922-001 Dilatrend Carvedilol 25mg Tablets 30's 30 82.50 2.75

1392-1922-002 Dilatrend Carvedilol 6.25mg Tablets 30's 30 65.00 2.17

1699-1426-002 Blopress Candesartan cilexetil 8mg Tablet 28's 28 63.00 2.25

1699-1426-001 Blopress Candesartan cilexetil 16mg Tablet 28's 28 77.00 2.75

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 25 of 45

Page 26: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1279-1277-006 Atacand Candesartan cilexetil 8mg Tablet 28's 28 127.50 4.55

1279-1277-002 Atacand Candesartan cilexetil 16mg Tablet 28's 28 158.00 5.64

1967-3000-002 Micardis Telmisartan 80mg Tablets 28's 28 151.00 5.39

1795-4656-001 Slow K Potassium chloride 600 mg Tablet 500's 500 125.00 0.25

1641-4606-001 Olmetec Olmesartan medoxomil 20mg Film Coated Tablets 28's 28 103.00 3.68

1641-4606-002 Olmetec Olmesartan medoxomil 40mg Film Coated Tablets 28's 28 135.00 4.82

1676-4191-001 Teveten Eposartan 600mg Film Coated Tablets 28's 28 137.50 4.91

1529-1750-002 Cozaar Losartan Potassium 50mg Tablets 28's 28 120.50 4.30

1556-1933-005 Diovan 80 Valsartan 80mg Film Coated Tablets 28's 28 157.50 5.63

1556-4590-001 Exforge 10/160 Amlodipine/Valsartan 10/160mg Film Coated Tablets 28's 28 208.50 7.45

1556-4590-002 Exforge 5/160 Amlodipine/Valsartan 5/160mg Film Coated Tablets 28's 28 208.50 7.45

1635-1223-002 Aprovel Irbesartan 300mg Film Coated Tablets 28's 28 158.00 5.64

1635-1673-002 Co-Aprovel Irbesartan/Hydrochlorothiazide 300/12.5mg Tablets 28's 28 184.00 6.57

1529-2562-002Hyzaar Losartan Potassium+Hydrochlorothiazide 50/12.5

Film Coated Tablets 28's 28

126.00 4.50

1556-1679-003 Co-Diovan 80/12.5 Valsartan/Hydrochlorothiazide 80/12.5 Film Coated Tablets 28's 28 157.50 5.63

1556-1933-002 Diovan 160 Valsartan 16000.0% Film Coated Tablets 28's 28 177.00 6.32

1556-1679-001 Co-Diovan 160/12.5 Valsartan/Hydrochlorothiazide 160/12.5 Film Coated Tablets 28's 28 177.00 6.32

1283-2773-002 Lasix Furosemide 40 mg Tablet 20's 20 26.50 1.33

1475-2323-001 Fusix Furosemide 40 mg Tablet 20's 20 19.50 0.98

1283-2773-001 Lasix Furosemide 20mg/2ml Solution for Injection 2ml Ampoule x 5 5 15.00 3.00

1472-3894-002 Salurin Furosemide 40 mg Tablet 20's 20 16.50 0.83

1656-1105-001 Aldactone Spironolactone 100 mg Tablet 10's 10 47.00 4.70

1656-1105-003 Aldactone Spironolactone 25 mg Tablet 20's 20 24.00 1.20

1471-3077-001 Monozide Hydrochlorothiazide 12.5 mg Tablet 30's 30 8.50 0.28

1471-3077-002 Monozide Hydrochlorothiazide 25 mg Tablet 30's 30 14.00 0.47

1556-2117-001 Esidrex Hydroclorothiazide 25 mg Tablet 20's 20 16.50 0.83

1499-3156-001 Natrilix SR Indapamide 1.5mg Tablet 30's 30 50.00 1.67

11. DIURETICS

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 26 of 45

Page 27: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1472-3968-001 Simvast Simvastatin 10mg Tablets 28's 28 63.50 2.27

1622-3967-001 Simvagen Simvastatin 10mg Film Coated Tablets 30's 30 61.00 2.03

1641-3969-001 Simvaten Simvastatin 10mg Film Coated Tablets 30's 30 55.00 1.83

1622-3967-002 Simvagen Simvastatin 20mg Film Coated Tablets 30's 30 67.50 2.25

1697-4377-002 Vasta Simvastatin 20 mg Tablets 30's 30 87.00 2.90

1472-3968-002 Simvast Simvastatin 20mg Tablets 28's 28 101.50 3.63

1542-4446-001 Viscor Simvastatin 20 mg Tablets 30's 30 81.00 2.70

1472-3968-003 Simvast Simvastatin 40mg Tablets 30's 30 123.00 4.10

1641-3969-003 Simvaten Simvastatin 40mg Tablets 30's 30 99.50 3.32

1574-2862-002 Lopid Gemfibrozil 600mg Tablets 30's 30 53.00 1.77

1280-1752-001 Crestor Rosuvastatin 10 mg Tablets 28's 28 133.50 4.77

1752-2821-002 Lipanthyl Fenofibrate 300mg Capsules 30's 30 41.00 1.37

1576-2822-001 Lipitor Atorvastatin 10 mg Tablets 30's 30 164.50 5.48

1576-2822-002 Lipitor Atorvastatin 20mg Film Coated Tablets 30's 30 263.50 8.78

1576-2822-003 Lipitor Atorvastatin 40mg Film Coated Tablets 30's 30 320.50 10.68

1531-2160-001 Ezetrol Ezetimibe 10mg Tablets 28's 28 224.00 8.00

1340-2828-003 Lipostat Pravastatin sodium 40 mg Tablets 30's 30 230.50 7.68

2060-5266-001 Cholestyramine resin Cholestyramine resin Granules 30's (4 gm) 30 126.90 4.23

1465-1801-003 Daktarin Miconazole 2.0% Cream 30g 1 16.00 16.00

1472-3019-002 Mikozal Miconazole 2.0% Cream 30g 1 12.00 12.00

1465-1801-006 Daktarin Miconazole 2.0% Dusting Topical Powder 20gm jar 1 11.50 11.50

1465-1800-001 Daktacort Hydrocortisone, Miconazole nitrate 2.0% Cream 15gm 1 12.00 12.00

1465-1801-005 Daktarin Miconazole 2.0% Oral Gel 40gm 1 20.00 20.00

1465-3254-001 Nizoral Ketoconazole 2.0% Cream 30g 1 18.50 18.50

1592-2715-002 Kenazole Ketoconazole 2.0% Cream 15gm 1 6.50 6.50

13.1 Antifungal medicines (Topical)

12. Lipid regulating drugs

13. DERMATOLOGICAL MEDICINES (Topical)

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 27 of 45

Page 28: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1552-2762-001 Lamisil Terbinafine 1.0% Cream 15gm 1 26.50 26.50

1552-2762-003 Lamisil Terbinafine 1.00% Spray 30ml 1 49.00 49.00

1556-2763-001 Lamisil Dermagel Terbinafine 1.0% Gel 15gm 1 26.50 26.50

1309-2153-001 Exoderil Naftifine HCl 1.00% Cream 30g 1 26.00 26.00

1497-1799-004 Daivonex Calcipotriol 50mcg/ml Scalp lotion 30ml 1 110.50 110.50

1497-1798-002 Daivobet Calcipotriol+Betamethasone 0.05mg+0.5mg Ointment 30gm 1 141.50 141.50

1523-1847-001 Dermamed Clobetasol propionate 0.1% Ointment 30g 1 18.50 18.50

1680-2981-002 Metaz Mometazone Furoate 0.1% Ointment 30g 1 20.50 20.50

1650-1942-002 Diprolene Betamethasine Dipropionate 0.1% Cream 30gm 1 22.00 22.00

1650-1942-004 Diprolene Betamethasine Dipropionate 0.1% Ointment 30gm 1 22.00 22.00

1622-2230-003 Flamazine Silver Sulfadiazine 1.0% Cream 50gm 1 14.50 14.50

1472-3963-003 Silvadiazin Silver Sulfadiazine 1.0% Cream 50gm 1 7.00 7.00

1472-2927-002 Mebo B-Sitosterol 0.25% Ointment 30 g 1 42.50 42.50

1497-2306-001 Fucidin Fucidic acid 2.0% Cream 15gm 1 18.00 18.00

1497-2306-006 Fucidin Fucidic acid(Na salt) 2.0% Ointment 15gm 1 18.00 18.00

1464-2320-001 Fusibact Sodium Fusidate 2.0% Cream 15gm 1 11.00 11.00

1464-2320-002 Fusibact Sodium Fusidate 2.0% Ointment 15gm 1 11.00 11.00

1680-2322-001 Fusiderm Fucidic Acid 2.0% Cream 15gm 1 10.50 10.50

1523-2308-001 Fucimed Fucidic Acid 2.0% Cream 15g 1 11.00 11.00

1309-1342-001 Baneocin (Bacitracin + Neomycin) Ointment Ointment 20gm 1 9.50 9.50

1309-1342-002 Baneocin (Bacitracin + Neomycin) powder Powder 10gm 1 6.50 6.50

1973-1331-003 Bactroban Mupirocin 2.0% Ointment 15gm 1 30.50 30.50

1418-4562-008 Zovirax Acyclovir 5.0% Cream 2gm 1 27.00 27.00

1433-4097-004 Supraviran Acyclovir 5.0% Cream 2gm 1 19.50 19.50

1629-2486-001 Herpesan Carbenoxolone 2.00% Gel 5gm 1 12.50 12.50

1689-4073-001 Stiemycin Erythromycin 2.0% Solution 25ml 1 17.00 17.00

1648-2055-002 Elocom Mometasone Furoate 0.1% Cream 30gm 1 29.50 29.50

13.2 Anti-infective medicines (Topical)

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 28 of 45

Page 29: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1648-2055-004 Elocom Mometasone Furoate 0.1% Ointment 15gm 1 16.50 16.50

1464-2051-001 Elica Mometasone furoate 0.1% Cream 30gm 1 19.50 19.50

1464-2051-002 Elica Mometasone furoate 0.1% Ointment 30gm 1 18.50 18.50

1595-1803-001 Dalacin T Clindamycin Topical Solution Topical Soln. 30ml 1 25.00 25.00

1804-4669-001 Damor LineFitostimoline 15% + Phenoxyethanole

1% 15%+1% Cream 32 gm1

49.00 49.00

2015-5378-001 Permetharin Permethrin 0.05 Cream 60gm 1 26.60 26.60

1288-1472-001 Calamine Calamine Lotion Lotion 100ml 1 3.00 3.00

1782-4641-001 Calamine Green Wood Calamine Lotion Lotion Lotion 150 ml 1 6.00 6.00

1410-2642-001 Ionil - T Coal tar, Salicylic acid 42.5mg, 20mg/ml Shampoo 200ml 1 45.00 45.00

1410-2844-003 Loceryl 5% Nail Lacquer Amorolfin 50mg/ml Topical Liquid

5ml Glass Bottle +

Nail files +

Spatulas + Swabs

1 274.00 274.00

1410-5075-001 Nutraderm liquid parafin 13.00% Cream 60 gm 1 40.00 40.00

1410-5075-002 Nutraderm Liquid Paraffin 13% W/W in O/W

emulsion13.00% Lotion 200ml 1 45.00 45.00

1410-3329-001 Nutraplus Urea 10.00% Cream 100gm 1 50.00 50.00

1410-1373-003 Benzac AC Benzoyl peroxide 5.00% Gel 60gm 1 23.00 23.00

1786-4642-001 Urecare Urea 10.0% Cream 100 g 1 39.00 39.00

1472-1109-001 Alfacort Hydrocortisone acetate 1.0% Cream 15gm 1 7.50 7.50

1472-1109-002 Alfacort Hydrocortisone acetate 1.0% Ointment 15gm 1 7.50 7.50

1622-1332-001 Balad Fusidic acid 2% Cream 15gm 1 10.00 10.00

1464-2321-001 Fusibact B Fusidic acid+Betamethasone 20mg+1mg/1gm Cream 15gm 1 13.50 13.50

1497-2305-001 Fucicort Fucidic acid+betamethasone 2%+0.1% Cream 15gm 1 23.50 23.50

1497-2307-001 Fucidin H Fucidic acid+Hydrocortisone 2%+1% Cream 15gm 1 25.50 25.50

1523-1385-001 Betamed Betamethasone 0.1% Cream 15g 1 4.50 4.50

1523-1385-002 Betamed Betamethasone 0.1% Ointment 15g 1 4.50 4.50

1379-1382-001 Betaderm Betamethasone 0.1% Cream 20gm 1 6.50 6.50

1379-1382-002 Betaderm Betamethasone 0.1% Ointment 20gm 1 6.50 6.50

13.3 Anti-inflammatory and antipruritic medicines (Topical)

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 29 of 45

Page 30: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1464-1393-001 Betazol Betamethasone+Miconazole 0.5mg+20mg Cream 30 gm 1 12.00 12.00

1464-1394-001 Betazol GBetamethasone+Gentamycin+miconazol

e0.5mg+20mg+0.1mg Cream 30 gm 1

15.50 15.50

1434-4113-001 Synalar Flucinolone Acetonide 0.0% Cream 15gm 1 18.00 18.00

1434-4114-001 Synalar-N Flucinolone Acetonide+Neomycin Cream 15gm 1 18.00 18.00

1262-1999-001 Dumozol 1% Metronidazole 1.0% Cream 25g 1 61.00 61.00

1410-5116-001 Rozex Metronidazole 0.75% Gel 30g 1 20.29 20.29

1508-3764-002Reparil Gel N

Sodium aescinate+Dimethylamine

salicylate20mg

Gel 40g Tube1

17.00 17.00

1434-4114-002 Synalar-N Flucinolone Acetonide+Neomycin 0.0% Ointment 15gm 1 18.00 18.00

1787-4643-001 Ceralan Aqua 55%, Ceramide 55.0% Cream 100gm 1 46.00 46.00

1787-4644-001 Humektan Aqua 80% / Butylene Glycol 60.0% Cream 100gm 1 40.00 40.00

1787-4645-001 Aqualan L Aqua 60%, Petrolatum 60.0% Cream 100gm 1 45.00 45.00

1787-4646-001 Hydran Aqua 40%,Paraffinum 80.0% Cream 100gm 1 40.00 40.00

1805-1375-007 Bepanthen Dexapanthenol 5.0% Cream 30gm 1 17.00 17.00

1805-1375-006 Bepanthen Dexapanthenol 5.0% Ointment 30gm 1 17.00 17.00

1284-2895-001 Maalox Aluminium hydroxide and MgHydroxide 500mg+240mg Suspension 180ml 1 8.508.50

1284-2897-003

Maalox PlusAl-Hydroxide+Mg-

Hydroxide+Simethicone225mg+200mg+25mg

Suspension 180ml

1

9.00 9.00

1523-2934-003Medacid Plus

Al-Hydroxide+Mg-

Hydroxide+Simethicone Suspension 200ml Bottle1

7.00 7.00

1379-2095-001 Epicogel Al-Hydroxide+Mg-Hydroxide

Dimethiconecombination

Suspension 125 ml1 5.50 5.50

1276-1255-001 Asia lox Al-Hydroxide+Mg-Hydroxide combinationChewable Tablets 60's

60 6.50 0.11

1472-3087-001 Moxal PlusAl-Hydroxide+Mg-

Hydroxide+Simethiconecombination

Chewable Tablets 30's 30

6.00 0.20

14.1 Antacids and other antiulcer medicines

14. GASTROINTESTINAL MEDICINES

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 30 of 45

Page 31: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1618-2347-004 Gaviscon Calcium carbonate, Sodium alginate,

Sodium bicarbonate500 mg Suspension 200ml 1 11.00

11.00

1622-3797-002 RialoxAluminium hydroxide, Magnesium

hydroxideCombination Suspension 180ml 1 6.50 6.50

1397-2344-003 GastrogelAluminium hydroxide, Magnesium

hydroxide, Magnesium trisilicateCombination Suspension 500ml 1 11.00 11.00

1379-2782-001 Laxomag Magnesium Hydroxide 7.5% Oral Suspension 125ml 1 5.50 5.50

1544-3185-001 Neogastro Aluminium hydroxide+MgHydroxide 200mg+200mg Chewable Tablets 50's 508.00 0.16

1618-2348-002 Gaviscon Advance Potassium bicarbonate, Sodium alginate 100mg, 500mg/5ml Suspension 300ml 1 26.5026.50

1379-2343-001 Gastrofait Sucralfate 1g Tablets 20's 20.00 17.00 0.85

1544-3201-001 Neoprazole Omeprazole 10 mg Capsule 14's 14 44.00 3.14

1472-3824-001 Risek Omeprazole 10mg Capsule 14's 14 44.00 3.14

1369-3846-001 R-Omez Omeprazole 20 mg tablets 20's(2's Strip x 10) 20 114.50 5.73

1697-3386-002 Omiz Omeprazole 20 mg Capsules 14's 14 80.00 5.71

1431-2068-001 Emilok Omeprazole 20 mg Tablets 14's 14 74.50 5.32

1641-3382-001 Omerpex Omeprazole 20mg Capsules 14's 14 67.50 4.82

1250-3401-002 Oprazol Omeprazole 20mg Enteric Coated Tablets 14's 14 64.50 4.61

1544-3201-004 Neoprazole Omeprazole 20mg Capsules 14's 14 80.50 5.75

1567-3384-001 Omezyn Omeprazole 20mg Capsules 15's 15 82.00 5.47

1475-3037-001 Minisec-20 Omeprazole 20 mg Capsules 14's 14 80.50 5.75

1673-2338-001 Gasec Omeprazole 20 mg GastroCaps 14's 14 104.50 7.46

1641-3382-002 Omeprez Omeprazole 20 mg Capsules 28's Bottle 28 135.50 4.84

1270-2340-001 Gastrazole Omeprazole 20 mg Capsule 14's 14 58.00 4.14

1360-3380-001 Omedar Omeprazole 20 mg Enteric Coated Tablets 14's Glass Bottle 14 63.50 4.54

1472-3824-002 Risek Omeprazole 20mg Capsule 14's 14 80.50 5.75

1544-3201-007 Neoprazole Omeprazole 40 mg Capsule 14's 14 156.50 11.18

1472-3824-005 Risek Omeprazole 40mg Capsule 14's 14 156.50 11.18

1264-3485-001 Pantozol Pantoprazole 20 mg Tablets 15's 15 73.00 4.87

1279-3234-001 Nexium Esomeprazole 20 mg Tablets 14's 14 79.50 5.68

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 31 of 45

Page 32: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1279-3234-003 Nexium Esomeprazole 40 mg Tablets 14's 14 111.00 7.93

1465-3492-003 Pariet Rabeprazole 20 mg Tablets 14's 14 98.00 7.00

1720-2771-001 Lanzor Lanzoprazol 30mg Capsules 14's 14 93.50 6.68

1264-3485-004 Pantozol Pantoprazole 40 mg Gastro-Resistant Tablets 15's 15 116.50 7.77

1276-1256-001 Asiamodin Famotidine 20mg Tablets 20's 20 30.50 1.53

1360-2164-002 Famodar Famotidine 40 mg Tablets 10's 10 46.50 4.65

1592-3139-003 Nadine Ranitidine 75mg Tablets 10's 10 10.50 1.05

1276-3716-001 Ranimed Ranitidine 150 mg Tablets 20's 20 32.00 1.60

1471-3713-001 Ranidine Ranitidine 150 mg Tablets 20's 20 19.00 0.95

1431-2395-002 Glotac Ranitidine 150 mg Film Coated Tablets 20's 20 33.00 1.65

1592-3139-001 Nadine Ranitidine 150 mg Tablets 20's 20 31.50 1.58

1471-3713-002 Ranidine Ranitidine 300 mg Tablets 10's 10 16.00 1.60

1592-3139-002 Nadine Ranitidine 300mg Tablets 10's 10 29.00 2.90

1405-2606-001 Infacol Simethicone 40 mg/ mL Suspension 50ml 1 23.00 23.00

1975-5457-001 Jasicone Simethicone 105.8mg / 1 lozenge Lozenge 20's 20 22.00 1.10

1453-1945-003 Disflatyl Simeticone 40mg Tablets/Chewable 30's 30 9.50 0.32

1368-2345-005 Gastronerton Metoclopramide 4.65 mg/5ml Drops 20ml 1 5.50 5.50

1472-3605-009 Premosan Metoclopramide 5mg/5ml Suspension 120ml 1 9.50 9.50

1464-1968-002 Dompy Domperidone 1mg/ml Suspension 200ml 1.00 12.00 12.00

1465-3082-005 Motilium Domperidone 1mg/ml Suspension 200ml 1 18.00 18.00

1635-3619-007 Primperan Metoclopramide 10 mg Tablet 20's 20 7.50 0.38

1465-3082-001 Motilium Domperidone 10mg Tablet 30's 30 24.50 0.82

1464-1968-001 Dompy Domperidone 10 mg Tablet 30's 30 14.00 0.47

1368-2345-006 Gastronerton Metoclopramide 8.92 mg Tablet 20's 20 6.50 0.33

1363-3619-002 Primperan Paediatric Metoclopramide 10mg Suppository 6's 6 5.00 0.83

1363-3619-005 Primperan Metoclopramide 20mg Suppository 6's 6 7.50 1.25

1465-3082-003 Motilium Baby Domperidone 10mg Suppository 6's 6 10.50 1.75

14.2 Antiemetic medicines

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 32 of 45

Page 33: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1465-3082-006 Motilium Child Domperidone 30 mg Suppository 6's 6 16.00 2.67

1465-3082-008 Motilium Adult Domperidone 60mg Suppository 6's 6 26.50 4.42

1400-3515-001 Pentasa Enema Mesalazine 1.0% Solution

100ml Squeeze

Bottle x 7 +

Polythene Disposal

Bags

7

185.50 26.50

1398-3515-003 Pentasa Mesalazine 1 g Suppositories 28's 28 271.50 9.70

1400-3515-004 Pentasa Mesalazine 500 mg Slow Release Tablets 100's 100 259.50 2.60

1400-3515-002 Pentasa Mesalazine 1 g Prolonged Release Granules 50 Sachets 50 309.00 6.18

1472-2779-004 Laxocodyl Bisacodyl 5mg Suppository 10's 10 7.50 0.75

1317-1995-001 Dulcolax Bisacodyl 5mg Tablets 30's 30 6.00 0.20

1608-3746-001 Regutol Docusate Sodium 100mg Tablets 30's 30 9.50 0.32

1823-4015-003 Soflax stool softener Docusate Sodium 100mg Tablets 30's 30 9.00 0.30

1676-2001-003 Duphalac Lactulose 667 mg/mL Syrup 300ml 1 25.50 25.50

1622-3794-001 Rialac Lactulose 66.0% Liquid (Oral) 200ml 1 11.50 11.50

1473-2410-001 Glycilax (children) Glycerine 0.75g Suppository 12's 12 7.50 0.63

1259-3984-001 Skilax Sodium Picosulphate 7.5mg/ml Drops 15ml 1 6.00 6.00

1544-4647-001 Neolyte Oral rehydration salts 15 gm Sachets 5's 5 17.50 3.50

1542-3432-001 ORS Powder Oral rehydration salts 30gm Sachets 25's 25 39.50 1.58

1475-3421-001 Oralite ORS 28.5g Solution (Oral)/Powder for 10 10 20.00 2.00

2082-4845-003 Pediatric electrolytepotassium 20meq, chloride 35 meq,

sodium 45 meq 20meq / 35 meq / 45 meqSolution 237ml 1 11.50 11.50

1465-2586-004 Imodium Loperamide 2mg Capsule 6's 6 7.50 1.25

1472-2700-001 Kaptin Kaolin 2.7 gm,Pectin 0.06gm/15 ml 2.7 gm+ 0.06gm/15ml Suspension 200ml 1 6.50 6.50

1471-1403-001 Bevacol Mebeverine HCl 135mg Film Coated Tablets 48's 48 33.00 0.69

1695-2104-001 Ercefuryl Nifuroxazide 200 mg Capsules (Hard Gelatin) 28's 28 21.00 0.75

14.5 Oral rehydration

14.6 Medicines for diarrhoea in adults

14.3 Anti-inflammatory medicines

14.4 Laxatives

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 33 of 45

Page 34: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1434-3629-001 Procto synalar Flucinolone Acetonide+Lidocane ointment Ointment 15 gm 1 13.50 13.50

1434-3629-002 Proctosynalar Flucinolone Acetonide+Lidocane Suppository Suppository 10's 10 16.00 1.60

1566-1976-001 Doxiproct Plus dobesilate,Lidocaine Ointment Ointment 20 gm 1 19.00 19.00

1279-4507-001 Xyloproct Aluminium diacetate, Hydrocortisone,

Lidocaine, Zinc oxide

Ointment Ointment 20gm 1

14.00 14.00

1552-3628-001 Procto Glyvenol Tribenoside+Lidocaine 5gm+2gm Cream 30gm 1 18.00 18.00

1552-3628-002 Procto Glyvenol Tribenoside+Lidocaine 5gm+2gm Suppository 10's 10 20.00 2.00

1360-3631-001 Proctoheal Bismuth subgallate, Fluocinolone

acetonide, Lidocaine HCl, Mentholointment Ointment 15 gm 1 8.50

8.50

1360-3631-002 Proctoheal Bismuth subgallate, Fluocinolone

acetonide, Lidocaine HCl, Menthol 0.1 mg / 40 mg Suppository 10's 10 8.50

0.85

1472-3919-006 Scopinal Hyoscine-N-Butyl Bromide 5 mg/5 mL Syrup 100ml 1 10.00 10.00

1472-3919-003 Scopinal Hyoscine-N-Butyl Bromide 10 mg Tablet 20's 20 7.50 0.38

1317-1465-001 Buscopan 10mg Hyoscine-N-Butyl Bromide 10 mg Tablet 20's 20 12.50 0.63

1675-1901-001 Dicetel Pinaverium Bromide 100mg Film Coated Tablets 20's 20 40.00 2.00

1276-2009-001 Duspamed Mebeverine HCL 135mg Tablet 20's 20 13.00 0.65

1379-1705-001 Colospasmin Forte Mebeverine HCL 135mg Tablets 20's 20 13.00 0.65

1676-2011-002 Duspatalin Mebeverine HCL 135mg Tablets 50's 50 64.00 1.28

1464-2993-001 Meva Mebeverine HCl 135mg Tablets 30's 30.00 16.00 0.53

1676-2012-001 Duspatalin Retard Mebeverine HCL 200 mg Tablets 30's 30 57.00 1.90

1489-2806-001 Librocol Chlordiazepoxide+Clidinium Bromide 5mg+2.5mg Tablets 30's 3015.00 0.50

1722-2805-002 Librax Chlordiazepoxide+Clidinium Bromide 5mg+2.5mg Tablets 30's 3014.00 0.47

1276-1254-001 Asia brax Chlordiazepoxide+Clidinium Bromide 5mg+2.5mg Tablets 30's 3010.00 0.33

1250-3586-001 Poxidium Chlordiazepoxide+Clidinium Bromide 5mg+2.5mg Tablets 30's 307.00 0.23

15. Insulins and other antidiabetic agents

14.7 Medicines for hemorrhoid

14.8 Antispasmodics

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 34 of 45

Page 35: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1559-1044-002 Actrapid HM Insulin injection (soluble) 100ml unit/ml vial 10ml 1 62.50 62.50

1382-2543-001 Humulin-R Insulin injection (soluble) 100 IU/ml in 10-ml Vial 10ml 1 54.50 54.50

1559-3073-001 Monotard HM Intermediate-acting insulin insulin zinc 100 IU/ml in 10-ml Vial 10ml 1 62.50 62.50

1559-2623-001 Insulatard HM Intermediate-acting insulin isophane

insulin100 IU/ml in 10-ml Vial 10ml 1

62.50 62.50

1382-2542-001 Humulin-N (Isophane) Intermediate-acting insulin isophane

insulin100 IU/ml in 10-ml Vial 10ml 1 54.50

54.50

1559-3057-001 Mixtard 30 HM Mixed Insulin 70/30(isophane/ soluble) 100 IU/ml in 10-ml Vial 10ml 1 62.50 62.50

1382-2536-001 Humulin(30/70) Mixed Insulin 70/30(isophane/ soluble) 100 IU/ml in 10-ml Vial 10ml 1 54.50 54.50

1559-1045-002 Actrapid HM Penfill Insulin 100IU/5x3ml Cartridge 3ml Cartridge x 5 5 108.50 21.70

1559-2624-002 Insulatard HM Penfil Insulin 100 IU/5x3ml Cartridge 3ml Cartridge x 5 5 108.50 21.70

1559-3313-001 Novo Mix 30 Penfil 100 IU/5x3mlInsulin - Aspart biphasic (human

recombinant)100 IU/5x3ml Cartridge

3ml Cartridge x 55

221.00 44.20

1969-2768-001 Lantus for Optipen Insulin 100 IU/5x3ml Cartridge 3ml Cartridge x 6 5 396.00 79.20

1559-3058-002 Mixtard 30 HM Penfill Insulin - Isophane biphasic (human) 100 IU/5x3ml Cartridge 3ml Cartridge x 5 5 108.50 21.70

1382-2530-002 Humalog® Insulin 100IU/ml Vial 10 ml 1 120.50 120.50

1501-2531-001 Humalog Mix25® Insulin Lispro 100IU/ml 3ml Pre-filled Pen x 53ml Pre-filled Pen

x 55 287.00 57.40

1969-2767-001 Lantus Insulin - Glargine 100 IU/ml Vials 10 ml 1 251.00 251.00

1969-5203-001 Lantus Solostar Insulin 100iu/ml Solution for Injection

3ml Pre-filled Pen

x 5 5 409.50 81.90

1969-2769-001 Lantus Optiset Insulin 100 IU/ml Solution 3ml Optiset x 5 5 409.50 81.90

1382-2532-001 Humalog® Mix 25 Insulin Lispro Mix 25 100 IU/ml Injection 10 ml 1 120.50 120.50

1501-2530-001 Humalog pen Insulin Lispro 100 IU/ml injection3ml prefilled

pens/5's5 273.00 54.60

1501-2530-003 Humalog 3ml cartridge Insulin Lispro 100 IU/ml injection 3ml cartridge/5's 5 221.50 44.30

1501-2530-004 Humalog® Mix 25, 3ml cartridge Insulin Lispro Mix 25 100 IU/ml injection 3ml cartridge/5's 5 221.50 44.30

1501-2530-005 Humalog® Mix 50, 3ml cartridge Insulin Lispro Mix 50 100 IU/ml injection 3ml cartridge/5's 5 221.50 44.30

1559-1045-001 Actrapid HM Penfill Insulin 100 IU/ml Cartridge 1.5ml x 5 5 60.00 12.00

1559-2799-001 Levemir Penfill Insulin 100 IU/ml Cartridge 3ml x 5 5 358.50 71.70

1559-2798-001 Levemir Flexpen 100 U/ml Insulin 100 IU/ml FlexPen 3ml x 5 5 398.00 79.60

1559-3318-001 Novorapid FlexPen Insulin 100 IU/ml FlexPen 3ml x 5 5.00 301.00 60.20

1559-3312-001 Novomix 30 FlexPen Insulin 100 IU/ml FlexPen 3ml x 6 5.00 301.00 60.20

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 35 of 45

Page 36: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1559-3058-001 Mixtard 30 HM Penfill Insulin 100 IU/ml Cartridge 1.5ml x 5 5 60.00 12.00

1559-3059-001 Mixtard 30 Novolet Insulin 100 IU/ml Novolet 3ml x 5 5 174.50 34.90

1559-3319-001 Novorapid Penfill Insulin 100 IU/ml Cartridge 3ml x 5 5 203.50 40.70

1969-1207-001 Apidra Insulin 100IU/ml Cartridge 3ml x 5 5 228.00 45.60

1969-1207-002 Apidra Insulin 100 U/ml Vial 10ml 1 152.00 152.00

1283-5181-001 Apidra Solostar Insulin 100IU/ml Solution for Injection

3ml Pre-filled Pen

x 5 5 241.00 48.20

1528-2401-003 Glucophage Metformin 500 mg Tablet 50's 50 14.50 0.29

1528-2401-005 Glucophage Metformin 850 mg Tablet 30's 30 15.00 0.50

1528-2401-001 Glucophage Metformin 1000 mg Tablet 30's 30 20.00 0.67

1528-2405-001 Glucovanace Metformin+Glibenclamide 500/2.5mg Tablet 30's 30 18.00 0.60

1528-2405-002 Glucovanace Metformin+Glibenclamide 500/5mg Tablet 30's 30 22.50 0.75

1484-2385-001 Glibomet Metformin+Glibenclamide 400mg/2.5mg Film Coated Tablets 40's 40 19.50 0.49

1531-4675-001 Janumet Metformin+Sitagliptin 50mg/1000mg Film Coated Tablets 56's 56 300.00 5.36

1489-2953-003 Melix Glibenclamide 5mg Tablets 30's 30 19.00 0.63

1448-1809-002 Daonil Glibenclamide 5mg Tablet 30's 30 31.00 1.03

1544-3195-001 Neomet Metformin 500mg Tablets 30's 30 5.00 0.17

1544-3196-001 Neomet XR Metformin extended release 500 mg Tablets 30's 30 12.00 0.40

1283-1143-001 Amaryl Glimepiride 1mg Tablet 30's 30 26.00 0.87

1283-1143-002 Amaryl Glimepiride 2mg Tablet 30's 30 45.50 1.52

1283-1143-003 Amaryl Glimepiride 3mg Tablet 30's 30 64.00 2.13

1544-4616-001 Sucratec Glimepiride 1mg Tablet 30's 30 18.00 0.60

1544-4616-006 Sucratec Glimepiride 2mg Tablet 30's 30 32.00 1.07

1544-4616-008 Sucratec Glimepiride 3mg Tablets 30's 30 45.00 1.50

1276-2386-001 Glimaryl-2 Glimepiride 2mg Tablets 30's 30 23.50 0.78

1300-2400-002 Glucobay Acarbose 50mg Tablet 30's 30 27.50 0.92

1300-2400-001 Glucobay Acarbose 100mg Tablet 30's 30 39.00 1.30

1598-3022-001 Minidiab Glipizide 5mg Tablet 30's 30 12.00 0.40

1499-1891-001 Diamicron MR Gliclazide 30mg Tablet 30's 30 41.50 1.38

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 36 of 45

Page 37: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1431-2062-002 Emicron Gliclazide 80 mg Tablet 60's 60 38.00 0.63

1472-2417-001 Glyzide Gliclazide 80 mg Tablet 60's 60 38.00 0.63

1556-5195-001 Galvus Vidagliptin 50 mg Tablets 28's 28 141.00 5.04

1699-1042-001 Actos Pioglitazone 15 mg Tablet 30's 30 132.00 4.40

1382-2406-001 Glustin Pioglitazone 15 mg Tablets 30's 30 151.50 5.05

1382-2406-002 Glustin Pioglitazone 30 mg Tablets 30's 30 215.00 7.17

1699-1042-002 Actos Pioglitazone 30 mg Tablet 30's 30 179.50 5.98

1420-1302-005 Avandia Rosiglitazon 4 mg Tablets 28's 28 140.50 5.02

1672-1300-007 Avandamet Rosiglitazone, Metformin 2mg/1gm Tablets 56's 56 173.00 3.09

1531-2679-002 Januvia Sitagliptin 25mg Film Coated Tablets 28's 28 292.00 10.43

1531-2679-003Januvia Sitagliptin phosphate 50 mg Tablets 28's 28

292.00 11.05

1531-2679-001Januvia Sitagliptin phosphate 100 mg Tablets 28's 28

292.00 11.05

1624-3194-001 Neo-Mercazole Carbimazole 5 mg Tablet 100's 100 24.50 0.25

1556-4573-001 Aclasta Zoledronic Acid 5mg/100ml Solution for Injection 100ml Plastic Vial 1 2525.50 2525.50

1527-2142-003 Euthyrox Levothyroxine Sodium 25mcg Tablet 100's 100 16.00 0.16

1527-2142-004 Euthyrox Levothyroxine Sodium 50mcg Tablet 100's 100 20.50 0.21

1417-2057-004 Eltroxin Levothyroxine Sodium 50 mcg Tablet 100's 100 21.00 0.21

1527-2142-001 Euthyrox Levothyroxine Sodium 100 mcg Tablet 100's 100 30.00 0.30

1417-2057-002 Eltroxin Levothyroxine Sodium 100 mcg Tablet 100's 100 23.00 0.23

1527-2142-002 Euthyrox Levothyroxine Sodium 150 mcg Tablet 100's 100 35.00 0.35

1529-2291-001 Fosamax(once weekly) Alendronate 70 mg Tablet Tablet 4's 4 190.50 47.63

1531-2292-001 Fosavance (Alendronate + Colecalciferol 70 mg/ 2800 IU Tablet 4's 4 203.00 50.75

1595-4023-001 Solu-Cortef Hydocortisone Sodium Succinate 100 mg Vial Injection 1's 1 7.50 7.50

1595-3675-004 Provera Medroxyprogesterone 5mg Tablets 24's 24 12.00 0.50

1644-3616-001 Primolut N Norethisterone 5mg Tablets 30's 30 27.50 0.92

1601-1973-001 Dostinex Cabergoline 0.5mg Tablets 2's 2 60.00 30.00

1644-3617-001Primolut Depot 250mg/ml ( 1ml )

injection Hydroxyprogesterone caproate

250 mg/mL (1 mL)

injectionInjection 1's 1

21.50 21.50

16. Hormones,Other Endocrine Medicines

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 37 of 45

Page 38: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1792-4648-001 Propylthiouracil Propylthiouracil 50mg Tablet Tablet 100's 100 38.00 0.38

1644-3645-001 Progyluton Estradiol, Norgestrel Tablets

21's Blister (11

White Tablets + 10 21 17.00 0.81

1735-3601-002 Premarin Conjugated Estrogen 0.625mg tablet 100's 100 24.00 0.24

1776-5276-001Conjugated Estrogens /

Medroxyprogesterone

Conjugated Estrogens /

Medroxyprogesterone0.625mg/2.5mg

tablet100's 100 36.30 0.36

1254-4221-002 Tobrex Tobramycin 0.3% Eye ointment 3.5gm 1 17.50 17.50

1254-4221-001 Tobrex Tobramycin 0.3% Eye Drops 5 ml 1 21.00 21.00

1254-4220-001 Tobradex Tobramycin+Dexamethasone 3mg+1mg/ml Eye Drops 5ml 1 27.00 27.00

1497-2309-001 Fucithalmic 1% Fusidic acid 10mg/gm Eye ointment 5 gm 1 18.00 18.00

1650-2333-003 Garamycin Gentamicin 0.3% Eye Drops 5ml 1 7.00 7.00

1268-1210-001 Apigen Gentamicin 0.3% Eye Drops 10ml 1 5.00 5.00

1622-2360-001 Gentacin Gentamicin 0.30% Eye drops 8ml 1 9.50 9.50

1773-2364-004 Gentamicin Gentamicin 0.3% Eye ointment 5gm 1 8.50 8.50

1622-2360-002 Gentacin Gentamicin 0.3% Eye Ointment 5gm 1 9.00 9.00

1252-1697-001 Colircusi Gentamicin Gentamicin 0.30% Eye Drops 10ml 1 8.00 8.00

1257-3351-001 Oflox Ofloxacin 0.30% Eye Drops 5ml 1 17.00 17.00

1464-3408-001 Optiflox Ofloxacin 0.3% Eye Drops 5ml 1 13.50 13.50

1622-3450-001 Oxacin Ofloxacin 0.3% Eye Drops 5ml 1 7.50 7.50

1472-3480-001 Panderm Nystatin,Neomycin,Gramicin and

Triamcinolone - 15 gCream Cream 15gm 1 11.50

11.50

1705-4562-004 Zovirax Acyclovir 3.0% Eye ointment 4.5 gm 1 53.50 53.50

1464-3403-001 Optichlor 0.5% Chloramphenicol 5mg/ml eye drops 10ml 1 8.00 8.00

1622-3792-002 Riachol Chloramphenicol 1.0% eye ointment 5 gm 1 6.00 6.00

1622-3792-001 Riachol Chloramphenicol 0.50% Eye Drops (Solution) 10ml 1 7.00 7.00

1253-1608-001 Ciloxan Ciprofloxacin 0.3% Eye Drops (Solution) 5ml 1 21.00 21.00

1622-1616-001 Ciprocin Ciprofloxacin 0.30% Eye / Ear Drops (Solution) 5ml 1 14.00 14.00

1622-3450-001 Oxacin ofloxacin 0.30% Eye drops 5ml 1 7.50 7.50

17. Opthalmic/Ear Preprations

17.1 Opthalmological/Ear (Anti Bacterial)Agents

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 38 of 45

Page 39: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1622-3348-001 Ocured Antazoline sulfate, Naphazoline nitrate combination Eye Drops (Solution) 10ml 1 8.00 8.00

1426-3445-002 Otosporin Neomycin+polymyxin+hydrocortisone Ear Drops Ear Drops 5ml 1 19.00 19.00

1268-3202-001 Neopred-P Prednisolone/NeomycinPolymyxin-B 0.5%/0.5%/1000000 Eye Drops 10 ml 1 11.00 11.00

1268-3181-001 NeodexTetrahydrozoline+Neomycine+Dexameth

asone0.5%/0.1% Eye/ear Drops 10 ml 1 8.50

8.50

1254-2924-001 Maxitrol Dexamethasone/ neomycin/ polymyxin Eye Drops Eye Drops 5ml 1 17.00 17.00

1254-2924-002 Maxitrol Dexamethasone/ neomycin/ polymyxin Eye oint Eye oint 3.5gm 1 11.00 11.00

1254-2921-001 Maxidex Dexamethasone 0.1% Eye/ear Drops Eye/ear Drops 5 ml 1 18.50 18.50

1256-2231-001 Flavaco Otic Neomycin+polymyxin B Ear Drops Ear Drops 10 ml 1 11.00 11.00

1268-3446-001 Otozol 1% Clotrimazole 1% Ear Drops Ear Drops 10 ml 1 15.00 15.00

1268-1860-001 Dewax Docusate Sodium Ear Drops Ear Drops 10 ml 1 5.00 5.00

1622-4386-001 Waxsol Docusate Sodium Ear Drops Ear Drops 10 ml 1 7.00 7.00

1629-4283-001 Tropex Phenazone 5% Drops 10ml 1 8.00 8.00

1256-4295-001 Tyotocin Antipyrine, Benzocaine, Hexylresorcinol,

TyrothricinEar Drops Ear Drops 15 ml 1 6.50

6.50

1464-3415-001 Optizolin Antazoline HCl, Tetrazoline HCl 0.5mg+0.4mg/ml Eye Drops 10 ml 1 7.50 7.50

1529-4215-001 Timoptol 0.25% Timolol 0.25% Eye Drops Eye Drops 5ml 1 42.50 42.50

1529-4215-002 Timoptol 0.5% Timolol 0.5% Eye Drops Eye Drops 5ml 1 50.00 50.00

1252-1762-002 Cusimolol Timolol 0.5% Eye Drops Eye Drops 5ml 1 18.00 18.00

1529-4285-001 Trusopt 2% Dorsolamide 2.0% Eye Drops 5 ml 1 70.00 70.00

1529-1746-001 Cosopt Dorzolamide + Timolol 2%, 0.5% Eye Drops 5ml 1 115.50 115.50

1556-4311-003 Ultracortenol Prednisolone 1.0% Eye Drops 5 ml 1 16.50 16.50

1257-3592-001 Pred Forte Prednisolone 1.0% Eye Drops 5ml 1 14.50 14.50

1464-3414-001 Optipred Prednisolone 1.0% Eye Drops 5ml 1 11.50 11.50

1464-3407-001 Optidex T Tobramycin+Dexamethasone 3mg+1mg/ml Eye Drops 5ml 1 20.50 20.50

1356-3354-001 Oftalmolosa Cusi Blefarida Cortisone Acetate+Chloramphenicol Eye Ointment Eye Ointment 3gm 1 4.00 4.00

1360-1907-001 Diclogesic 0.1% Diclofenac Sodium 5 ml Eye Drops 5ml 1 13.50 13.50

1253-4251-001 Travatan 0.004% Travoprost 0.004% eye drops 2.5ml 1 95.00 95.00

17.2 Opthalmological/Ear (Anti-inflammatory agents)

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 39 of 45

Page 40: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1344-2841-003 Locacorten Vioform Clioquinol/Flumethasone 1% / 0.02% Ear Drops 7.5 ml 1 14.00 14.00

1254-4150-001Tears Natural

Dextran 70, Hydroxypropylmethyl

celluloseEye Drops Eye Drops 15 ml

112.00 12.00

1253-4152-001Tears Natural II

Dextran 70, Hydroxypropylmethyl

celluloseEye Drops Eye Drops 15 ml

114.50 14.50

1253-2029-001 Econopred Plus 1% Prednisolone 1.00% Eye Drops 5ml 1 14.50 14.50

1881-5122-002

Systane

0.18 % HP Guar , Polyethylene glycol

400 , Propylene glycol, Polyquad combination

Eye Drops

10ml 1 47.00 47.00

1471-1262-002 Asmanore Salbutamol 4 mg Tablet 30's 30 3.00 0.10

1417-4398-005 Ventolin Salbutamol 2mg Tablet 20's 20 8.50 0.43

1472-1467-008 Butalin Salbutamol 4 mg Tablets 20's 20 8.00 0.40

1698-4395-001 Vental Inhaler Salbutamol 100 mcg per metered

dose MD Inhaler 200 doses 1 15.50

15.50

1419-4400-001 Ventolin Evohaler Salbutamol 100mcg Evohaler 200 doses 1 42.00 42.00

1419-4399-001 Ventolin Diskus Salbutamol 200mcg Dry Powder Inhaler 60 doses 1 39.00 39.00

1422-4398-011 Ventolin Resp. Solution Salbutamol 5 mg/mL Solution for

nebulizationSolution 20ml 1 25.50

25.50

1523-3887-001 Salbutamed Salbutamol 2mg/5ml Syrup (Sugar Free) 100ml 1 6.50 6.50

1750-3946-001 Seretide Diskus Fluticasone + Salmetrol 50/100mcg Dry Powder Inhaler 60 discus 1 211.50 211.50

1750-3946-002 Seretide Diskus Fluticasone + Salmetrol 50/250mcg Dry Powder Inhaler 60 discus 1 264.00 264.00

1422-2243-008 Flixotide 250 Fluticasone propionate 250 mg Inhaler/Aerosol60 Metered Dose

Inhaler1 150.50 150.50

1422-2243-007 Flixotide 50 Fluticasone propionate 50mg Inhaler/Aerosol60 Metered Dose

Inhaler1 42.50 42.50

1234-3325-003 Nuelin sa Theophylline 250 mg Tablet 20's 20 14.50 0.73

1294-4327-001 Uniphyllin Continus Theophylline 200mg Tablet 56's 56 28.00 0.50

1294-4327-002 Uniphyllin Continus Theophylline 300mg Tablet 56's 56 40.50 0.72

1967-1290-001 Atrovent N Ipratropim 20 mcg per puff MD Inhaler 200 doses 1 47.00 47.00

1279-3684-003 Pulmicort Budesonide 0.5 mg/mL (2 mL) nebule

(for inhalation)Solution 2ml Units x 20 (5's

x 4)20

233.00 11.65

1279-3684-002 Pulmicort Budesonide 0.25 mg/mL (2 mL)

nebule (for inhalation)Solution

2ml Units x 20 (5's

x 4)20

181.00 9.05

18. MEDICINES ACTING ON THE RESPIRATORY TRACT

18.1 Antiasthmatic and medicines for chronic obstructive pulmonary disease

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 40 of 45

Page 41: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1279-3684-005 Pulmicort turbuhalerBudesonide

200mcg/dose inhaler

100 Dose

Turbuhaler1

115.00 115.00

1279-3784-001 Rhinocort Aqua Budesonide 32mcg/dose Nasal Spray 120 Dose Spray 1 44.50 44.50

1531-3976-002 Singulair Paediatric Montelukast 4 mg Chewable Tablets 28's 28 219.00 7.82

1531-3976-001 Singulair Paediatric Montelukast 4 mg Granules 28 sachet 28 219.00 7.82

1531-3975-002 Singulair 5mg (Paediatric) Montelukast 5mg Tablets/Chewable 28's 28 242.00 8.64

1531-3975-001 Singulair Montelukast Sodium 10mg Tablets 28's 28 242.00 8.64

1279-4108-002 Symbicort Turbuhaler

budesonide 80 mcg and formoterol

fumarate

5 dihydrate 4.5 mcg)

80/4.5mcg/dose Inhaler (Dry Powder) 120 Dose Inhaler 1 232.50232.50

1279-4109-001 Symbicort Turbuhaler

budesonide 80 mcg and formoterol

fumarate

5 dihydrate 4.5 mcg)

160/4.5mcg/dose Inhaler (Dry Powder) 120 Dose Inhaler 1

275.00 275.00

1264-1140-001Alvesco Cicesonide 160mcg

Aerosol Inhaler

120 Puffs Metered

Dose Inhaler1

306.50 306.50

1714-1279-004 Atarax Hydroxyzine 25 mg Tablet Tablet 25's 25 6.50 0.26

1650-3153-001 Nasonex Mometasone 50 mcg per metered doseNasal Spray (Metered-dose

Pump Spray) 120 doses 1

74.00 74.00

1420-2242-001Flixonase Fluticasone Propionate

0.05%NASAL SPRAY

(120 Metered

sprays)1

76.50 76.50

1750-5182-001Avamys Fluticasone furoate

27.5mcg/DoseNasal Spray

120 Actuations

Spray Bottle 1 87.00 87.00

1417-1033-001 Actifed Syrup Triprolidine,Pseudophederine 1.25 mg / 30 mg per 5 mL Syrup 100 ml 1 8.508.50

1250-4259-001 Trifed Triprolidine,Pseudophederine 1.25 mg / 30 mg per 5 mL Syrup 100 ml 1 4.004.00

1622-3804-001 Riaxin Bromhexine HCl 4mg/5ml Syrup 100ml 1 7.50 7.50

1552-3971-001 Sinecod Butamirate citrate 0.15% w/v Syrup 200ml 1 20.00 20.00

1472-2260-003 FlukitParacetamol, Phenylephrine HCl,

Promethazine HCl, Salicylamidecombination tablets

20's20

7.00 0.35

1250-4259-002 Trifed Triprolidine,Pseudophederine 2.5 mg / 60 mg Tablet 20's 20 5.50 0.28

1417-1033-006 Actifed Tablet Triprolidine,Pseudophederine 2.5 mg / 60 mg Tablet 24's 24 12.50 0.52

1472-3095-001 Mucolyte Bromhexine HCl 4mg/5ml Syrup 100ml 1 7.50 7.50

1472-3100-001 Mucum Ambroxol 15mg/5ml Syrup (Sugar Free) 100ml 1 7.50 7.50

18.2 Decongestants/Cough Syrups/Mucolytics/Expectorants

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 41 of 45

Page 42: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1552-3448-007 Otrivin Menthol Xylometazoline Menthol 0.1% Nasal spray 10ml 1 25.50 25.50

1472-4503-002Xyloloin Xylometazoline 0.1% Nasal spray

10ml Metered

Dose Spray Bottle

(200 Dose)1

9.50 9.50

1552-3448-004 Otrivin Adults 0.1% (adult) Xylometazoline 0.1% Nasal spray 10ml 1 21.50 21.50

2083-4964-002 Co-Codamol Paracetamol + codiene 500 mg+ 30 mg Tablet 100's 100 30.00 0.30

1552-4417-004 Vibrocil Dimethindene maleate, Phenylephrine 0.25mg, 2.5mg/ml Nasal Spray 10ml 1 11.50 11.50

1552-4418-001 Vibrocil MD Dimethindene maleate, Phenylephrine Nasal Spray

15ml Meterd Dose

Spray Bottle 1 21.50 21.50

1552-3448-003 Otrivin Paeds Xylometazoline 0.05% Nasal drops 10 ml 1 14.50 14.50

1622-4504-001 Xylomet (adult) Xylometazoline 0.1% Nasal drops 15 ml 1 9.00 9.00

1368-1337-001 Balkis Xylometazoline 0.1% Nasal drops 10ml Bottle 1 5.50 5.50

1368-1337-002 Balkis Xylometazoline 0.1% Nasal drops 10ml Bottle 1 7.50 7.50

1268-1825-001 Decozal (pediatric) Xylometazoline 0.1% Nasal drops 10 ml 1 5.50 5.50

1622-4505-001 Xylomet (pediatric) Xylometazoline 0.1% Nasal drops 15 mL 1 8.00 8.00

2079-5330-001 Isomer Baby spray No Gas isotonic solution spray 30ml 1 39.00 39.00

2084-5398-001 Salinose adult Sodium chloride 0.90% spray 30ml 1 12.00 12.00

2084-5399-001 Salinose Baby Sodium chloride 0.90% drops 20ml 1 12.00 12.00

1961-5170-006 Tonimer Normal spray Sodium chloride 0.90% Spray 30ml 1 30.00 30.00

1472-4458-002 VitaminB Complex B complex B complex Tablet 20's 20 2.50 0.13

1471-1674-002 Cobal Vitamin- B12 (Mecobalamin) 500mcg Tablets 30's 30.00 25.50 0.85

1472-3694-004 Pyridoxin Pyridoxine 40mg Tablet 20's 20 7.00 0.35

1591-4457-002 Viitamin A 50000 I.U. Vitamin A 50 000 IU(110 mg) Capsule 24's 24 9.50 0.40

1526-3225-002 Neurobion Vit.B1+B6+B12 B-Complex Tablets 20's 20 23.00 1.15

1489-4261-003 Trilagavit Vit.B1+B6+B12 200mg+100mg+1000mcg Film Coated Tablets 30's 30 28.00 0.93

1276-1259-001 Asiavit M Vitamins and minerals combination Syrup 200ml 1 12.50 12.50

1735-2917-001 Materna Pregnancy Multivitamin Pregnancy Multivitamin Tablets 100's 100 38.50 0.39

1793-4855-001 Pregnacare Pregnancy Multivitamin Pregnancy Multivitamin Tablets 30's 30.00 25.60 0.85

1732-2221-001 Ferus B12 Pregnancy Multivitamin Pregnancy Multivitamin Capsules 30's 30 11.50 0.38

1632-1482-001 Calcium Sandoz forte Calcium Carbonate 500 mg Eff. Tablet 10's 10 11.00 1.10

19. VITAMINS AND MINERALS (covered in case of deficiency only)

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 42 of 45

Page 43: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1475-1489-001 CalsyrCalcium glubionate, Calcium

lactobionate combinationSyrup (Alcohol Free) 100ml 1

7.00 7.00

1735-1490-001 Caltrate Calcium Carbonate 600mg Tablet 60's 60 25.50 0.43

1794-4649-001 Caltrate with vit.D Calcium Carbonate+Vit. D3 600mg+200 IU. Tablet 60's 60 44.00 0.73

1732-3442-001 Osteocare Calcium+Vit.D3+mg+zn 150mg+75iu+3mg Syrup 200ml 1 13.50 13.50

1732-3442-002 Osteocare Calcium+Vit.D3+mg+zn400mg+100iu+150mg+15

mgTablet 30's 30 24.00

0.80

1552-5456-001 Sandoz Osteomix Ca, vit D, Mag., Zn, Vit K combination Eff. Tablet 20's 20 26.00 1.30

1270-1820-001 Decal B12 Calcium+Vit.D3+B12 calcium+Vit.D3+B12 Syrup 120 ml 1 8.50 8.50

1525-3228-002 Neurorubine Forte Lactabs Vit.B1+B6+B12 200mg+50mg+1000mcg Tablets 20's 20 18.50 0.93

1727-4460-001 Vitamin B12 Depot Hydroxycobalamine acetate 1mg/ml Solution for Injection 1ml Ampoule x 3 3 32.00 10.67

1526-3225-001 Neurobion Vit.B1+B6+B12 3ml Injection 3ml Ampoule x 3 3 16.00 5.33

1250-3229-001 Neurovitan Vitamine B-Complex combination Tablets 30's 30 11.00 0.37

1262-1399-001 Betolvex Vitamin B12 1000 mcg/mL injection Vial 1's 1 24.50 24.50

1497-3395-002 One alpha Alfacalcidol 0.25mcg Capsule 30's 30 34.00 1.13

1497-3395-004 One alpha Alfacalcidol 0.5mcg Capsule 30's 30 76.00 2.53

1498-3395-006 One alpha Alfacalcidol 2mcg/ml Drops 20ml 1 105.50 105.50

1497-3395-005 One Alpha Alfacalcidol 1mcg Capsule 100's 100 314.50 3.15

1499-3669-001 Protelos Strontium Ranelate 2gm Granules 28 Sachets 28 270.50 9.66

2066-5253-001 Calciferol Ergocalciferol (Vitamin D2) 8,000 or 8288IU/ml Drops 60ml 1 176.00 176.00

1828-5283-001D-Forte Vitamin D 50000 IU Capsules 100's 100

127.00 1.27

2081-5384-001Phosphorus Phosphorus 500mg Eff. Tablet 100's 100

275.00 2.75

1256-4337-001 Urispas Flavoxate HCL 200mg Tablet 30's 30 31.50 1.05

1379-2097-001 Epimag Magnisium Citrate 42.49gm/100gm Powder 10 sachets 10 6.00 0.60

1238-4330-001 Ural

Citric Acid Anhydrous+Sodium

Bicarbonate+Sodium Citrate

Anhydrous+Tartaric Acid

combination Effervescent Granules 4g Sachet x 28 28 15.50

0.55

1542-1116-001

Alka-URSodium Bicarbonate+Tartaric Acid+Citric

AcidEffervescent Granules 4g Sachet x 10

10 10.00

1.00

20. Urology

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 43 of 45

Page 44: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1508-4331-001

Uralyt-U Hexapotassium Hexasodium pentacitrate combination

Granules 280g Jar

1 69.00

69.00

1525-4345-001 Uvamin retard Nitrofurantoin 100 mg Capsules 20's 20 15.00 0.75

1598-1858-001 Detrusitol Tolterodine 1mg Tablets 28's 28 84.50 3.02

1629-3861-002 RowatinexBorneol, Camphene, Cineol, Fenchone,

Olive oil, Pinenecombination capsules 50's 50 14.50 0.29

1629-3858-002 RowacholBorneol, Camphene, Cineol, Menthol,

Menthone, Olive Oil, Pinenecombination capsules 50's 50 21.00 0.42

1400-3036-001 Minirin Desmopressin 0.1mg Tablets 30's 30.00 181.00 6.03

1400-3036-003 Minirin Desmopressin 0.2mg Tablets 30's 30.00 329.50 10.98

1244-2674-001 Itrin 2mg Terazosin 2mg Tablets 30's 30 50.00 1.67

1244-2674-002 Itrin 5mg Terazosin 5mg Tablets 14's 14 58.00 4.14

1695-4493-001 Xatral XL Alfuzosin 10mg Tablets 30's 30 184.00 6.13

1695-4492-001 Xatral SR 5mg Alfuzocin 5mg Sustained Release Tablets 56's 56 143.00 2.55

1442-1515-001 Cardura 1mg Doxazosin Mesylate 1mg Tablets 20's 20 62.50 3.13

1442-1515-003 Cardura 4mg Doxazosin Mesylate 4mg Tablets 20's 20 107.50 5.38

1641-3387-001 Omnic 0.4mg caps Tamsulosin 0.4 mg Capsule 30's 30 144.00 4.80

1531-3656-001 Proscar Finasteride 5 mg Tablet 28's 28 223.50 7.98

1552-4394-001 Venoruton Forte Ramipril 500mg Tablets 30's 30 99.00 3.30

1499-1789-001 Daflon Diosmin+Hespiridin 500mg Tablets 30's 30 46.00 1.53

1566-1911-006 Dicynone Etamsylate 500 mg Tablets 20's 20.00 51.50 2.58

1788-4650-001 Rescuvolin Calcium Folinate 15mg Tablet 10's 10 84.60 8.46

1417-2797-001 Leukeran Thioguanine 2mg Tablet 25's 25 29.50 1.18

1556-3900-001 Sandimmun Neoral Cyclosporin 100mg Capsule 50's 50 1030.27 20.61

1556-3900-004 Sandimmun Neoral Cyclosporin 25mg Capsule 50's 50 266.77 5.34

1277-2081-002 Endoxan Asta Cyclophosphamide 50mg Tablet 50's 50 32.00 0.64

22. Malignancy & Immunosuppression

20.1 BPH therapy agents

21. Vasoprotective

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 44 of 45

Page 45: Abu Dhabi Plan Drug List

Shaded Drugs are available only in Public Providers

Code Drug Trade Name Generic Name Strength Dosage Form Pack Size No. Of units Pack Price Unit Price

National Health Insurance Company - Daman

P.O. Box 128888

Abu Dhabi, U.A.E

Phone: + 971 2 6149555

Fax: +971 2 6149550

Abu Dhabi Plan Drug List

Version 4 - Effective from 1st of June 2009

1336-4401-001 Vepesid Etoposide 100mg Capsule 10's 10 1523.50 152.35

1789-4651-001 Plaquenil Hydroxychloroquine 200 mg Tablet 60's 60 107.76 1.80

1778-4652-001 Hydrea Hydroxyurea 500 mg Capsule 100's 100 178.00 1.78

1788-4653-001 Megaplex Megestrol 160 mg Tablet 30's 30 242.50 8.08

1781-4654-001 Purinethol Mercaptopurine 50 mg Tablet 25's 25 73.50 2.94

1776-2985-008 Methotrexate Methotrexate 2.5mg Tablet 100's 100 86.30 0.86

1790-4655-001 Procarbazine Procarbazine 50mg Tablet 50's 50 566.76 11.34

1280-3261-001 Nolvadex D 20mg Tamoxifen 20 mg Tablet 30's 30 78.00 2.60

1280-3260-001 Nolvadex Tamoxifen 10mg Coated Tablets 30's 30 63.00 2.10

1280-1241-001 Arimidex Anastrozole 1mg Tablet 28's 28 694.00 24.79

1383-2144-001 Evista Raloxifene 60 mg Tablet 14's 14 90.00 6.43

1496-4132-002 Tamofen Tamoxifen 20 mg Tablet 30's 30 55.00 1.83

1556-2188-001 Femara Letrozole 2.5mg Tablet 30's 30 909.50 30.32

Copyright: Daman Doc. No.: EXH/NW.05 Version No.: 1 Revision No.: 0 Date Issued: 13/05/2009 45 of 45