WHO Model List of Essential Medicines

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WHO Model List of Essential Medicines is published by the World Health Organization (WHO). The first list, published in 1977, included 204 pharmaceutical drugs.[1] The WHO updates the list every two years. The WHO later added a separate WHO Model List of Essential Medicines for Children up to 12 years of age.

More than 130 countries have created national lists of essential medicines based on the WHO's model list.[2] The national lists contain between 334 and 580 medications.[2]

In the United States, price increases of up to 5,000% or more, starting in 2004, have made many first-line drugs on the list, such as pyrimethamine and albendazole, unaffordable for low-income people. These drugs are still available at lower prices outside the U.S.[3]

In April 2015, the WHO published the 19th edition of the adult list and 5th edition of the list for children.[4][5] The following list is based on the 19th edition of the adult list:

Contents

Anaesthetics

General anaesthetics and oxygen

Inhalational medicines

Injectable medicines

Local anaesthetics

Preoperative medication and sedation for short-term procedures

Medicines for pain and palliative care

Nonopioids and nonsteroidal anti-inflammatory drugs (NSAIDs)

Opioid analgesics

Medicines for other common symptoms in palliative care

Antiallergics and medicines used in anaphylaxis

Antidotes and other substances used in poisonings

Nonspecific

Specific

Anticonvulsive medication

Anti-infective medicines

Antihelminthics

Intestinal antihelminthics

Antifilarials

Antischistosomals and other antinematode medicines

Antibacterials

Beta Lactam medicines

Other antibacterials

Antileprosy medicines

Antituberculosis medicines

Antifungal medicines

Antiviral medicines

Antiherpes medicines

Antiretrovirals

Nucleoside/nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Fixed-dose combinations
Other antivirals
Antihepatitis medicines
Medicines for hepatitis B
—Nucleoside/Nucleotide reverse transcriptase inhibitors
Medicines for hepatitis C
—Nucleotide polymerase inhibitors
—Protease inhibitors
—NS5A inhibitors
—Non-nucleoside polymerase inhibitors
—Other antivirals
—Fixed-dose combinations

Antiprotozoal medicines

Antiamoebic and antigiardiasis medicines

Antileishmaniasis medicines

Antimalarial medicines

For curative treatment
For prevention

Antipneumocystosis and antitoxoplasmosis medicines

Antitrypanosomal medicines

African trypanosomiasis
Medicines for the treatment of 1st stage African trypanosomiasis
Medicines for the treatment of second stage African trypanosomiasis

American trypanosomiasis

Antimigraine medicines

Acute attack

Prevention

Antineoplastic and immunosuppressives

Immunosuppressive medicines

Cytotoxic and adjuvant medicines

Hormones and antihormones

Antiparkinsonism medicines

Medicines affecting the blood

Antianaemia medicines

Medicines affecting coagulation

Other medicines for haemoglobinopathies

Blood products and plasma substitutes of human origin

Blood and blood components

Plasma-derived medicines

Human immunoglobulins

Blood coagulation factors

Plasma substitutes

Cardiovascular medicines

Antianginal medicines

Antiarrhythmic medicines

Antihypertensive medicines

Medicines used in heart failure

Antithrombotic medicines

Anti-platelet medicines

Thrombolytic medicines

Lipid-lowering agents

Dermatological (topical)

Antifungal medicines

Anti-infective medicines

Anti-inflammatory and antipruritic medicines

Medicines affecting skin differentiation and proliferation

Scabicides and pediculicides

Diagnostic agents

Ophthalmic medicines

Radiocontrast media

Disinfectants and antiseptics

Antiseptics

Disinfectants

Diuretics

Gastrointestinal medicines

Antiulcer medicines

Antiemetic medicines

Anti-inflammatory medicines

Laxatives

Medicines used in diarrhea

Oral rehydration

Medicines for diarrhea in children

Hormones, other endocrine medicines, and contraceptives

Adrenal hormones and synthetic substitutes

Androgens

Contraceptives

Oral hormonal contraceptives

Injectable hormonal contraceptives

Intrauterine devices

Barrier methods

Implantable contraceptives

Intravaginal contraceptives

Estrogens

Insulins and other medicines used for diabetes

Ovulation inducers

Progestogens

Thyroid hormones and antithyroid medicines

Immunologicals

Diagnostic agents

Sera and immunoglobulins

Vaccines

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

Eye preparations

Anti-infective agents

Anti-inflammatory agents

Local anesthetics

Miotics and antiglaucoma medicines

Mydriatics

Anti vascular endothelial growth factor (VEGF)

Oxytocics and antioxytocics

Oxytocics and Abortifacients

Antioxytocics (tocolytics)

Peritoneal dialysis solution

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

Medicines used in mood disorders

Medicines used in depressive disorders

Medicines used in bipolar disorders

Medicines for anxiety disorders

Medicines used for obsessive compulsive disorders

Medicines for disorders due to psychoactive substance use

Medicines acting on the respiratory tract

Antiasthmatic and medicines for chronic obstructive pulmonary disease

Solutions correcting water, electrolyte and acid-base disturbances

Oral

Parenteral

Miscellaneous

Vitamins and minerals

Ear, nose and throat medicines in children

Specific medicines for neonatal care

Medicines administered to the neonate

Medicines administered to the mother

Medicines for diseases of joints

Medicines used to treat gout

Disease-modifying agents used in rheumatoid disorders

Juvenile joint diseases

Notes

^ A indicates the medicine is a complementary item, for which specialized diagnostic or monitoring and/or specialist training are needed. An item may also be listed as complementary on the basis of higher costs and/or a less attractive cost/benefit ratio.
  1. Thiopental may be used as an alternative depending on local availability and cost.
  2. Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect
  3. Alternatives limited to hydromorphone and oxycodone.
  4. There may be a role for sedating antihistamines for limited indications (EMLc)
  5. For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders.
  6. For surgical prophylaxis.
  7. Only listed for single‐dose treatment of uncomplicated ano‐genital gonorrhoea.
  8. Do not administer with calcium and avoid in infants with hyperbilirubinemia
  9. Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
  10. 3rd generation cephalosporin of choice for use in hospitalized neonates.
  11. Only listed for the treatment of life‐threatening hospital‐based infection due to suspected or proven multidrug‐resistant infection
  12. Only listed for single‐dose treatment of genital Chlamydia trachomatis and of trachoma.
  13. For use in combination regimens for eradication of H. pylori in adults.
  14. For use only in patients with HIV receiving protease inhibitors.
  15. For treatment of latent TB infection (LTBI) only
  16. Terizidone may be an alternative.
  17. Prothionamide may be an alternative.
  18. Ofloxacin and moxifloxacin may be alternatives based on availability and programme considerations.
  19. 19.0 19.1 FTC is an acceptable alternative to 3TC, based on knowledge of the pharmacology, the resistance patterns and clinical trials of antiretrovirals.
  20. Potentially severe or complicated illness due to confirmed or suspected influenza virus infection in accordance with WHO treatment guidelines.
  21. For the treatment of viral haemorrhagic fevers and in combination with pegylated interferons for the treatment of Hepatitis C.
  22. For the treatment of hepatitis C, in combination with peginterferon and/or direct acting anti-viral medicines.
  23. To be used in combination with ribavirin.
  24. To be used in combination with artesunate 50 mg.
  25. For use in the management of severe malaria.
  26. Not recommended in the first trimester of pregnancy or in children below 5 kg.
  27. To be used in combination with either amodiaquine, mefloquine or sulfadoxine + pyrimethamine.
  28. Other combinations that deliver the target doses required such as 153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be alternatives.
  29. For use only for the treatment of P.vivax infection.
  30. For use only in combination with quinine.
  31. To be used in combination with artesunate 50 mg.
  32. Only for use to achieve radical cure of P.vivax and P.ovale infections, given for 14 days.
  33. For use only in the management of severe malaria, and should be used in combination with doxycycline.
  34. Only in combination with artesunate 50 mg.
  35. For use only in central American regions, for use for P.vivax.
  36. For use only in combination with chloroquine.
  37. To be used for the treatment of Trypanosoma brucei gambiense infection.
  38. To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection.
  39. To be used for the treatment of Trypanosoma brucei gambiense infection
  40. Only to be used in combination with eflornithine, for the treatment of T. b. gambiense infection.
  41. Deferasirox oral form may be an alternative, depending on cost and availability.
  42. Polygeline, injectable solution, 3.5% is considered as equivalent.
  43. 43.0 43.1 43.2 43.3 Includes metoprolol and carvedilol as alternatives.
  44. Hydralazine is listed for use in the acute management of severe pregnancy‐induced hypertension only. Its use in the treatment of essential hypertension is not recommended in view of the availability of more evidence of efficacy and safety of other medicines.
  45. Methyldopa is listed for use in the management of pregnancy‐induced hypertension only. Its use in the treatment of essential hypertension is not recommended in view of the availability of more evidence of efficacy and safety of other medicines.
  46. For use in high‐risk patients.
  47. In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
  48. Glibenclamide not suitable above 60 years.
  49. Exact type to be defined locally.
  50. 50.0 50.1 50.2 50.3 50.4 Recommended for some high-risk populations
  51. 51.0 51.1 51.2 Recommended for certain regions
  52. Or homatropine (hydrobromide) or cyclopentolate (hydrochloride).
  53. Requires close medical supervision.
  54. Ergocalciferol can be used as an alternative.
  55. For use for rheumatic fever, juvenile arthritis, Kawasaki disease

References

  1. "Comparative Table of Medicines on the WHO Essential Medicines Lists from 1977–2011" (XLS). World Health Organization. Retrieved 2013-12-30. 
  2. 2.0 2.1 Bansal, D; Purohit, VK (January 2013). "Accessibility and use of essential medicines in health care: Current progress and challenges in India.". Journal of pharmacology & pharmacotherapeutics. 4 (1): 13–8. PMID 23662019. doi:10.4103/0976-500X.107642. 
  3. Alpern JD, Song J, Stauffer WM. (2016 May 19). "Essential Medicines in the United States--Why Access Is Diminishing.". N Engl J Med. 374 (20): 1904–7. PMID 27192669. doi:10.1056/NEJMp1601559.  Check date values in: |date= (help)
  4. "19th WHO Model List of Essential Medicines (April 2015)" (PDF). WHO. April 2015. Retrieved May 10, 2015. 
  5. "WHO moves to improve access to lifesaving medicines for hepatitis C, drug-resistant TB and cancers". 8 May 2015. Retrieved 8 May 2015. 

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