WHO Model List of Essential Medicines

The WHO Model List of Essential Medicines (EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health system.[1] The list is frequently used by countries to help develop their own local lists of essential medicine.[1] As of 2016, more than 155 countries have created national lists of essential medicines based on the World Health Organization's model list.[2] This includes countries in both the developed and developing world.[1][3]

2017 marked the 40th anniversary of the WHO Model List of Essential Medicines.

The list is divided into core items and complementary items.[4] The core items are deemed to be the most cost-effective options for key health problems and are usable with little additional health care resources.[4] The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost–benefit ratio.[4] About 25% of items are in the complementary list.[5] Some medications are listed as both core and complementary.[6] While most medications on the list are available as generic products, being under patent does not preclude inclusion.[7]

The first list was published in 1977 and included 208 medications.[8][1][9] The WHO updates the list every two years.[10] The 14th list was published in 2005 and contained 306 medications.[11] In 2015, the 19th edition of the list was published and contains around 410 medications.[10] The 20th edition was published in 2017, and contains 433 medications.[12][13] The 21st list was published in 2019 and contains 460 medications.[14][15][16] The national lists contain between 334 and 580 medications.[5]

A separate list for children up to 12 years of age, known as the WHO Model List of Essential Medicines for Children (EMLc), was created in 2007 and is in its 7th edition.[10][17] It was created to make sure that the needs of children were systematically considered such as availability of proper formulations.[18][19] Everything in the children's list is also included in the main list.[20] The list and notes are based on the 19th to 21st edition of the main list.[4][12][14] An α indicates a medicine is only on the complementary list.[4][14]

Anaesthetics, preoperative medicines and medical gases

General anaesthetics and oxygen

Inhalational medicines

• Halothane
• Isoflurane
• Nitrous oxide
• Oxygen

Injectable medicines

• Ketamine
• Propofol[note 1]

Local anaesthetics

• Bupivacaine
• Lidocaine
• Lidocaine/epinephrine (lidocaine + epinephrine)
• Ephedrine^α (For use in spinal anaesthesia during delivery, to prevent hypotension).

Preoperative medication and sedation for short-term procedures

• Atropine
• Midazolam
• Morphine

Medical gases

• Oxygen[note 2]

Medicines for pain and palliative care

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

A skeletal model of the chemical structure of aspirin

• Acetylsalicylic acid (aspirin)
• Ibuprofen
• Paracetamol[note 3] (acetaminophen)

Opioid analgesics

• Codeine
• Fentanyl[note 4]
• Morphine[note 5]
• Methadone^α[note 6]

Medicines for other common symptoms in palliative care

• Amitriptyline
• Cyclizine
• Dexamethasone
• Diazepam
• Docusate sodium
• Fluoxetine
• Haloperidol
• Hyoscine butylbromide
• Hyoscine hydrobromide
• Lactulose
• Loperamide
• Metoclopramide
• Midazolam
• Ondansetron
• Senna

Antiallergics and medicines used in anaphylaxis

• Dexamethasone
• Epinephrine (adrenaline)
• Hydrocortisone
• Loratadine[note 7]
• Prednisolone

Antidotes and other substances used in poisonings

Nonspecific

• Charcoal, activated

Specific

• Acetylcysteine
• Atropine
• Calcium gluconate
• Methylthioninium chloride (methylene blue)
• Naloxone
• Penicillamine
• Prussian blue
• Sodium nitrite
• Sodium thiosulfate
• Deferoxamine^α
• Dimercaprol^α
• Fomepizole^α
• Sodium calcium edetate^α
• Succimer^α

Anticonvulsants/antiepileptics

• Carbamazepine
• Diazepam
• Lamotrigine[note 8]
• Lorazepam
• Magnesium sulfate[note 9]
• Midazolam[note 10]
• Phenobarbital
• Phenytoin[note 11]
• Valproic acid (sodium valproate)
• Ethosuximide^α
• Valproic acid (sodium valproate)^α

Anti-infective medicines

Anthelminthics

Intestinal anthelminthics

A skeletal model of the chemical structure of albendazole

• Albendazole
• Ivermectin
• Levamisole
• Mebendazole
• Niclosamide
• Praziquantel
• Pyrantel

Antifilarials

• Albendazole
• Diethylcarbamazine
• Ivermectin

Antischistosomals and other antinematode medicines

• Praziquantel
• Triclabendazole
• Oxamniquine^α[note 12]

Antibacterials

Access group antibiotics

• Amikacin
• Amoxicillin
• Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)
• Ampicillin
• Benzathine benzylpenicillin
• Benzylpenicillin
• Cefalexin
• Cefazolin
• Chloramphenicol[note 13]
• Clindamycin
• Cloxacillin[note 14]
• Doxycycline
• Gentamicin
• Metronidazole
• Nitrofurantoin
• Phenoxymethylpenicillin (penicillin V)
• Procaine benzylpenicillin[note 15]
• Spectinomycin
• Sulfamethoxazole/trimethoprim[note 16]

Watch group antibiotics

• Azithromycin[note 17]
• Cefixime
• Cefotaxime[note 18]
• Ceftriaxone[note 19]
• Cefuroxime
• Ciprofloxacin
• Clarithromycin[note 20]
• Piperacillin/tazobactam
• Vancomycin
• Ceftazidime^α
• Meropenem^α[note 21]
• Vancomycin^α

Reserve group antibiotics

• Ceftazidime/avibactam^α
• Colistin^α
• Fosfomycin^α
• Linezolid^α
• Meropenem/vaborbactam^α
• Plazomicin^α
• Polymyxin B^α

Antileprosy medicines

• Clofazimine
• Dapsone
• Rifampicin

Antituberculosis medicines

Pure crystals of ethambutol

• Ethambutol
• Ethambutol/isoniazid/pyrazinamide/rifampicin (ethambutol + isoniazid + pyrazinamide + rifampicin)
• Ethambutol/isoniazid/rifampicin (ethambutol + isoniazid + rifampicin)
• Isoniazid
• Isoniazid/pyrazinamide/rifampicin (isoniazid + pyrazinamide + rifampicin)
• Isoniazid/rifampicin (isoniazid + rifampicin)
• Pyrazinamide
• Rifabutin[note 22]
• Rifampicin
• Rifapentine[note 23]
• Amikacin^α
• Amoxicillin/clavulanic acid^α[note 24]
• Bedaquiline^α
• Clofazimine^α
• Cycloserine^α[note 25]
• Delamanid^α
• Ethionamide^α[note 26]
• Levofloxacin^α[note 27]
• Linezolid^α
• Meropenem^α[note 28]
• Moxifloxacin
• P-aminosalicylic acid^α
• Streptomycin^α

Antifungal medicines

• Amphotericin B
• Clotrimazole
• Fluconazole
• Flucytosine
• Griseofulvin
• Itraconazole[note 29]
• Nystatin
• Voriconazole[note 30]
• Potassium iodide^α

Antiviral medicines

Antiherpes medicines

• Aciclovir

Antiretrovirals

Nucleoside/nucleotide reverse transcriptase inhibitors

• Abacavir (ABC)
• Lamivudine (3TC)
• Tenofovir disoproxil fumarate (TDF)
• Zidovudine (ZDV or AZT)

Non-nucleoside reverse transcriptase inhibitors

• Efavirenz (EGV or EFZ)
• Nevirapine (NVP)

Protease inhibitors

Two capsules of atazanavir

• Atazanavir
• Atazanavir/ritonavir
• Darunavir
• Lopinavir/ritonavir (LPV/r)
• Ritonavir

Integrase inhibitors

• Dolutegravir
• Raltegravir[note 31]

Fixed-dose combinations

• Abacavir/lamivudine
• Dolutegravir/lamivudine/tenofovir (dolutegravir + lamivudine + tenofovir)
• Efavirenz/emtricitabine/tenofovir[note 32]
• Efavirenz/lamivudine/tenofovir
• Emtricitabine/tenofovir[note 32][note 33]
• Lamivudine/nevirapine/zidovudine
• Lamivudine/zidovudine

Medicines for prevention of HIV-related opportunistic infections

• Isoniazid/pyridoxine/sulfamethoxazole/trimethoprim

Other antivirals

• Ribavirin[note 34]
• Valganciclovir[note 35]
• Oseltamivir^α[note 36]
• Valganciclovir^α[note 37]

Antihepatitis medicines

Medicines for hepatitis B

Nucleoside/Nucleotide reverse transcriptase inhibitors

• Entecavir
• Tenofovir disoproxil fumarate (TDF)

Medicines for hepatitis C

Pangenotypic direct-acting antivirals

• Daclatasvir[note 38]
• Glecaprevir/pibrentasvir
• Sofosbuvir[note 39]
• Sofosbuvir/velpatasvir

Non-pangenotypic direct-acting antivirals

• Dasabuvir
• Ledipasvir/sofosbuvir
• Ombitasvir/paritaprevir/ritonavir

Other antivirals for hepatitis C

• Ribavirin[note 40]
• Pegylated interferon-alpha-2a or pegylated interferon-alpha-2b^α[note 41]

Antiprotozoal medicines

Antiamoebic and antigiardiasis medicines

• Diloxanide
• Metronidazole

Antileishmaniasis medicines

• Amphotericin B
• Miltefosine
• Paromomycin
• Sodium stibogluconate or meglumine antimoniate

Antimalarial medicines

For curative treatment

• Amodiaquine[note 42]
• Artemether[note 43]
• Artemether/lumefantrine[note 44]
• Artesunate[note 45]
• Artesunate/amodiaquine[note 46]
• Artesunate/mefloquine
• Artesunate/pyronaridine tetraphosphate
• Chloroquine[note 47]
• Dihydroartemisinin/piperaquine phosphate
• Doxycycline[note 48]
• Mefloquine[note 42]
• Primaquine[note 49]
• Quinine[note 50]
• Sulfadoxine/pyrimethamine[note 51]

For chemoprevention

• Amodiaquine + sulfadoxine/pyrimethamine (Co-packaged)
• Chloroquine[note 52]
• Doxycycline
• Mefloquine
• Proguanil[note 53]
• Sulfadoxine/pyrimethamine

Antipneumocystosis and antitoxoplasmosis medicines

• Pyrimethamine
• Sulfadiazine
• Sulfamethoxazole/trimethoprim
• Pentamidine^α

Antitrypanosomal medicines

African trypanosomiasis

• Fexinidazole[note 54]

Medicines for the treatment of 1st stage African trypanosomiasis

• Pentamidine[note 55]
• Suramin sodium[note 56]

Medicines for the treatment of 2nd stage African trypanosomiasis

• Eflornithine[note 57]
• Melarsoprol
• Nifurtimox[note 58]
• Melarsoprol^α

American trypanosomiasis

• Benznidazole
• Nifurtimox

Medicines for ectoparasitic infections

• Ivermectin

Antimigraine medicines

For treatment of acute attack

• Acetylsalicylic acid (aspirin)
• Ibuprofen
• Paracetamol (acetaminophen)

For prophylaxis

• Propranolol

Immunomodulators and antineoplastics

Immunomodulators for non-malignant disease

• Adalimumab^α[note 59]
• Azathioprine^α
• Ciclosporin^α

Antineoplastics and supportive medicines

Cytotoxic medicines

• Arsenic trioxide^α
• Asparaginase^α
• Bendamustine^α
• Bleomycin^α
• Calcium folinate^α
• Capecitabine^α
• Carboplatin^α
• Chlorambucil^α
• Cisplatin^α
• Cyclophosphamide^α
• Cytarabine^α
• Dacarbazine^α
• Dactinomycin^α
• Daunorubicin^α
• Docetaxel^α
• Doxorubicin^α
• Etoposide^α
• Fludarabine^α
• Fluorouracil^α
• Gemcitabine^α
• Hydroxycarbamide^α
• Ifosfamide^α
• Irinotecan^α
• Melphalan^α
• Mercaptopurine^α
• Methotrexate^α
• Oxaliplatin^α
• Paclitaxel^α
• Pegaspargase^α[note 60]
• Procarbazine^α
• Realgar Indigo naturalis formulation^α
• Tioguanine^α
• Vinblastine^α
• Vincristine^α
• Vinorelbine^α

Targeted therapies

• All-trans retinoic acid (tretinoin) (ATRA)^α
• Bortezomib^α
• Dasatinib^α
• Erlotinib^α[note 61]
• Imatinib^α
• Nilotinib^α
• Rituximab^α[note 60]
• Trastuzumab^α[note 60]

Immunomodulators

• Filgrastim^α
• Lenalidomide^α
• Nivolumab^α[note 62]
• Thalidomide^α

Hormones and antihormones

• Abiraterone^α
• Anastrozole^α
• Bicalutamide^α
• Dexamethasone^α
• Hydrocortisone^α
• Leuprorelin^α
• Methylprednisolone^α
• Prednisolone^α
• Tamoxifen^α

Supportive medicines

• Allopurinol^α
• Mesna^α
• Zoledronic acid^α

Antiparkinsonism medicines

• Biperiden
• Levodopa/carbidopa (levodopa + carbidopa)

Medicines affecting the blood

Antianaemia medicines

• Ferrous salt
• Ferrous salt/folic acid
• Folic acid
• Hydroxocobalamin
• Erythropoiesis-stimulating agents^α[note 63]

Medicines affecting coagulation

• Dabigatran[note 64]
• Enoxaparin[note 65]
• Heparin sodium
• Phytomenadione
• Protamine sulfate
• Tranexamic acid
• Warfarin
• Desmopressin^α
• Heparin sodium^α
• Protamine sulfate^α
• Warfarin^α

Other medicines for haemoglobinopathies

• Deferoxamine^α[note 66]
• Hydroxycarbamide^α

Blood products of human origin and plasma substitutes

Blood and blood components

Bag containing one unit of fresh frozen plasma

• Fresh frozen plasma
• Platelet concentrates
• Packed red blood cells
• Whole blood

Plasma-derived medicines

Human immunoglobulins

• Rho(D) immune globulin (anti-D immunoglobulin)
• Anti-rabies immunoglobulin
• Anti-tetanus immunoglobulin
• Human normal immunoglobulin^α

Blood coagulation factors

• Coagulation factor VIII^α
• Coagulation factor IX^α

Plasma substitutes

• Dextran 70[note 67]

Cardiovascular medicines

Antianginal medicines

• Bisoprolol[note 68]
• Glyceryl trinitrate
• Isosorbide dinitrate
• Verapamil

Antiarrhythmic medicines

• Bisoprolol[note 68]
• Digoxin
• Epinephrine (adrenaline)
• Lidocaine
• Verapamil
• Amiodarone^α

Antihypertensive medicines

• Amlodipine
• Bisoprolol[note 69]
• Enalapril
• Hydralazine[note 70]
• Hydrochlorothiazide
• Lisinopril/amlodipine (lisinopril + amlodipine)
• Lisinopril/hydrochlorothiazide
• Losartan
• Methyldopa[note 71]
• Telmisartan/amlodipine (telmisartan + amlodipine)
• Telmisartan/hydrochlorothiazide
• Sodium nitroprusside^α

Medicines used in heart failure

• Bisoprolol[note 68]
• Digoxin
• Enalapril
• Furosemide
• Hydrochlorothiazide
• Losartan
• Spironolactone
• Dopamine^α

Antithrombotic medicines

Anti-platelet medicines

• Acetylsalicylic acid (aspirin)
• Clopidogrel

Thrombolytic medicines

• Alteplase^α
• Streptokinase^α

Lipid-lowering agents

• Simvastatin[note 72]

Dermatological medicines (topical)

Antifungal medicines

• Miconazole
• Selenium sulfide
• Sodium thiosulfate
• Terbinafine

Anti-infective medicines

• Mupirocin
• Potassium permanganate
• Silver sulfadiazine

Anti-inflammatory and antipruritic medicines

• Betamethasone
• Calamine
• Hydrocortisone

Medicines affecting skin differentiation and proliferation

• Benzoyl peroxide
• Coal tar
• Fluorouracil
• Podophyllum resin
• Salicylic acid
• Urea

Scabicides and pediculicides

• Benzyl benzoate
• Permethrin

Diagnostic agents

Ophthalmic medicines

• Fluorescein
• Tropicamide

Radiocontrast media

• Amidotrizoate
• Barium sulfate
• Iohexol
• Barium sulfate^α
• Meglumine iotroxate^α

Disinfectants and antiseptics

Antiseptics

• Chlorhexidine
• Ethanol
• Povidone iodine

Disinfectants

• Alcohol based hand rub
• Chlorine base compound
• Chloroxylenol
• Glutaral

Diuretics

• Amiloride
• Furosemide
• Hydrochlorothiazide
• Mannitol
• Spironolactone
• Hydrochlorothiazide^α
• Mannitol^α
• Spironolactone^α

Gastrointestinal medicines

• Pancreatic enzymes^α

Antiulcer medicines

• Omeprazole
• Ranitidine

Antiemetic medicines

• Dexamethasone
• Metoclopramide
• Ondansetron
• Aprepitant^α

Anti-inflammatory medicines

• Sulfasalazine
• Hydrocortisone^α

Laxatives

• Senna

Medicines used in diarrhoea

• Oral rehydration salts + zinc sulfate (Co-packaged)

Oral rehydration

• Oral rehydration salts

Medicines for diarrhea

• Zinc sulfate[note 73]

Medicines for endocrine disorders

Adrenal hormones and synthetic substitutes

• Fludrocortisone
• Hydrocortisone

Androgens

• Testosterone^α

Estrogens

No listings in this section.

Progestogens

• Medroxyprogesterone acetate

Medicines for diabetes

Insulins

• Insulin injection (soluble)
• Intermediate-acting insulin

Oral hypoglycaemic agents

• Gliclazide[note 74]
• Metformin
• Metformin^α

Medicines for hypoglycaemia

• Glucagon
• Diazoxide^α

Thyroid hormones and antithyroid medicines

• Levothyroxine
• Potassium iodide
• Methimazole[note 75]
• Propylthiouracil[note 76]
• Lugol's solution^α
• Methimazole^α[note 77]
• Potassium iodide^α
• Propylthiouracil^α[note 78]

Immunologicals

Diagnostic agents

• Tuberculin, purified protein derivative (PPD)

Sera and immunoglobulins

• Antivenom immunoglobulin[note 79]
• Diphtheria antitoxin

Vaccines

A vial of oral cholera vaccine

Recommendations for all

• BCG vaccine
• Diphtheria vaccine
• Haemophilus influenzae type b vaccine
• Hepatitis B vaccine
• HPV vaccine
• Measles vaccine
• Pertussis vaccine
• Pneumococcal vaccine
• Poliomyelitis vaccine
• Rotavirus vaccine
• Rubella vaccine
• Tetanus vaccine

Recommendations for certain regions

• Japanese encephalitis vaccine[note 80]
• Yellow fever vaccine[note 80]
• Tick-borne encephalitis vaccine[note 80]

Recommendations for some high-risk populations

• Cholera vaccine[note 81]
• Dengue vaccine[note 81]
• Hepatitis A vaccine[note 81]
• Meningococcal meningitis vaccine[note 81]
• Rabies vaccine[note 81]
• Typhoid vaccine[note 81]

Recommendations for immunization programmes with certain characteristics

• Influenza vaccine[note 82]
• Mumps vaccine[note 82]
• Varicella vaccine[note 82]

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

• Atracurium
• Neostigmine
• Suxamethonium
• Vecuronium
• Pyridostigmine^α
• Vecuronium^α

Eye preparations

Anti-infective agents

• Aciclovir
• Azithromycin
• Erythromycin[note 83]
• Gentamicin
• Natamycin
• Ofloxacin
• Tetracycline

Anti-inflammatory agents

• Prednisolone

Local anesthetics

• Tetracaine

Miotics and antiglaucoma medicines

• Acetazolamide
• Latanoprost
• Pilocarpine
• Timolol

Mydriatics

• Atropine[note 84]
• Epinephrine (adrenaline)^α

Anti-vascular endothelial growth factor (VEGF)

• Bevacizumab^α

Medicines for reproductive health and perinatal care

Contraceptives

Oral hormonal contraceptives

• Ethinylestradiol/levonorgestrel
• Ethinylestradiol/norethisterone
• Levonorgestrel
• Ulipristal

Injectable hormonal contraceptives

• Estradiol cypionate/medroxyprogesterone acetate
• Medroxyprogesterone acetate
• Norethisterone enantate

Intrauterine devices

• IUD with copper
• IUD with progestogen

Barrier methods

• Condoms
• Diaphragms

Implantable contraceptives

• Etonogestrel-releasing implant
• Levonorgestrel-releasing implant

Intravaginal contraceptives

• Progesterone vaginal ring[note 85]

Ovulation inducers

• Clomifene^α

Uterotonics

• Carbetocin
• Ergometrine
• Mifepristone + misoprostol (Co-packaged)[note 86]
• Misoprostol[note 87]
• Oxytocin

Antioxytocics (tocolytics)

• Nifedipine

Medicines administered to the mother

• Dexamethasone
• Tranexamic acid

Medicines administered to the neonate

• Caffeine citrate
• Chlorhexidine
• Ibuprofen^α
• Prostaglandin E^α
  • Prostaglandin E1
  • Prostaglandin E2
• Surfactant^α

Peritoneal dialysis solution

• Intraperitoneal dialysis solution (of appropriate composition)^α

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

• Chlorpromazine
• Fluphenazine
• Haloperidol
• Risperidone
• Chlorpromazine^α
• Clozapine^α
• Haloperidol^α

Medicines used in mood disorders

Medicines used in depressive disorders

• Amitriptyline
• Fluoxetine
• Fluoxetine^α

Medicines used in bipolar disorders

• Carbamazepine
• Lithium carbonate
• Valproic acid (sodium valproate)

Medicines for anxiety disorders

• Diazepam

Medicines used for obsessive compulsive disorders

• Clomipramine

Medicines for disorders due to psychoactive substance use

• Nicotine replacement therapy
• Methadone^α[note 88]

Medicines acting on the respiratory tract

Antiasthmatics and medicines for chronic obstructive pulmonary disease

• Beclometasone
• Budesonide
• Budesonide/formoterol
• Epinephrine (adrenaline)
• Ipratropium bromide
• Salbutamol (albuterol)
• Tiotropium

Solutions correcting water, electrolyte and acid-base disturbances

Oral

• Oral rehydration salts
• Potassium chloride

Parenteral

• Glucose
• Glucose with sodium chloride
• Potassium chloride
• Sodium chloride
• Sodium hydrogen carbonate
• Sodium lactate, compound solution

Miscellaneous

• Water for injection

Vitamins and minerals

• Ascorbic acid
• Calcium
• Cholecalciferol[note 89]
• Ergocalciferol
• Iodine
• Multiple micronutrient powder
• Nicotinamide
• Pyridoxine
• Retinol
• Riboflavin
• Sodium fluoride
• Thiamine
• Calcium gluconate^α

Ear, nose and throat medicines

• Acetic acid
• Budesonide
• Ciprofloxacin
• Xylometazoline

Medicines for diseases of joints

Medicines used to treat gout

• Allopurinol

Disease-modifying agents used in rheumatoid disorders (DMARDs)

• Chloroquine
• Azathioprine^α
• Hydroxychloroquine^α
• Methotrexate^α
• Penicillamine^α
• Sulfasalazine^α

Juvenile joint diseases

• Acetylsalicylic acid (aspirin)[note 90]

Notes

An α indicates the medicine is only on the complementary list. For these items specialized diagnostic or monitoring or specialist training are needed. An item may also be listed as complementary on the basis of higher costs or a less attractive cost-benefit ratio.[4][14]

1. Thiopental may be used as an alternative depending on local availability and cost.
2. No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
3. Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect
4. For the management of cancer pain
5. Alternatives limited to hydromorphone and oxycodone
6. For the management of cancer pain
7. There may be a role for sedating antihistamines for limited indications (EMLc).
8. as adjunctive therapy for treatment-resistant partial or generalized seizures.
9. For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders
10. for buccal administration when solution for oromucosal administration is not available
11. The presence of both 25 mg/5 mL and 30 mg/5 mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
12. Oxamniquine is listed for use when praziquantel treatment fails.
13. Only for the presumptive treatment of epidemic meningitis in children older than two years and in adults.
14. cloxacillin, dicloxacillin and flucloxacillin are preferred for oral administration due to better bioavailability.
15. 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.
16. single agent trimethoprim may be an alternative for lower urinary tract infection.
17. Also listed for single-dose treatment of trachoma and yaws.
18. Third-generation cephalosporin of choice for use in hospitalized neonates
19. Do not administer with calcium and avoid in infants with hyperbilirubinemia.
20. Erythromycin may be an alternative. For use in combination regimens for eradication of H. pylori in adults
21. Imipenem/cilastatin is an alternative, except for acute bacterial meningitis, where meropenem is preferred
22. For use only in patients with HIV receiving protease inhibitors
23. For treatment of latent TB infection (LTBI) only
24. For use only in combination with meropenem or imipenem/cilastatin
25. Terizidone may be an alternative
26. Prothionamide may be an alternative
27. Ofloxacin and moxifloxacin may be alternatives based on availability and programme considerations.
28. Imipenem/cilastatin may be an alternative
29. For treatment of chronic pulmonary aspergillosis, histoplasmosis, sporotrichosis, paracoccidioidomycosis, mycoses caused by Talaromyces marneffei and chromoblastomycosis; and prophylaxis of histoplasmosis and infections caused by T. marneffei in AIDS patients
30. For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis
31. For use in pregnant women and in second-line regimens in accordance with WHO treatment guidelines.
32. Emtricitabine (FTC) is an acceptable alternative to 3TC, based on knowledge of the pharmacology, the resistance patterns and clinical trials of antiretrovirals.
33. Combination also indicated for pre-exposure prophylaxis
34. For the treatment of viral haemorrhagic fevers
35. For the treatment of cytomegalovirus retinitis (CMVr).
36. For severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
37. For the treatment of cytomegalovirus retinitis (CMVr).
38. When used in combination with sofosbuvir
39. When used in combination with daclatasvir
40. For the treatment of hepatitis C, in combination with direct acting anti-viral medicines
41. To be used in combination with ribavirin
42. To be used in combination with artesunate 50 mg
43. For use in the management of severe malaria
44. Not recommended in the first trimester of pregnancy or in children below 5 kg
45. To be used in combination with either amodiaquine, mefloquine or sulfadoxine + pyrimethamine
46. Other combinations that deliver the target doses required such as 153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be alternatives.
47. For use only for the treatment of P. vivax infection
48. For use only in combination with quinine
49. Only for use to achieve radical cure of P. vivax and P. ovale infections, given for 14 days
50. For use only in the management of severe malaria, and should be used in combination with doxycycline
51. Only in combination with artesunate 50 mg
52. For use only in Central American regions, for P. vivax infections
53. For use only in combination with chloroquine
54. For the treatment of 1st and 2nd stage human African trypanosomiasis due to Trypanosoma brucei gambiense infection
55. To be used for the treatment of Trypanosoma brucei gambiense infection
56. To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection
57. To be used for the treatment of T. b. gambiense infection
58. Only to be used in combination with eflornithine, for the treatment of T. b. gambiense infection
59. Certolizumab pegol, etanercept, golimumab and infliximab are alternatives, including quality-assured biosimilars
60. Including quality-assured biosimilars
61. Gefitinib and afatinib are alternatives
62. Pembrolizumab is an alternative
63. the square box applies to epoetin alfa, beta and theta, darbepoetin alfa, methoxy polyethylene glycol-epoetin beta,and their respective biosimilars.
64. Apixaban, edoxaban and rivaroxaban are alternatives
65. Alternatives are limited to nadroparin and dalteparin
66. Deferasirox oral form may be an alternative, depending on cost and availability.
67. Polygeline, injectable solution, 3.5% is considered as equivalent.
68. Includes metoprolol and carvedilol as alternatives
69. Includes atenolol, metoprolol and carvedilol as alternatives. Atenolol should not be used as a first-line agent in uncomplicated hypertension in patients >60 years
70. 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.
71. 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.
72. For use in high‐risk patients
73. In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
74. Glibenclamide not suitable above 60 years
75. Carbimazole is an alternative depending on local availability
76. For use when alternative first-line treatment is not appropriate or available
77. Carbimazole is an alternative depending on local availability
78. For use when alternative first-line treatment is not appropriate or available
79. Exact type to be defined locally
80. Recommended for certain regions
81. Recommended for some high-risk populations
82. Recommended only for immunization programmes with certain characteristics
83. For infections due to Chlamydia trachomatis or Neisseria gonorrhoeae
84. Or homatropine (hydrobromide) or cyclopentolate (hydrochloride)
85. For use in women actively breastfeeding at least 4 times per day
86. Where permitted under national law and where culturally acceptable
87. For induction of labour, should only be used where appropriate facilities are available
88. The square box is added to include buprenorphine. The medicines should only be used within an established support programme.
89. Ergocalciferol can be used as an alternative.
90. For use for rheumatic fever, juvenile arthritis, Kawasaki disease

References

1. "Essential medicines". World Health Organization. Retrieved 19 January 2017.
2. "The WHO Essential Medicines List (EML): 30th anniversary". World Health Organization. Retrieved 26 June 2016.
3. Persaud N, Jiang M, Shaikh R, Bali A, Oronsaye E, Woods H, Drozdzal G, Rajakulasingam Y, Maraj D, Wadhawan S, Umali N, Wang R, McCall M, Aronson JK, Plüddemann A, Moja L, Magrini N, Heneghan C (June 2019). "Comparison of essential medicines lists in 137 countries". Bull. World Health Organ. 97 (6): 394–404C. doi:10.2471/BLT.18.222448. hdl:10665/325509. ISSN 0042-9686. PMC 6560372. PMID 31210677.
4. "19th WHO Model List of Essential Medicines" (PDF). World Health Organization. April 2015. p. Annex 1. Retrieved 17 January 2017.
5. 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): 13–18. doi:10.4103/0976-500X.107642. PMC 3643337. PMID 23662019.
6. "The Selection and Use of Essential Medicines - WHO Technical Report Series, No. 920: 5. Reviews of sections of the Model List: 5.2 Review of core versus complementary listing of medicines". World Health Organization (WHO). 2003. Retrieved 6 March 2017.
7. Beall, Reed (2016). "Patents and the WHO Model List of Essential Medicines (18th Edition): Clarifying the Debate on IP and Access" (PDF). World Intellectual Property Organization (WIPO). Retrieved 3 May 2017.
8. World Health Organization (1977). The selection of essential drugs : report of a WHO expert committee [meeting held in Geneva from 17 to 21 October 1977]. Geneva: World Health Organization. hdl:10665/41272. ISBN 9241206152. Technical report series ; no. 615.
9. Wirtz, VJ; Hogerzeil, HV; Gray, AL; Bigdeli, M; de Joncheere, CP; et al. (28 January 2017). "Essential medicines for universal health coverage". The Lancet. 389 (10067): 403–476. doi:10.1016/S0140-6736(16)31599-9. PMC 7159295. PMID 27832874.
10. "WHO Model Lists of Essential Medicines". World Health Organization. Retrieved 17 January 2017.
11. Prakash, B; Nadig, P; Nayak, A (2016). "Rational Prescription for a Dermatologist". Indian Journal of Dermatology. 61 (1): 32–38. doi:10.4103/0019-5154.174017. PMC 4763692. PMID 26955092.
12. World Health Organization (2017). WHO model list of essential medicines, 20th list (March 2017, amended August 2017). Geneva. hdl:10665/273826.
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14. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
15. World Health Organization (2019). Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines. Geneva. hdl:10665/325773. WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO.
16. "Strengthening access to essential medicines". World Health Organization. Retrieved 3 May 2020.
17. World Health Organization (2019). World Health Organization model list of essential medicines for children: 7th list 2019. Geneva. hdl:10665/325772. WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO.
18. Rose, K; Anker, JNVd (2010). Guide to Paediatric Drug Development and Clinical Research. Karger Medical and Scientific Publishers. p. 42. ISBN 9783805593625.
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20. Kalle, H (9 February 2017). "Essential Medicines for Children". Clinical Pharmacology & Therapeutics. 101 (6): 718–720. doi:10.1002/cpt.661. PMID 28182281.

Further reading

• World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. hdl:10665/44053. ISBN 9789241547659.
• World Health Organization (2015). The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children). Geneva. hdl:10665/189763. ISBN 9789240694941. ISSN 0512-3054. WHO technical report series ; no. 994.
• World Health Organization (2017). The selection and use of essential medicines: report of the WHO Expert Committee, 2017 (including the 20th WHO Model List of Essential Medicines and the 6th Model List of Essential Medicines for Children). Geneva. hdl:10665/259481. ISBN 978-92-4-121015-7. ISSN 0512-3054. WHO technical report series ; no. 1006.
• World Health Organization (2019). The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. hdl:10665/330668. ISBN 9789241210300. ISSN 0512-3054. WHO technical report series;1021.
• World Health Organization (2019). "Additions and deletions of medicines on the WHO model lists of essential medicines: 1977-2017". hdl:10665/278038. WHO/MVP/EMP/IAU/2019.01. License: CC BY-NC-SA 3.0 IGO. Cite journal requires |journal= (help)

External links

eEML - Electronic Essential Medicines List