WHO Model List of Essential Medicines

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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. The list is frequently used by countries to help develop their own local lists of essential medicine. As of 2016, more than 155 countries have created national lists of essential medicines based on the World Health Organization's model list. This includes countries in both the developed and developing world.

The list is divided into core items and complementary items. 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. The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost-benefit ratio. About 25% of items are in the complementary list. Some medications are listed as both core and complementary. While most medications on the list are available as generic products, being under patent does not exclude inclusion.

The first list was published in 1977 and included 212 medications. The WHO updates the list every two years. The 14th list was published in 2005 and contained 306 medications. In 2015 the 19th edition of the list was published and contains around 410 medications. The 20th edition was published in 2017. The national lists contain between 334 and 580 medications.

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 5th edition. It was created to make sure that the needs of children were systematically considered such as availability of proper formulations. Everything in the children's list is also included in the main list. The list and notes are based on the 19th and 20th edition of the main list. An ? indicates a medicine is only on the complementary list.

Video WHO Model List of Essential Medicines

Anaesthetics

General anaesthetics and oxygen

Inhalational medicines

• Halothane
• Isoflurane
• Nitrous oxide
• Oxygen

Injectable medicines

• Ketamine
• Propofol

Local anaesthetics

• Bupivacaine
• Lidocaine
• Lidocaine/epinephrine
• Ephedrine^? (not a local anaesthetic, included in this list for prevention of low blood pressure associated with spinal anaesthesia during caesarean section)

Preoperative medication and sedation for short-term procedures

• Atropine
• Midazolam
• Morphine

Maps WHO Model List of Essential Medicines

Medicines for pain and palliative care

Nonopioids and nonsteroidal anti-inflammatory drugs (NSAIDs)

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

Opioid analgesics

• Codeine
• Fentanyl
• Morphine
• Methadone

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

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Antiallergics and medicines used in anaphylaxis

• Dexamethasone
• Epinephrine (adrenaline)
• Hydrocortisone
• Loratadine
• Prednisolone

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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^?
• Dimercaprol^?
• Fomepizole^?
• Sodium calcium edetate^?
• Succimer^?

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Anticonvulsive medication

• Carbamazepine
• Diazepam
• Lamotrigine
• Lorazepam
• Magnesium sulfate
• Midazolam
• Phenobarbital
• Phenytoin
• Valproic acid (sodium valproate)
• Ethosuximide^?

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Anti-infective medicines

Antihelminthics

Intestinal antihelminthics

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

Antifilarials

• Albendazole
• Diethylcarbamazine
• Ivermectin

Antischistosomals and other antinematode medicines

• Praziquantel
• Triclabendazole
• Oxamniquine^?

Antibiotics

Beta Lactam medicines

• Amoxicillin
• Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)
• Ampicillin
• Benzathine benzylpenicillin
• Benzylpenicillin
• Cefalexin
• Cefazolin
• Cefixime
• Cefotaxime

• Ceftriaxone
• Cloxacillin
• Phenoxymethylpenicillin (penicillin V)
• Piperacillin/tazobactam
• Procaine benzylpenicillin
• Ceftazidime^?
• Meropenem^?
• Aztreonam^?
• Imipenem/cilastatin^?

Other antibacterials

• Amikacin
• Azithromycin
• Chloramphenicol
• Ciprofloxacin
• Clarithromycin
• Clindamycin
• Doxycycline
• Erythromycin
• Gentamicin
• Metronidazole
• Nitrofurantoin
• Spectinomycin
• Trimethoprim/sulfamethoxazole
• Trimethoprim
• Vancomycin

Antileprosy medicines

• Clofazimine
• Dapsone
• Rifampicin

Antituberculosis medicines

• Ethambutol
• Ethambutol/isoniazid (ethambutol + isoniazid)
• 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
• Rifampicin
• Rifapentine
• Amikacin^?
• Bedaquiline^?
• Capreomycin^?
• Clofazimine^?
• Cycloserine^?
• Delamanid^?
• Ethionamide^?
• Kanamycin^?
• Levofloxacin^?
• Linezolid^?
• Moxifloxacin
• p-aminosalicylic acid^?
• Streptomycin^?

Antifungal medicines

• Amphotericin B
• Clotrimazole
• Fluconazole
• Flucytosine
• Griseofulvin
• Itraconazole
• Nystatin
• Voriconazole
• Potassium iodide^?

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

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

Integrase inhibitors

• Dolutegravir
• Raltegravir

Fixed-dose combinations

• Abacavir/lamivudine
• Efavirenz/emtricitabine/tenofovir
• Efavirenz/lamivudine/tenofovir
• Emtricitabine/tenofovir
• Lamivudine/nevirapine/zidovudine
• Lamivudine/zidovudine

Medicines for prevention of HIV-related opportunistic infections

• Isoniazid/pyridoxine/sulfamethoxazole/trimethoprim

Other antivirals

• Ribavirin
• Valganciclovir
• Oseltamivir^?

Antihepatitis medicines

Medicines for hepatitis B

Nucleoside/Nucleotide reverse transcriptase inhibitors

• Entecavir
• Tenofovir disoproxil fumarate (TDF)

Medicines for hepatitis C

Nucleotide polymerase inhibitors

• Sofosbuvir

Protease inhibitors

• Simeprevir

NS5A inhibitors

• Daclatasvir

Non-nucleoside polymerase inhibitors

• Dasabuvir

Other antivirals

• Ribavirin
• Pegylated interferon-alpha-2a or pegylated interferon-alpha-2b^?

Fixed-dose combinations

• Ledipasvir/sofosbuvir
• Ombitasvir/paritaprevir/ritonavir
• Sofosbuvir/velpatasvir

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
• Artemether
• Artemether/lumefantrine
• Artesunate
• Artesunate/amodiaquine
• Artesunate/mefloquine
• Artesunate/pyronaridine
• Chloroquine
• Dihydroartemisinin/piperaquine
• Doxycycline
• Mefloquine
• Primaquine
• Quinine
• Sulfadoxine/pyrimethamine

For prevention

• Chloroquine
• Doxycycline
• Mefloquine
• Proguanil

Antipneumocystosis and antitoxoplasmosis medicines

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

Antitrypanosomal medicines

African trypanosomiasis

• Pentamidine
• Suramin sodium

• Eflornithine
• Melarsoprol
• Nifurtimox

American trypanosomiasis

• Benznidazole
• Nifurtimox

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Antimigraine medicines

Acute attack

• Acetylsalicylic acid (Aspirin)
• Ibuprofen
• Paracetamol

Prevention

• Propranolol

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Antineoplastic and immunosuppressives

Immunosuppressive medicines

• Azathioprine^?
• Ciclosporin^?

Cytotoxic and adjuvant medicines

• All-trans retinoic acid (tretinoin)^?
• Allopurinol^?
• Asparaginase^?
• Bendamustine^?
• Bleomycin^?
• Calcium folinate^?
• Capecitabine^?
• Carboplatin^?
• Chlorambucil^?
• Cisplatin^?
• Cyclophosphamide^?
• Cytarabine^?
• Dacarbazine^?
• Dactinomycin^?
• Dasatinib^?
• Daunorubicin^?
• Docetaxel^?
• Doxorubicin^?
• Etoposide^?
• Filgrastim^?
• Fludarabine^?
• Fluorouracil^?
• Gemcitabine^?
• Hydroxycarbamide^?
• Ifosfamide^?
• Imatinib^?
• Irinotecan^?
• Mercaptopurine^?
• Mesna^?
• Methotrexate^?
• Oxaliplatin^?
• Paclitaxel^?
• Procarbazine^?
• Rituximab^?
• Thioguanine^?
• Trastuzumab^?
• Vinblastine^?
• Vincristine^?
• Vinorelbine^?
• Zoledronic acid^?

Hormones and antihormones

• Anastrozole^?
• Bicalutamide^?
• Dexamethasone^?
• Hydrocortisone^?
• Leuprorelin^?
• Methylprednisolone^?
• Prednisolone^?
• Tamoxifen^?

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Antiparkinsonism medicines

• Biperiden
• Carbidopa/levodopa (levodopa + carbidopa)

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Medicines affecting the blood

Antianaemia medicines

• Ferrous salt
• Ferrous salt/folic acid
• Folic acid
• Hydroxocobalamin
• Erythropoiesis-stimulating agents^?

Medicines affecting coagulation

• Enoxaparin
• Heparin sodium
• Phytomenadione
• Protamine sulfate
• Tranexamic acid
• Warfarin
• Desmopressin^?

Other medicines for haemoglobinopathies

• Deferoxamine^?
• Hydroxycarbamide^?

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Blood products and plasma substitutes of human origin

Blood and blood components

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

Plasma-derived medicines

Human immunoglobulins

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

Blood coagulation factors

• Coagulation factor VIII^?
• Coagulation factor IX^?

Plasma substitutes

• Dextran 70

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Cardiovascular medicines

Antianginal medicines

• Bisoprolol
• Glyceryl trinitrate
• Isosorbide dinitrate
• Verapamil

Antiarrhythmic medicines

• Bisoprolol
• Digoxin
• Epinephrine (adrenaline)
• Lidocaine
• Verapamil
• Amiodarone^?

Antihypertensive medicines

• Amlodipine
• Bisoprolol
• Enalapril
• Hydralazine
• Hydrochlorothiazide
• Methyldopa
• Losartan
• Sodium nitroprusside^?

Medicines used in heart failure

• Bisoprolol
• Digoxin
• Enalapril
• Furosemide
• Hydrochlorothiazide
• Losartan
• Spironolactone
• Dopamine^?

Antithrombotic medicines

Anti-platelet medicines

• Acetylsalicylic acid (aspirin)
• Clopidogrel

Thrombolytic medicines

• Streptokinase^?

Lipid-lowering agents

• Simvastatin

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Dermatological (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
• Meglumine iotroxate^?

Disinfectants and antiseptics

Antiseptics

• Chlorhexidine
• Ethanol
• Povidone iodine

Disinfectants

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

Diuretics

• Amiloride
• Furosemide
• Hydrochlorothiazide
• Mannitol
• Spironolactone

Gastrointestinal medicines

• Pancreatic enzymes^?

Antiulcer medicines

• Omeprazole
• Ranitidine

Antiemetic medicines

• Dexamethasone
• Metoclopramide
• Ondansetron

Anti-inflammatory medicines

• Sulfasalazine
• Hydrocortisone^?

Laxatives

• Senna

Medicines used in diarrhea

Oral rehydration

• Oral rehydration salts

Medicines for diarrhea in children

• Zinc sulfate

Hormones, other endocrine medicines, and contraceptives

Adrenal hormones and synthetic substitutes

• Fludrocortisone
• Hydrocortisone

Androgens

• Testosterone^?

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

Insulins and other medicines used for diabetes

• Gliclazide
• Glucagon
• Insulin injection (soluble)
• Intermediate-acting insulin
• Metformin

Ovulation inducers

• Clomifene^?

Progestogens

• Medroxyprogesterone acetate

Thyroid hormones and antithyroid medicines

• Levothyroxine
• Potassium iodide
• Propylthiouracil
• Lugol's solution^?

Immunologicals

Diagnostic agents

• Tuberculin, purified protein derivative (PPD)

Sera and immunoglobulins

• Antivenom immunoglobulin
• Diphtheria antitoxin

Vaccines

• BCG vaccine
• Cholera vaccine
• Diphtheria vaccine
• Haemophilus influenzae type b vaccine
• Hepatitis A vaccine
• Hepatitis B vaccine
• HPV vaccine
• Influenza vaccine
• Japanese encephalitis vaccine
• Measles vaccine
• Meningococcal meningitis vaccine
• Mumps vaccine
• Pertussis vaccine
• Pneumococcal vaccine
• Poliomyelitis vaccine
• Rabies vaccine
• Rotavirus vaccine
• Rubella vaccine
• Tetanus vaccine
• Tick-borne encephalitis vaccine
• Typhoid vaccine
• Varicella vaccine
• Yellow fever vaccine

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

• Atracurium
• Neostigmine
• Suxamethonium
• Vecuronium
• Pyridostigmine^?

Eye preparations

Anti-infective agents

• Aciclovir
• Azithromycin
• Erythromycin
• Gentamicin
• Natamycin
• Ofloxacin
• Tetracycline

Anti-inflammatory agents

• Prednisolone

Local anesthetics

• Tetracaine

Miotics and antiglaucoma medicines

• Acetazolamide
• Latanoprost
• Pilocarpine
• Timolol

Mydriatics

• Atropine
• Epinephrine (adrenaline)^?

Anti-vascular endothelial growth factor (VEGF)

• Bevacizumab^?

Oxytocics and antioxytocics

Oxytocics and abortifacients

• Ergometrine
• Misoprostol
• Oxytocin
• Mifepristone used with misoprostol^?

Antioxytocics (tocolytics)

• Nifedipine

Peritoneal dialysis solution

• Intraperitoneal dialysis solution (of appropriate composition)^?

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

• Chlorpromazine
• Fluphenazine
• Haloperidol
• Risperidone
• Clozapine^?

Medicines used in mood disorders

Medicines used in depressive disorders

• Amitriptyline
• Fluoxetine

Medicines used in bipolar disorders

• Carbamazepine
• Lithium
• 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^?

Medicines acting on the respiratory tract

Antiasthmatic and medicines for chronic obstructive pulmonary disease

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

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
• Ergocalciferol
• Iodine
• Nicotinamide
• Pyridoxine
• Retinol
• Riboflavin
• Sodium fluoride
• Thiamine
• Calcium gluconate^?

Ear, nose and throat medicines in children

• Acetic acid
• Budesonide
• Ciprofloxacin
• Xylometazoline

Specific medicines for neonatal care

Medicines administered to the neonate

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

Medicines administered to the mother

• Dexamethasone

Medicines for diseases of joints

Medicines used to treat gout

• Allopurinol

Disease-modifying agents used in rheumatoid disorders

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

Juvenile joint diseases

• Aspirin

Notes

^ An ? 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.

References

Further reading

• WHO Model Formulary 2008 (PDF). World Health Organization. 2009. ISBN 9789241547659. 
• 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) (PDF). WHO. 2015. ISBN 9789240694941. 

Source of article : Wikipedia