WHOModelList
of
EssentialMedicines
17thlist
(March2011)
Statusofthisdocument
ThisisareprintofthetextontheWHOMedicineswebsite
http://www.who.int/medicines/publications/essentialmedicines/en/index.html
Thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.The
responsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshalltheWorldHealth
Organizationbeliablefordamagesarisingfromitsuse.
17thedition
EssentialMedicines
WHOModelList(March2011)
ExplanatoryNotes
Thecorelistpresentsalistofminimummedicineneedsforabasichealth‐caresystem,listingthemost
efficacious,safeandcost‐effectivemedicinesforpriorityconditions.Priorityconditionsareselectedonthe
basisofcurrentandestimatedfuturepublichealthrelevance,andpotentialforsafeandcost‐effective
treatment.
Thecomplementarylistpresentsessentialmedicinesforprioritydiseases,forwhichspecializeddiagnostic
ormonitoringfacilities,and/orspecialistmedicalcare,and/orspecialisttrainingareneeded.Incaseofdoubt
medicinesmayalsobelistedascomplementaryonthebasisofconsistenthighercostsorlessattractivecost‐
effectivenessinavarietyofsettings.
Thesquareboxsymbol()isprimarilyintendedtoindicatesimilarclinicalperformancewithina
pharmacologicalclass.Thelistedmedicineshouldbetheexampleoftheclassforwhichthereisthebest
evidenceforeffectivenessandsafety.Insomecases,thismaybethefirstmedicinethatislicensedfor
marketing;inotherinstances,subsequentlylicensedcompoundsmaybesaferormoreeffective.Wherethere
isnodifferenceintermsofefficacyandsafetydata,thelistedmedicineshouldbetheonethatisgenerally
availableatthelowestprice,basedoninternationaldrugpriceinformationsources.Notallsquareboxesare
applicabletomedicineselectionforchildren—seethesecondEMLcfordetails.
Therapeuticequivalenceisonlyindicatedonthebasisofreviewsofefficacyandsafetyandwhenconsistent
withWHOclinicalguidelines.Nationallistsshouldnotuseasimilarsymbolandshouldbespecificintheir
finalselection,whichwoulddependonlocalavailabilityandprice.
Theasymbolindicatesthatthereisanageorweightrestrictiononuseofthemedicine;detailsforeach
medicinecanbefoundinTable1.
Wherethe[c]symbolisplacednexttothecomplementarylistitsignifiesthatthemedicine(s)require(s)
specialistdiagnosticormonitoringfacilities,and/orspecialistmedicalcare,and/orspecialisttrainingfor
theiruseinchildren.
Wherethe[c]symbolisplacednexttoanindividualmedicineorstrengthofmedicineitsignifiesthatthere
isaspecificindicationforrestrictingitsusetochildren.
ThepresenceofanentryontheEssentialMedicinesListcarriesnoassuranceastopharmaceuticalquality.It
istheresponsibilityoftherelevantnationalorregionaldrugregulatoryauthoritytoensurethateach
productisofappropriatepharmaceuticalquality(includingstability)andthatwhenrelevant,different
productsareinterchangeable.
ForrecommendationsandadviceconcerningallaspectsofthequalityassuranceofmedicinesseetheWHO
Medicineswebsitehttp://www.who.int/medicines/areas/quality_assurance/en/index.html.
Medicinesanddosageformsarelistedinalphabeticalorderwithineachsectionandthereisnoimplication
ofpreferenceforoneformoveranother.Standardtreatmentguidelinesshouldbeconsultedforinformation
onappropriatedosageforms.
ThemaintermsusedfordosageformsintheEssentialMedicinesListcanbefoundinAnnex1.
Definitionsofmanyofthesetermsandpharmaceuticalqualityrequirementsapplicabletothedifferent
categoriesarepublishedinthecurrenteditionofTheInternationalPharmacopoeia
http://www.who.int/medicines/publications/pharmacopoeia/en/index.html.
EssentialMedicines17thedition
WHOModelList
EML 17 (March 2011) page - 1
1. ANAESTHETICS
1.1 General anaesthetics and oxygen
1.1.1 Inhalational medicines
halothaneInhalation.
isoflurane Inhalation.
nitrousoxide Inhalation.
oxygenInhalation(medicinalgas).
1.1.2 Injectable medicines
ketamineInjection:50mg(ashydrochloride)/mlin10‐mlvial.
propofol*
Injection:10mg/ml;20mg/ml.
*Thiopentalmaybeusedasanalternativedependingonlocal
availabilityandcost.
1.2 Local anaesthetics
bupivacaine
Injection:0.25%;0.5%(hydrochloride)invial.
Injectionforspinalanaesthesia:0.5%(hydrochloride)in
4‐mlampouletobemixedwith7.5%glucosesolution.
lidocaine
Injection:1%;2%(hydrochloride)invial.
Injectionforspinalanaesthesia:5%(hydrochloride)in
2‐mlampouletobemixedwith7.5%glucosesolution.
Topicalforms:2%to4%(hydrochloride).
lidocaine+epinephrine(adrenaline)
Dentalcartridge:2%(hydrochloride)+epinephrine1:80000.
Injection:1%;2%(hydrochlorideorsulfate)+epinephrine
1:200000invial.
ComplementaryList
ephedrine
Injection:30mg(hydrochloride)/mlin1‐mlampoule.
(Foruseinspinalanaesthesiaduringdelivery,topreventhypotension).
1.3 Preoperative medication and sedation for short-term procedures
atropineInjection:1mg(sulfate)in1‐mlampoule.
midazolam
Injection:1mg/ml.
Oralliquid:2mg/ml[c].
Tablet:7.5mg;15mg.
morphineInjection:10mg(sulfateorhydrochloride)in1‐mlampoule.