Nomor Kelas Dosis Regimen Alasan Pengusulan (Bedasarkan

Kelas Terapi, Efektivitas dan Keamanan)

No. Urut Obat

Terapi Nama Obat,

Khusus
Bentuk
Sediaan,
Kekuatan
Sediaan,
Keamanan
I II III IV V VI
Codein tab 20 mg Dapat digunakan hingga 7 hari

Esau, R. (2009) ‘OPIOID

Esau, R. (2009) ‘OPIOID
ADMINISTRATION
ADMINISTRATION
GUIDELINES’, pp. 1–12.
GUIDELINES’, pp. 1–12.

Fentanyl 100 mcg Maksimal 3 hari untuk diganti

patch dengan patch baru
Road, G. W. (2004) ‘Annex i
list of the names,
Road, G. W. (2004) ‘Annex i list of
pharmaceutical forms, strengths
the names, pharmaceutical forms,
of the medicinal products, route
strengths of the medicinal products,
of administration, applicants
route of administration, applicants
and marketing authorisation
and marketing authorisation holders
holders in the member states’,
in the member states’, pp. 1–47.
pp. 1–47.

MST 10 – 30 mg Dapat digunakan hingga 7 hari

Esau, R. (2009) ‘OPIOID

Esau, R. (2009) ‘OPIOID
ADMINISTRATION
ADMINISTRATION
GUIDELINES’, pp. 1–12.
GUIDELINES’, pp. 1–12.

Parasetamol Anak: 15 mg/ KgBB/kali Dapat dipakai selama 24 hari

iv
de Martino, M. and Chiarugi,
A. (2015) ‘Recent Advances in
Pediatric Use of Oral
Paracetamol in Fever and Pain
Management’, Pain and
Therapy. Springer Healthcare,
4(2), pp. 149–168. doi:
10.1007/s40122-015-0040-z.
de Martino, M. and Chiarugi, A.
(2015) ‘Recent Advances in Pediatric
Use of Oral Paracetamol in Fever and
Pain Management’, Pain and
Therapy. Springer Healthcare, 4(2),
pp. 149–168. doi: 10.1007/s40122-
015-0040-z.

(Road, 2004; Esau, 2009; de Martino and Chiarugi, 2015)

Esau, R. (2009) ‘OPIOID ADMINISTRATION GUIDELINES’, pp. 1–12.
de Martino, M. and Chiarugi, A. (2015) ‘Recent Advances in Pediatric Use of Oral Paracetamol in
Fever and Pain Management’, Pain and Therapy. Springer Healthcare, 4(2), pp. 149–168. doi:
10.1007/s40122-015-0040-z.
Road, G. W. (2004) ‘Annex i list of the names, pharmaceutical forms, strengths of the medicinal
products, route of administration, applicants and marketing authorisation holders in the member
states’, pp. 1–47.