WHO Model List of Essential Medicines

For the list for children, see WHO Model List of Essential Medicines for Children.

The WHO Model List of Essential Medicines (a.k.a. Essential Medicines List or EML^[1]), 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.^[2] The list is frequently used by countries to help develop their own local lists of essential medicines.^[2] As of 2016^[update], more than 155 countries have created national lists of essential medicines based on the World Health Organization's model list.^[1] This includes both developed and developing countries.^[2][3]

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][2][9] The WHO updates the list every two years.^[10] There are 306 medications in the 14th list in 2005,^[11] 410 in the 19th list in 2015,^[10] 433 in the 20th list in 2017,^[12][13] 460 in the 21st list in 2019,^[14][15][16] and 479 in the 22nd list in 2021.^[17][18] Various national lists contain between 334 and 580 medications.^[5][19] The Essential Medicines List (EML) was updated in September 2025 to its 24th edition.^[20] The list contains recommendations for 523 medications.

A separate list for children up to twelve years of age, known as the WHO Model List of Essential Medicines for Children (EMLc), was created in 2007, and is in its 10th edition.^{[10][21][22][23][24]} It was created to make sure that the needs of children were systematically considered such as availability of proper formulations.^[25][26] Everything in the children's list is also included in the main list.^[27] The list and notes are based on the 19th to 24th edition of the main list.^{[4][12][14][17][28]} Therapeutic alternatives with similar clinical performance are listed for some medicines and they may be considered for national essential medicines lists.^[17][18] The 10th Essential Medicines List for Children was updated in September 2025.^[24][29][30]

Note: An α indicates a medicine is on the complementary list.^[4][14][17]

Anaesthetics, preoperative medicines and medical gases

General anaesthetics and oxygen

Inhalational medicines

• Isoflurane
• Nitrous oxide^{[note 1]}
• Oxygen
• Sevoflurane

Injectable medicines

• Ketamine
• Propofol^{[note 2]}

Local anaesthetics

• Bupivacaine
• Lidocaine
• Lidocaine/epinephrine (lidocaine + epinephrine (adrenaline))

Complementary:

• Ephedrine^{α[note 3]}

Preoperative medication and sedation for short-term procedures

• Atropine
• Midazolam
• Morphine

Medical gases

• Oxygen^{[note 4]}

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^{[note 5]}
• Paracetamol (acetaminophen)^{[note 6]}

Opioid analgesics

• Codeine
• Fentanyl^{[note 7]}
• Morphine^{[note 8]}

Complementary:

• Methadone^{α[note 9]}

Medicines for other common symptoms in palliative care

• Amitriptyline
• Cyclizine
• Dexamethasone
• Diazepam
• Docusate sodium
• Fluoxetine
• Haloperidol
• Hyoscine butylbromide
• Hyoscine hydrobromide
• Lactulose
• Loperamide
• Metoclopramide
• Midazolam^{[note 10]}
• Ondansetron^{[note 11]}
• Senna

Antiallergics and medicines used in anaphylaxis

• Dexamethasone
• Epinephrine (adrenaline)
• Hydrocortisone
• Loratadine^{[note 12]}
• Prednisolone^{[note 13]}

Antidotes and other substances used in poisonings

Non-specific

• Charcoal, activated^{[note 14]}

Specific

• Acetylcysteine
• Atropine
• Calcium gluconate
• Methylthioninium chloride (methylene blue)
• Naloxone
• Penicillamine
• Potassium ferric hexacyano-ferrate(II) -2H₂O (prussian blue)
• Sodium nitrite
• Sodium thiosulfate

Complementary:

• Deferoxamine^α
• Dimercaprol^α
• Fomepizole^α
• Sodium calcium edetate^α
• Succimer^α

Medicines for neurological disorders

Medicines for central nervous system disorders

Antiseizure medicines

• Carbamazepine
• Diazepam
• Lamotrigine^{[note 15]}
• Levetiracetam
• Lorazepam^{[note 16]}
• Magnesium sulfate^{[note 17]}
• Midazolam^{[note 10]}
• Phenobarbital
• Phenytoin^{[note 18]}
• Valproic acid (sodium valproate)^{[note 19]}

Complementary:

• Ethosuximide^α
• Levetiracetam^α
• Valproic acid (sodium valproate)^{α[note 19]}

Medicines for multiple sclerosis

Complementary:

• Cladribine^α
• Glatiramer acetate^α
• Rituximab^{α[note 20]}

Medicines for parkinsonism

• Biperiden^{[note 21]}
• Levodopa/carbidopa (levodopa + carbidopa)^{[note 22]}

Medicines for cerebral palsy

• Baclofen

Medicines for headache disorders

Medicines for acute migraine attacks

• Acetylsalicylic acid (aspirin)
• Ibuprofen^{[note 23]}
• Paracetamol (acetaminophen)^{[note 24]}
• Sumatriptan^{[note 25]}

Medicines for migraine prophylaxis

• Propranolol

Medicines for cluster headache

• Prednisolone
• Sumatriptan
• Verapamil

Medicines for central nervous system infections

Medicines for bacterial central nervous system infections

• Amoxicillin
• Ampicillin
• Benzylpenicillin
• Cefotaxime^{[note 26]}
• Ceftriaxone^{[note 27][note 28]}
• Chloramphenicol^{[note 29]}
• Gentamicin

Complementary:

• Meropenem^{α[note 30]}

Medicines for viral central nervous system infections

• Aciclovir^{[note 31]}

Medicines for peripheral nervous system disorders

Medicines for Guillain-Barré syndrome

Complementary:

• Normal immunoglobulin^α

Medicines for myasthenia gravis

• Neostigmine

Complementary:

• Pyridostigmine^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^{[note 32]}

Antischistosomals and other antinematode medicines

• Praziquantel^{[note 33]}
• Triclabendazole

Complementary:

• Oxamniquine^{α[note 34]}

Cysticidal medicines

Complementary:

• Albendazole^α
• Mebendazole^α
• Praziquantel^α

Antibacterials

Access group antibiotics

• Amikacin
• Amoxicillin
• Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)
• Ampicillin
• Benzathine benzylpenicillin
• Benzylpenicillin
• Cefalexin
• Cefazolin^{[note 35]}
• Chloramphenicol^{[note 36]}
• Clindamycin
• Cloxacillin^{[note 37][note 38]}
• Doxycycline^{[note 39]}
• Gentamicin
• Metronidazole
• Nitrofurantoin
• Phenoxymethylpenicillin (penicillin V)
• Procaine benzylpenicillin^{[note 40]}
• Spectinomycin
• Sulfamethoxazole/trimethoprim (sulfamethoxazole + trimethoprim)
• Trimethoprim

Watch group antibiotics

• Azithromycin
• Cefixime
• Cefotaxime^{[note 41]}
• Ceftriaxone^{[note 27][note 28]}
• Cefuroxime
• Ciprofloxacin
• Clarithromycin^{[note 42][note 43]}
• Piperacillin/tazobactam (piperacillin + tazobactam)
• Vancomycin^{[note 44]}

Complementary:

• Ceftazidime^α
• Meropenem^{α[note 45][note 30]}
• Vancomycin^α

Reserve group antibiotics

Complementary:

• Cefiderocol^α
• Ceftazidime/avibactam (ceftazidime + avibactam)^α
• Ceftolozane/tazobactam (ceftolozane + tazobactam)^α
• Colistin^α
• Fosfomycin^α
• Linezolid^{α[note 46]}
• Meropenem/vaborbactam (meropenem + vaborbactam)^α
• Plazomicin^α
• Polymyxin B^α

Antileprosy medicines

• Clofazimine
• Dapsone
• Rifampicin

Antituberculosis medicines

Pure crystals of ethambutol

• Amikacin
• Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)^{[note 47]}
• Bedaquiline
• Clofazimine
• Cycloserine^{[note 48]}
• Delamanid
• Ethambutol
• Ethambutol/isoniazid/pyrazinamide/rifampicin (ethambutol + isoniazid + pyrazinamide + rifampicin)
• Ethambutol/isoniazid/rifampicin (ethambutol + isoniazid + rifampicin)
• Ethionamide^{[note 49]}
• Isoniazid
• Isoniazid/pyrazinamide/rifampicin (isoniazid + pyrazinamide + rifampicin)
• Isoniazid/rifampicin (isoniazid + rifampicin)
• Isoniazid/rifapentine (isoniazid + rifapentine)
• Levofloxacin
• Linezolid
• Meropenem^{[note 50]}
• Moxifloxacin
• Moxifloxacin
• P-aminosalicylic acid (p-aminosalicylate sodium)
• Pretomanid
• Pyrazinamide
• Rifabutin
• Rifampicin
• Rifapentine
• Streptomycin

Antifungal medicines

• Amphotericin B
• Clotrimazole
• Fluconazole
• Flucytosine
• Griseofulvin
• Itraconazole^{[note 51]}
• Nystatin
• Voriconazole^{[note 52]}

Complementary:

• Micafungin^{α[note 53]}
• Potassium iodide^α

Antiviral medicines

Antiherpes medicines

• Aciclovir^{[note 31]}

Antiretrovirals

Nucleoside/nucleotide reverse transcriptase inhibitors

• Abacavir
• Lamivudine
• Tenofovir disoproxil fumarate^{[note 54]}
• Zidovudine

Non-nucleoside reverse transcriptase inhibitors

• Efavirenz
• Nevirapine^{[note 55]}

Protease inhibitors

• Atazanavir/ritonavir (atazanavir + ritonavir)
• Darunavir^{[note 56]}
• Lopinavir/ritonavir (lopinavir + ritonavir)
• Ritonavir

Integrase inhibitors

• Dolutegravir^{[note 57]}
• Raltegravir^{[note 58]}

Fixed-dose combinations of antiretroviral medicines

• Abacavir/dolutegravir/lamivudine (abacavir + dolutegravir + lamivudine)
• Abacavir/lamivudine (abacavir + lamivudine)
• Dolutegravir/lamivudine/tenofovir (dolutegravir + lamivudine + tenofovir)
• Efavirenz/emtricitabine/tenofovir^{[note 59]}
• Efavirenz/lamivudine/tenofovir (efavirenz + lamivudine + tenofovir)
• Emtricitabine/tenofovir (emtricitabine + tenofovir)^{[note 59][note 60]}
• Lamivudine/zidovudine (lamivudine + zidovudine)

Medicines for prevention of HIV-related opportunistic infections

• Isoniazid/pyridoxine/sulfamethoxazole/trimethoprim (isoniazid + pyridoxine + sulfamethoxazole + trimethoprim)

Other antivirals

• Valganciclovir^{[note 61]}

Complementary:

• Oseltamivir^{α[note 62]}
• Valganciclovir^{α[note 63]}

Antihepatitis medicines

Medicines for hepatitis B

Nucleoside/Nucleotide reverse transcriptase inhibitors

• Entecavir
• Tenofovir disoproxil fumarate

Medicines for hepatitis C

Pangenotypic direct-acting antiviral combinations

• Daclatasvir^{[note 64]}
• Daclatasvir/sofosbuvir (daclatasvir + sofosbuvir)
• Glecaprevir/pibrentasvir (glecaprevir + pibrentasvir)
• Ravidasvir^{[note 65]}
• Sofosbuvir^{[note 66]}
• Sofosbuvir/velpatasvir (sofosbuvir + velpatasvir)

Non-pangenotypic direct-acting antiviral combinations

• Ledipasvir/sofosbuvir (ledipasvir + sofosbuvir)

Other antivirals for hepatitis C

• Ribavirin^{[note 67]}

Antiprotozoal medicines

Antiamoebic and antigiardiasis medicines

• Diloxanide^{[note 68][note 69]}
• Metronidazole^{[note 70]}

Antileishmaniasis medicines

• Amphotericin B^{[note 71]}
• Meglumine antimoniate
• Miltefosine
• Paromomycin
• Sodium stibogluconate

Antimalarial medicines

Medicines for curative treatment

• Artemether^{[note 72]}
• Artemether/lumefantrine (artemether + lumefantrine)
• Artesunate^{[note 72]}
• Artesunate/amodiaquine (artesunate + amodiaquine)
• Artesunate/mefloquine (artesunate + mefloquine)
• Artesunate/pyronaridine tetraphosphate (artesunate + pyronaridine tetraphosphate)
• Artesunate + sulfadoxine/pyrimethamine (Co-packaged)
• Chloroquine^{[note 73]}
• Dihydroartemisinin/piperaquine phosphate (dihydroartemisinin + piperaquine phosphate)
• Primaquine^{[note 74]}
• Quinine^{[note 72]}

Medicines for chemoprevention

• Amodiaquine + sulfadoxine/pyrimethamine (Co-packaged)
• Sulfadoxine/pyrimethamine (sulfadoxine + pyrimethamine)

Medicines for chemoprophylaxis in travellers

• Chloroquine^{[note 75]}
• Doxycycline^{[note 76]}
• Mefloquine

Antipneumocystosis and antitoxoplasmosis medicines

• Pyrimethamine
• Sulfadiazine
• Sulfamethoxazole/trimethoprim (sulfamethoxazole + trimethoprim)

Complementary:

• Pentamidine^α

Antitrypanosomal medicines

African trypanosomiasis

• Fexinidazole^{[note 77]}

Medicines for the treatment of 1st stage African trypanosomiasis

• Pentamidine^{[note 78]}
• Suramin sodium^{[note 79]}

Medicines for the treatment of 2nd stage African trypanosomiasis

• Eflornithine^{[note 78]}
• Melarsoprol
• Nifurtimox^{[note 80]}

Complementary:

• Melarsoprol^α

American trypanosomiasis

• Benznidazole
• Nifurtimox

Medicines for ectoparasitic infections

• Ivermectin

Medicines for Ebola virus disease

• Ansuvimab
• Atoltivimab/maftivimab/odesivimab (atoltivimab + maftivimab + odesivimab)

Medicines for COVID-19

No listings in this section.

Medicines for cystic fibrosis

• Elexacaftor/tezacaftor/ivacaftor (elexacaftor + tezacaftor + ivacaftor)
• Ivacaftor

Complementary:

• Pancreatic enzymes^α

Immunomodulators and antineoplastics

Immunomodulators for non-malignant disease

Complementary:

• Adalimumab^{α[note 81]}
• Azathioprine^α
• Ciclosporin^α
• Tacrolimus^α

Antineoplastics and supportive medicines

Cytotoxic medicines

Complementary:

• Arsenic trioxide^α
• Asparaginase^{α[note 20]}
• Bendamustine^α
• Bleomycin^α
• Calcium folinate (leucovorin calcium)^α
• Capecitabine^α
• Carboplatin^α
• Chlorambucil^α
• Cisplatin^α
• Cyclophosphamide^α
• Cytarabine^α
• Dacarbazine^α
• Dactinomycin^α
• Daunorubicin^α
• Docetaxel^α
• Doxorubicin^α
• Doxorubicin (as pegylated liposomal)^α
• Etoposide^α
• Fludarabine^α
• Fluorouracil^α
• Gemcitabine^α
• Hydroxycarbamide (hydroxyurea)^α
• Ifosfamide^α
• Irinotecan^α
• Melphalan^α
• Mercaptopurine^α
• Methotrexate^α
• Oxaliplatin^α
• Paclitaxel^α
• Pegaspargase^{α[note 20]}
• Procarbazine^α
• Realgar Indigo naturalis formulation^α
• Tioguanine^α
• Vinblastine^α
• Vincristine^α
• Vinorelbine^α

Targeted therapies

Complementary:

• All-trans retinoic acid (tretinoin) (ATRA)^α
• Bortezomib^α
• Dasatinib^α
• Erlotinib^{α[note 82]}
• Everolimus^α
• Ibrutinib^{α[note 83]}
• Imatinib^α
• Nilotinib^α
• Rituximab^{α[note 20]}
• Trastuzumab^{α[note 20]}

Immunomodulators

Complementary:

• Blinatumomab^{α[note 20]}
• Filgrastim^{α[note 20]}
• Lenalidomide^α
• Pegfilgrastim^{α[note 20]}
• Pembrolizumab^{α[note 20][note 84]}
• Pembrolizumab^{α[note 85]}
• Pembrolizumab^{α[note 86]}
• Thalidomide^α

Hormones and antihormones

Complementary:

• Abiraterone^{α[note 87]}
• Anastrozole^{α[note 88]}
• Bicalutamide^{α[note 89]}
• Dexamethasone^α
• Hydrocortisone^α
• Leuprorelin^{α[note 90]}
• Methylprednisolone^α
• Prednisolone^{α[note 13]}
• Tamoxifen^α

Supportive medicines

Complementary:

• Allopurinol^α
• Mesna^{α[note 91]}
• Rasburicase^α
• Zoledronic acid^α

Therapeutic foods

• Ready-to-use therapeutic food^{[note 92]}

Medicines affecting the blood

Antianaemia medicines

• Ferrous salt
• Ferrous salt/folic acid (ferrous salt + folic acid)
• Folic acid^{[note 93]}
• Hydroxocobalamin

Complementary:

• Erythropoiesis-stimulating agents^{α[note 94]}

Medicines affecting coagulation

• Dabigatran^{[note 95]}
• Desmopressin
• Emicizumab
• Enoxaparin^{[note 96]}
• Heparin sodium
• Phytomenadione
• Protamine sulfate
• Tranexamic acid
• Warfarin^{[note 97]}

Complementary:

• Heparin sodium^α
• Protamine sulfate^α
• Warfarin^α

Medicines for haemoglobinopathies

Medicines for sickle-cell disease

• Deferasirox^{[note 98]}
• Hydroxyurea (hydroxycarbamide)

Complementary:

• Deferoxamine^α

Medicines for thalassaemias

• Deferasirox^{[note 98]}

Complementary:

• Deferoxamine^α

Blood products, coagulation factors and plasma substitutes

Blood and blood components

• Cryoprecipitate, pathogen-reduced^{[note 99]}
• Fresh frozen plasma
• Platelets
• Red blood cells
• Whole blood

Human immunoglobulins

• Anti-D immunoglobulin
• Anti-rabies immunoglobulin
• Anti-tetanus immunoglobulin

Complementary:

• Normal immunoglobulin^α

Coagulation factors

• Coagulation factor VIII, plasma-derived
• Coagulation factor IX, plasma-derived
• Coagulation factor VIII, recombinant
• Coagulation factor IX, recombinant

Plasma substitutes

• Dextran 70^{[note 100]}

Cardiovascular medicines

Antianginal medicines

• Bisoprolol^{[note 101]}
• Glyceryl trinitrate
• Isosorbide dinitrate
• Verapamil

Antiarrhythmic medicines

• Bisoprolol^{[note 101]}
• Digoxin
• Epinephrine (adrenaline)
• Lidocaine
• Verapamil

Complementary:

• Amiodarone^α

Antihypertensive medicines

• Amlodipine^{[note 102]}
• Bisoprolol^{[note 103]}
• Enalapril^{[note 104]}
• Hydralazine^{[note 105]}
• Hydrochlorothiazide^{[note 106]}
• Lisinopril/amlodipine (lisinopril + amlodipine)^{[note 107]}
• Lisinopril/hydrochlorothiazide (lisinopril + hydrochlorothiazide)^{[note 108]}
• Losartan^{[note 109]}
• Methyldopa^{[note 110]}
• Perindopril/amlodipine/indapamide (perindopril + amlodipine + indapamide)^{[note 111]}
• Telmisartan/amlodipine (telmisartan + amlodipine)^{[note 112]}
• Telmisartan/hydrochlorothiazide (telmisartan + hydrochlorothiazide)^{[note 113]}
• Valsartan/amlodipine/hydrochlorothiazide (valsartan + amlodipine + hydrochlorothiazide)^{[note 114]}

Complementary:

• Sodium nitroprusside^α

Medicines used in heart failure

• Bisoprolol^{[note 101]}
• Digoxin
• Enalapril^{[note 115]}
• Furosemide^{[note 116]}
• Hydrochlorothiazide^{[note 106]}
• Losartan^{[note 109]}
• Spironolactone

Complementary:

• Digoxin^α
• Dopamine^α

Antithrombotic medicines

Anti-platelet medicines

• Acetylsalicylic acid (aspirin)
• Clopidogrel

Thrombolytic medicines

Complementary:

• Alteplase^α
• Streptokinase^α

Lipid-lowering agents

• Simvastatin^{[note 117]}

Fixed-dose combinations for prevention of atherosclerotic cardiovascular disease

• Acetylsalicylic acid/atorvastatin/ramipril (acetylsalicylic acid + atorvastatin + ramipril)^{[note 118][note 119]}
• Acetylsalicylic acid/simvastatin/ramipril/atenolol/hydrochlorothiazide (acetylsalicylic acid + simvastatin + ramipril + atenolol + hydrochlorothiazide)^{[note 120][note 119][note 121][note 122]}
• Atorvastatin/perindopril/amlodipine (atorvastatin + perindopril + amlodipine)^{[note 118][note 123][note 124]}

Dermatological medicines

Antifungal medicines

• Miconazole^{[note 125]}
• Selenium sulfide
• Sodium thiosulfate
• Terbinafine

Anti-infective medicines

• Mupirocin
• Potassium permanganate
• Silver sulfadiazine

Anti-inflammatory and antipruritic medicines

• Betamethasone^{[note 126]}
• Calamine
• Hydrocortisone^{[note 127]}

Medicines affecting skin differentiation and proliferation

• Benzoyl peroxide
• Calcipotriol^{[note 128]}
• Coal tar
• Fluorouracil
• Podophyllum resin^{[note 129]}
• Salicylic acid
• Urea

Complementary:

• Adalimumab^{α[note 130]}
• Methotrexate^α
• Ustekinumab^{α[note 20]}

Scabicides and pediculicides

• Benzyl benzoate^{[note 131]}
• Permethrin

Moisturizers

• Urea
• Glycerol

Sunscreens, broad-spectrum

• Sunscreen, broad-spectrum

Diagnostic agents

Ophthalmic medicines

• Fluorescein
• Tropicamide^{[note 132]}

Radiocontrast media

• Amidotrizoate
• Barium sulfate
• Iohexol

Complementary:

• Barium sulfate^α
• Meglumine iotroxate^α

Antiseptics and disinfectants

Antiseptics

• Chlorhexidine
• Ethanol^{[note 133]}
• Povidone iodine^{[note 134]}

Disinfectants

• Alcohol based hand rub
• Chlorine base compound
• Chloroxylenol^{[note 135]}
• Glutaral
• Hypochlorous acid

Diuretics

• Amiloride
• Furosemide^{[note 136]}
• Hydrochlorothiazide^{[note 106]}
• Mannitol
• Spironolactone

Complementary:

• Hydrochlorothiazide^{α[note 137]}
• Mannitol^α
• Spironolactone^α

Gastrointestinal medicines

Complementary:

• Pancreatic enzymes^α

Antiulcer medicines

• Omeprazole^{[note 138]}
• Ranitidine^{[note 139]}

Antiemetic medicines

• Dexamethasone
• Metoclopramide
• Ondansetron^{[note 11]}

Complementary:

• Aprepitant^α

Anti-inflammatory medicines

• Sulfasalazine^{[note 140]}

Complementary:

• Hydrocortisone^α
• Prednisolone^α

Laxatives

• Senna^{[note 141]}

Medicines used in diarrhoea

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

Oral rehydration

• Oral rehydration salts

Medicines for diarrhoea

• Zinc sulfate^{[note 142]}

Medicines for endocrine disorders

Adrenal hormones and synthetic substitutes

• Fludrocortisone
• Hydrocortisone
• Prednisolone^{[note 13]}

Androgens

Complementary:

• Testosterone^α

Estrogens

No listings in this section.

Progestogens

• Medroxyprogesterone acetate^{[note 143]}

Medicines for diabetes

Insulins

• Insulin (analogue, long-acting)^{[note 144]}
• Insulin (analogue, rapid-acting)^{[note 145]}
• Insulin (human, intermediate-acting)^{[note 20]}
• Insulin (human, short-acting)^{[note 20]}

Hypoglycaemic agents

• Empagliflozin^{[note 146]}
• Gliclazide^{[note 147]}
• Metformin
• Semaglutide^{[note 148]}

Complementary:

• Metformin^α

Medicines for hypoglycaemia

• Glucagon

Complementary:

• Diazoxide^α

Thyroid hormones and antithyroid medicines

• Levothyroxine
• Potassium iodide
• Methimazole^{[note 149]}
• Propylthiouracil^{[note 150]}

Complementary:

• Iodine + potassium iodide (Lugol's solution)^α
• Methimazole^{α[note 149]}
• Potassium iodide^α
• Propylthiouracil^{α[note 151]}

Medicines for disorders of the pituitary hormone system

• Cabergoline^{[note 152]}

Complementary:

• Octreotide^α

Immunologicals

Diagnostic agents

• Tuberculin, purified protein derivative (PPD)

Sera, immunoglobulins and monoclonal antibodies

• Anti-rabies virus monoclonal antibodies^{[note 20]}
• Antivenom immunoglobulin^{[note 153]}
• Diphtheria antitoxin
• Equine rabies immunoglobulin

Vaccines

• BCG vaccine
• Cholera vaccine
• Dengue vaccine
• Diphtheria vaccine
• Ebola vaccine
• Haemophilus influenzae type b vaccine
• Hepatitis A vaccine
• Hepatitis B vaccine
• Hepatitis E vaccine
• Human papilloma virus (HPV) vaccine
• Influenza vaccine (seasonal)
• Japanese encephalitis vaccine
• Malaria vaccine
• Measles vaccine
• Meningococcal meningitis vaccine
• Mpox vaccine
• Mumps vaccine
• Pertussis vaccine
• Pneumococcal vaccine
• Poliomyelitis vaccine
• Rabies vaccine
• Respiratory syncytial virus 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^{[note 154]}

Complementary:

• Pyridostigmine^α
• Vecuronium^α

Ophthalmological preparations

Anti-infective agents

• Aciclovir
• Azithromycin
• Erythromycin^{[note 155]}
• Gentamicin^{[note 156]}
• Natamycin
• Ofloxacin^{[note 157]}
• Tetracycline^{[note 158]}

Anti-inflammatory agents

• Prednisolone

Local anaesthetics

• Tetracaine^{[note 159]}

Miotics and antiglaucoma medicines

• Acetazolamide
• Latanoprost
• Pilocarpine^{[note 160]}
• Timolol^{[note 161]}

Mydriatics

• Atropine^{[note 162]}

Complementary:

• Epinephrine (adrenaline)^α

Anti-vascular endothelial growth factor (VEGF) preparations

Complementary:

• Bevacizumab^{α[note 20]}

Medicines for reproductive health and perinatal care

Contraceptives

Oral hormonal contraceptives

• Ethinylestradiol/levonorgestrel (ethinylestradiol + levonorgestrel)
• Ethinylestradiol/norethisterone (ethinylestradiol + norethisterone)
• Levonorgestrel
• Ulipristal

Injectable hormonal contraceptives

• Estradiol cypionate/medroxyprogesterone acetate (estradiol cypionate + medroxyprogesterone acetate)
• Medroxyprogesterone acetate
• Norethisterone enantate

Intrauterine devices

• Copper-containing device
• Levonorgestrel-releasing intrauterine system

Barrier methods

• Condoms
• Diaphragms

Implantable contraceptives

• Etonogestrel-releasing implant
• Levonorgestrel-releasing implant

Intravaginal contraceptives

• Ethinylestradiol/etonogestrel (ethinylestradiol + etonogestrel)
• Progesterone vaginal ring^{[note 163]}

Ovulation inducers

Complementary:

• Clomifene^α
• Letrozole^{α[note 164]}

Uterotonics

• Carbetocin
• Ergometrine^{[note 165]}
• Misoprostol^{[note 166]}
• Oxytocin

Medicines for medical abortion

• Mifepristone + misoprostol (Co-packaged)
• Misoprostol

Antioxytocics (tocolytics)

• Nifedipine

Other medicines administered to the mother

• Dexamethasone
• Multiple micronutrient supplement
• Tranexamic acid

Medicines administered to the neonate

• Caffeine citrate
• Chlorhexidine

Complementary:

• Alprostadil (prostaglandin E1)^{α[note 167]}
• Beractant^α
• Ibuprofen^{α[note 168]}
• Poractant alfa^α

Peritoneal dialysis solution

Complementary:

• Intraperitoneal dialysis solution (of appropriate composition in accordance with local clinical guidelines.)^α

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

• Fluphenazine^{[note 169]}
• Haloperidol^{[note 170]}
• Olanzapine
• Paliperidone^{[note 171]}
• Risperidone^{[note 172]}

Complementary:

• Clozapine^α

Medicines used in mood disorders

Medicines used in depressive disorders

• Amitriptyline
• Fluoxetine^{[note 173]}

Medicines used in bipolar disorders

• Carbamazepine
• Lithium carbonate
• Quetiapine^{[note 174]}
• Valproic acid (sodium valproate)^{[note 19]}

Medicines for anxiety disorders

• Diazepam^{[note 175][note 176]}
• Fluoxetine^{[note 173]}

Medicines used for obsessive compulsive disorders

• Clomipramine
• Fluoxetine^{[note 173]}

Medicines for disorders due to psychoactive substance use

Medicines for alcohol use disorders

• Acamprosate calcium
• Naltrexone

Medicines for nicotine use disorders

• Bupropion
• Cytisine (cytisinicline)
• Nicotine replacement therapy (NRT)
• Varenicline

Medicines for opioid use disorders

Complementary:

• Methadone^{α[note 177]}

Medicines acting on the respiratory tract

Antiasthmatic medicines and medicines for chronic obstructive pulmonary disease

• Budesonide^{[note 178]}
• Budesonide/formoterol (budesonide + formoterol)^{[note 179]}
• Epinephrine (adrenaline)
• Ipratropium bromide
• Salbutamol^{[note 180]}
• Tiotropium^{[note 181]}

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 (Ringer's lactate solution)

Miscellaneous

• Water for injection

Vitamins and minerals

• Ascorbic acid
• Calcium
• Colecalciferol^{[note 182]}
• Ergocalciferol^{[note 183]}
• Iodine
• Multiple micronutrient powder
• Nicotinamide
• Pyridoxine
• Retinol
• Riboflavin
• Thiamine

Complementary:

• Calcium gluconate^α

Ear, nose and throat medicines

• Acetic acid
• Budesonide
• Ciprofloxacin^{[note 184]}
• Xylometazoline

Medicines for diseases of joints

Medicines used to treat gout

• Allopurinol

Disease-modifying anti-rheumatic drugs (DMARDs)

• Chloroquine

Complementary:

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

Medicines for juvenile joint diseases

Complementary:

• Acetylsalicylic acid (aspirin)^{[note 185]}
• Adalimumab^{α[note 81]}
• Methotrexate^α
• Triamcinolone hexacetonide^{α[note 186]}

Dental medicines and preparations

• Fluoride
• Glass ionomer cement
• Resin-based composite (low-viscosity)^{[note 187]}
• Resin-based composite (high-viscosity)^{[note 188]}
• Silver diamine fluoride

Notes

An α indicates the medicine is on the complementary list for which specialized diagnostic or monitoring or training is 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. Piped nitrous oxide is a major source of atmospheric pollution from healthcare facilities. Point-of-care cylinders are the preferred delivery system over centrally-supplied (piped) delivery systems
2. Thiopental is an alternative
3. For use in spinal anaesthesia during delivery, to prevent hypotension
4. No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation
5. Not in children less than three months
6. Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect
7. For the management of cancer pain
8. Hydromorphone and oxycodone are alternatives
9. For the management of cancer pain
10. May be used for buccal administration when solution for oromucosal administration is not available
11. Dolasetron, granisetron, palonosetron, and tropisetron are alternatives
12. Cetirizine and fexofenadine are alternatives
13. Prednisone is an alternative
14. Alternative formulations of activated charcoal may be used if granules are not available
15. For use as adjunctive therapy for treatment-resistant partial or generalized seizures
16. Diazepam (injection) and midazolam (injection) are alternatives
17. For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders
18. 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
19. Valproic acid (sodium valproate) is not recommended in women and girls of childbearing potential owing to the high risk of birth defects and neurodevelopmental disorders in children exposed to valproic acid (sodium valproate) in the womb
20. Including quality-assured biosimilars
21. Trihexyphenidyl is an alternative
22. Benserazide is an alternative for carbidopa
23. Naproxen is an alternative
24. The presence of both 120 mg/5 mL and 125 mg/5mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided
25. Eletriptan is an alternative
26. Third-generation cephalosporin of choice for use in hospitalized neonates
27. Do not administer with calcium and avoid in infants with hyperbilirubinemia
28. > 41 weeks corrected gestational age
29. Only for the presumptive treatment of epidemic meningitis in children older than two years
30. > three months
31. Oral valaciclovir is an alternative
32. Moxidectin is an alternative
33. Arpraziquantel is an alternative
34. Oxamniquine is listed for use when praziquantel treatment fails
35. > one month
36. Only for the presumptive treatment of epidemic meningitis in children older than two years and in adults
37. Alternatives are 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)
38. Cloxacillin, dicloxacillin, and flucloxacillin are preferred for oral administration due to better bioavailability
39. Use in children <8 years only for life-threatening infections when no alternative exists
40. 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
41. Third-generation cephalosporin of choice for use in hospitalized neonates
42. Erythromycin is an alternative as second choice treatment for pharyngitis in children (EMLc only)
43. For use in combination regimens for eradication of H. pylori in adults
44. Vancomycin powder for injection may also be used for oral administration
45. Imipenem/cilastatin is an alternative for complicated intraabdominal infections and high-risk febrile neutropenia only. Meropenem is the preferred choice for acute bacterial meningitis in neonates
46. Tedizolid phosphate is an alternative
47. For use only in combination with meropenem or imipenem/cilastatin
48. Terizidone is an alternative
49. Prothionamide is an alternative for multidrug-resistant tuberculosis
50. Imipenem/cilastatin is an alternative
51. For treatment of chronic pulmonary aspergillosis, histoplasmosis, sporotrichosis, paracoccidioidomycosis, mycoses caused by T. marneffei and chromoblastomycosis; and prophylaxis of histoplasmosis and infections caused by T. marneffei in AIDS patients
52. For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis
53. Anidulafungin and caspofungin are alternatives
54. Also indicated for pre-exposure prophylaxis
55. > six weeks
56. > three years
57. ≥ 4 weeks and ≥ 3 kg; ≥ 25 kg
58. For use in pregnant women and in second-line regimens in accordance with WHO treatment guidelines
59. Lamivudine is an alternative for emtricitabine
60. Combination also indicated for pre-exposure prophylaxis
61. For the treatment of cytomegalovirus retinitis (CMVr)
62. For severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
63. For the treatment of cytomegalovirus retinitis (CMVr)
64. Pangenotypic when used in combination with sofosbuvir
65. Pangenotypic when used in combination with sofosbuvir
66. Pangenotypic when used in combination with daclatasvir or ravidasvir
67. For the treatment of hepatitis C, in combination with direct acting anti-viral medicines
68. Proposed for deletion in 2027
69. > 25 kg
70. Tinidazole is an alternative
71. Liposomal amphotericin B has a better safety profile than the sodium deoxycholate formulation and should be prioritized for selection and use depending on local availability and cost
72. For use in the management of severe malaria
73. For use only for the treatment of Plasmodium vivax infection
74. For use to reduce the transmission of Plasmodium falciparum and for radical cure of Plasmodium vivax and Plasmodium ovale infections
75. For use only for prophylaxis of Plasmodium vivax infection
76. > 8 years
77. For the treatment of 1st and 2nd stage human African trypanosomiasis due to Trypanosoma brucei gambiense infection
78. To be used for the treatment of Trypanosoma brucei gambiense infection
79. To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection
80. Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection
81. Certolizumab pegol, etanercept, golimumab, and infliximab are alternatives, including quality-assured biosimilars
82. Afatinib and gefitinib are alternatives
83. Zanubrutinib is an alternative
84. As monotherapy for deficient mismatch repair (dMMR ) / microsatellite instability-high (MSI-H) tumours
85. Atezolizumab and cemiplimab are alternatives, including quality-assured biosimilars
86. Nivolumab is an alternative, including quality-assured biosimilars
87. Enzalutamide is an alternative
88. Alternatives are 4th level ATC chemical subgroup (L02BG Aromatase inhibitors)
89. Flutamide and nilutamide are alternatives
90. Goserelin and triptorelin are alternatives
91. May also be used for oral administration
92. Biscuit or paste of nutritional composition as determined by the UN joint statement on the community-based management of severe acute malnutrition and Codex alimentarius guidelines
93. Periconceptual use for prevention of first occurrence of neural tube defects
94. Epoetin alfa, beta and theta; darbepoetin alfa; methoxy polyethylene glycol-epoetin beta; and their quality-assured biosimilars are alternatives
95. Apixaban, edoxaban, and rivaroxaban are alternatives
96. Alternatives are dalteparin and nadroparin, including their quality-assured biosimilars
97. Acenocoumarol is an alternative
98. Deferiprone is an alternative
99. Cryoprecipitate (not pathogen-reduced) is an alternative. Native cryoprecipitate should only be used in situations of life-threatening haemorrhage when pathogen-reduced cryoprecipitate is not available
100. Polygeline, injectable solution, 3.5% is an alternative
101. Carvedilol and metoprolol are alternatives
102. Alternatives are 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives)
103. Atenolol, carvedilol, and metoprolol are alternatives. Atenolol should not be used as a first-line agent in uncomplicated hypertension in patients > 60 years
104. Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
105. Hydralazine is listed for use only in the acute management of severe pregnancy-induced hypertension. Its use in the treatment of essential hypertension is not recommended in view of the evidence of greater efficacy and safety of other medicines
106. Chlorothiazide, chlorthalidone, and indapamide are alternatives
107. Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for lisinopril) and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine)
108. Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for lisinopril) and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
109. Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain)
110. Methyldopa is listed for use only in the management of pregnancy-induced hypertension. Its use in the treatment of essential hypertension is not recommended in view of the evidence of greater efficacy and safety of other medicines
111. Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for perindopril); and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine); and chlorthalidone, chlorothiazide, hydrochlorothiazide (for indapamide)
112. Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for telmisartan); and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine)
113. Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for telmisartan); and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
114. Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for valsartan); 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine); and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
115. Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
116. Bumetanide and torasemide are alternatives
117. For use in high‐risk patients. Atorvastatin, fluvastatin, lovastatin, and pravastatin are alternatives
118. Fluvastatin, lovastatin, pravastatin, and simvastatin are alternatives for atorvastatin
119. 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) are alternatives for ramipril
120. Atorvastatin, fluvastatin, lovastatin, and pravastatin are alternatives for simvastatin
121. Bisoprolol, carvedilol, and metoprolol are alternatives for atenolol
122. Chlorthalidone, chlorothiazide, and indapamide are alternatives for hydrochlorothiazide
123. 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) are alternatives for perindopril
124. 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) are alternatives for amlodipine
125. Alternatives are 4th level ATC chemical subgroup (D01AC Imidazole and triazole derivatives) excluding combinations
126. Alternatives are 4th level ATC chemical subgroup (D07AC Corticosteroids, potent (group III))
127. Alternatives are 4th level ATC chemical subgroup (D07AA Corticosteroids, weak (group I))
128. Calcitriol and tacalcitol are alternatives
129. Podophyllotoxin is an alternative
130. Certolizumab pegol, etanercept, infliximab, including quality-assured biosimilars, are alternatives
131. Precipitated sulfur topical ointment is an alternative
132. Atropine and cyclopentolate are alternatives
133. Propanol is an alternative
134. Iodine is an alternative
135. Alternatives are 4th level ATC chemical subgroup (D08AE Phenol and derivatives)
136. Bumetanide and torasemide are alternatives
137. Chlorothiazide and chlorthalidone are alternatives
138. Alternatives are 4th level ATC chemical subgroup (A02BC Proton pump inhibitors) excluding combinations
139. Alternatives are 4th level ATC chemical subgroup (A02BA H2-receptor antagonists) excluding combinations
140. Mesalazine is an alternative
141. Bisacodyl is an alternative
142. In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
143. Norethisterone is an alternative
144. Insulin glargine, Insulin degludec, and insulin detemir, including quality-assured biosimilars, are alternatives
145. Insulin lispro, Insulin aspart, and insulin glulisine, including quality-assured biosimilars, are alternatives
146. Canagliflozin and dapagliflozin are alternatives
147. Glibenclamide not suitable above 60 years. Alternatives are 4th level ATC chemical subgroup (A10BB Sulfonylureas)
148. Dulaglutide, liraglutide, and tirzepatide, including quality-assured biosimilars, are alternatives
149. Carbimazole is an alternative depending on local availability
150. For use when alternative first-line treatment is not appropriate or available; and in patients during the first trimester of pregnancy
151. For use when alternative first-line treatment is not appropriate or available
152. Bromocriptine is an alternative
153. Exact type to be defined locally
154. Atracurium is an alternative
155. For infections due to Chlamydia trachomatis or Neisseria gonorrhoeae
156. Amikacin, kanamycin, netilmicin, and tobramycin are alternatives
157. Alternatives are 4th level ATC chemical subgroup (S01AE Fluoroquinolones)
158. Chlortetracycline and oxytetracycline are alternatives
159. Alternatives are 4th level ATC chemical subgroup (S01HA Local anaesthetics) excluding cocaine and combinations
160. Carbachol is an alternative
161. Alternatives are 4th level ATC chemical subgroup (S01ED Beta blocking agents) excluding combinations
162. Cyclopentolate hydrochloride or homatropine hydrobromide are alternatives only for the EMLc
163. For use in women actively breastfeeding at least 4 times per day
164. Anastrozole is an alternative
165. Methylergometrine is an alternative
166. Only for use for induction of labour where appropriate facilities are available
167. dinoprostone (prostaglandin E2) is an alternative
168. Indometacin is an alternative
169. Haloperidol decanonate and zuclopenthixol decanonate are alternatives
170. Chlorpromazine is an alternative for the tablet
171. Risperidone injection is an alternative
172. Aripiprazole, olanzapine, paliperidone, and quetiapine are alternatives
173. Citalopram, escitalopram, fluvoxamine, paroxetine, and sertraline are alternatives
174. Aripiprazole, olanzapine, and paliperidone are alternatives
175. Lorazepam is an alternative
176. For short-term emergency management of acute and severe anxiety symptoms only
177. Buprenorphine is an alternative. The medicines should only be used within an established support programme
178. Beclometasone, ciclesonide, flunisolide, fluticasone, and mometasone are alternatives
179. Beclometasone/formoterol, budesonide/salmeterol, fluticasone/formoterol, fluticasone furoate/vilanterol, and mometasone/formoterol are alternatives
180. Terbutaline is an alternative
181. Aclidinium, glycopyrronium, and umeclidinium are alternatives
182. Ergocalciferol is an alternative
183. Colecalciferol is an alternative
184. Ofloxacin is an alternative
185. For use for rheumatic fever, juvenile arthritis, Kawasaki disease
186. Triamcinolone acetonide is an alternative
187. Of any type for use as dental sealant
188. Of any type for use as dental filling material