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WHO Model List of Essential Medicines for Children

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The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children[1] or EMLc[1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.[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]

The first list for children was created in 2007, and the list is in its 10th edition as of 2025.[4][5][6][7][8][9]

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

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Anaesthetics, preoperative medicines and medical gases

General anaesthetics and oxygen

Inhalational medicines

Injectable medicines

Local anaesthetics

Preoperative medication and sedation for short-term procedures

Medical gases

Medicines for pain and palliative care

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

Opioid analgesics

Complementary:

Medicines for other common symptoms in palliative care

Antiallergics and medicines used in anaphylaxis

Antidotes and other substances used in poisonings

Non-specific

Specific

Complementary:

Medicines for neurological disorders

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Medicines for central nervous system disorders

Antiseizure medicines

Complementary:

Medicines for multiple sclerosis

No listings in this section.

Medicines for parkinsonism

No listings in this section.

Medicines for cerebral palsy

Complementary:

Medicines for headache disorders

Medicines for acute migraine attacks
Medicines for migraine prophylaxis
Medicines for cluster headache

No listings in this section.

Medicines for central nervous system infections

Medicines for bacterial central nervous system infections

Complementary:

Medicines for viral central nervous system infections

Medicines for peripheral nervous system disorders

Medicines for Guillain-Barré syndrome

Complementary:

Medicines for myasthenia gravis

Complementary:

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Anti-infective medicines

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Anthelminthics

Intestinal anthelminthics

Thumb
A skeletal model of the chemical structure of albendazole

Antifilarials

Antischistosomals and other antinematode medicines

Complementary:

Cysticidal medicines

Complementary:

Antibacterials

Access group antibiotics

Watch group antibiotics

Complementary:

Reserve group antibiotics

Complementary:

Antileprosy medicines

Antituberculosis medicines

Antifungal medicines

Complementary:

Antiviral medicines

Antiherpes medicines

Antiretrovirals

Nucleoside/nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors
Fixed-dose combinations of antiretroviral medicines

Other antivirals

Complementary:

Antihepatitis medicines

Medicines for hepatitis B
Nucleoside/Nucleotide reverse transcriptase inhibitors
Medicines for hepatitis C
Pangenotypic direct-acting antiviral combinations
Non-pangenotypic direct-acting antiviral combinations

No listings in this section.

Other antivirals for hepatitis C

No listings in this section.

Antiprotozoal medicines

Antiamoebic and antigiardiasis medicines

Antileishmaniasis medicines

Antimalarial medicines

Medicines for curative treatment
Medicines for chemoprevention
Medicines for chemoprophylaxis in travellers

Antipneumocystosis and antitoxoplasmosis medicines

Antitrypanosomal medicines

African trypanosomiasis
Medicines for the treatment of 1st stage African trypanosomiasis
Medicines for the treatment of 2nd stage African trypanosomiasis

Complementary:

American trypanosomiasis

Medicines for ectoparasitic infections

Medicines for Ebola virus disease

Medicines for COVID-19

No listings in this section.

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Medicines for cystic fibrosis

Complementary:

Immunomodulators and Antineoplastics

Immunomodulators for non-malignant disease

Complementary:

Antineoplastic and supportive medicines

Cytotoxic medicines

Complementary:

Targeted therapies

Complementary:

Immunomodulators

Complementary:

Hormones and antihormones

Complementary:

Supportive medicines

Complementary:

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Therapeutic foods

Medicines affecting the blood

Antianaemia medicines

Complementary:

Medicines affecting coagulation

Complementary:

Medicines for haemoglobinopathies

Medicines for sickle-cell disease

Complementary:

Medicines for thalassaemias

Complementary:

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Blood products, coagulation factors and plasma substitutes

Blood and blood components

Human immunoglobulins

Complementary:

Coagulation factors

Plasma substitutes

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Cardiovascular medicines

Antianginal medicines

No listings in this section.

Antiarrhythmic medicines

No listings in this section.

Antihypertensive medicines

Medicines used in heart failure

Complementary:

Antithrombotic medicines

No listings in this section.

Lipid-lowering agents

No listings in this section.

Fixed-dose combinations for prevention of atherosclerotic cardiovascular disease

No listings in this section.

Dermatological medicines

Antifungal medicines

Anti-infective medicines

Anti-inflammatory and antipruritic medicines

Medicines affecting skin differentiation and proliferation

Complementary:

Scabicides and pediculicides

Moisturizers

Sunscreens, broad-spectrum

Diagnostic agents

Ophthalmic medicines

Radiocontrast media

Complementary:

Antiseptics and disinfectants

Antiseptics

Disinfectants

Diuretics

Complementary:

Gastrointestinal medicines

Complementary:

Antiulcer medicines

Antiemetic medicines

Complementary:

Anti-inflammatory medicines

No listings in this section.

Laxatives

No listings in this section.

Medicines used in diarrhoea

Oral rehydration

Medicines for diarrhoea

Medicines for endocrine disorders

Adrenal hormones and synthetic substitutes

Androgens

No listings in this section.

Estrogens

No listings in this section.

Progestogens

No listings in this section.

Medicines for diabetes

Insulins

Hypoglycaemic agents

Complementary:

Medicines for hypoglycaemia

Complementary:

Thyroid hormones and antithyroid medicines

Complementary:

Medicines for disorders of the pituitary hormone system

No listings in this section.

Immunologicals

Diagnostic agents

Sera, immunoglobulins and monoclonal antibodies

Vaccines

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

Complementary:

Ophthalmological preparations

Anti-infective agents

Anti-inflammatory agents

Local anaesthetics

Miotics and antiglaucoma medicines

No listings in this section.

Mydriatics

Complementary:

Anti-vascular endothelial growth factor (VEGF) preparations

No listings in this section.

Medicines for reproductive health and perinatal care

Contraceptives

No listings in this section.

Ovulation inducers

No listings in this section.

Uterotonics

No listings in this section.

Medicines for medical abortion

No listings in this section.

Antioxytocics (tocolytics)

No listings in this section.

Other medicines administered to the mother

No listings in this section.

Medicines administered to the neonate

Complementary:

Peritoneal dialysis solution

Complementary:

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

No listings in this section.

Medicines used in mood disorders

No listings in this section.

Medicines used in depressive disorders

No listings in this section.

Medicines used in bipolar disorders

No listings in this section.

Medicines for anxiety disorders

No listings in this section.

Medicines used for obsessive compulsive disorders

No listings in this section.

Medicines for disorders due to psychoactive substance use

No listings in this section.

Medicines for alcohol use disorders

No listings in this section.

Medicines for nicotine use disorders

No listings in this section.

Medicines for opioid use disorders

No listings in this section.

Medicines acting on the respiratory tract

Antiasthmatic medicines

Solutions correcting water, electrolyte and acid-base disturbances

Oral

Parenteral

Miscellaneous

Vitamins and minerals

Complementary:

Ear, nose and throat medicines

Medicines for diseases of joints

Medicines used to treat gout

No listings in this section.

Disease-modifying anti-rheumatic drugs (DMARDs)

Complementary:

Medicines for juvenile joint diseases

Complementary:

Dental medicines and preparations

Notes

  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. No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
  4. Not in children less than three months.
  5. Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
  6. Hydromorphone and oxycodone are alternatives
  7. For the management of cancer pain
  8. May be used for buccal administration when solution for oromucosal administration is not available
  9. Cetirizine and fexofenadine are alternatives
  10. There may be a role for sedating antihistamines for limited indications.
  11. Prednisone is an alternative
  12. Alternative formulations of activated charcoal may be used if granules are not available
  13. For use as adjunctive therapy for treatment-resistant partial or generalized seizures.
  14. Diazepam (injection) and midazolam (injection) are alternatives
  15. For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders
  16. 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
  17. 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
  18. Third-generation cephalosporin of choice for use in hospitalized neonates
  19. Do not administer with calcium and avoid in infants with hyperbilirubinemia
  20. > 41 weeks corrected gestational age
  21. Only for the presumptive treatment of epidemic meningitis in children older than two years
  22. > three months
  23. Moxidectin is an alternative
  24. Arpraziquantel is an alternative
  25. For use when praziquantel treatment fails.
  26. > 1 month.
  27. Only for the presumptive treatment of epidemic meningitis in children older than two years.
  28. Alternatives are 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)
  29. Cloxacillin, dicloxacillin, and flucloxacillin are preferred for oral administration due to better bioavailability
  30. Use in children <8 years only for life-threatening infections when no alternative exists.
  31. 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.
  32. Third-generation cephalosporin of choice for use in hospitalized neonates.
  33. Erythromycin is an alternative.
  34. Vancomycin powder for injection may also be used for oral administration
  35. 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
  36. For use only in combination with meropenem
  37. Prothionamide is an alternative for multidrug-resistant tuberculosis
  38. Imipenem/cilastatin is an alternative
  39. 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
  40. For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis
  41. Anidulafungin and caspofungin are alternatives
  42. > six weeks
  43. > three years
  44. ≥ 4 weeks and ≥ 3 kg; ≥ 25 kg
  45. For use in second-line regimens in accordance with WHO treatment guidelines
  46. Severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
  47. For the treatment of cytomegalovirus retinitis (CMVr).
  48. Pangenotypic when used in combination with sofosbuvir
  49. Pangenotypic when used in combination with daclatasvir
  50. Proposed for deletion in 2027
  51. > 25 kg
  52. Tinidazole is an alternative
  53. 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
  54. For use in the management of severe malaria
  55. For pre-referral treatment of severe malaria only.
  56. For use only for the treatment of Plasmodium vivax infection
  57. For use to reduce the transmission of Plasmodium falciparum and for radical cure of Plasmodium vivax and Plasmodium ovale infections
  58. For use only for prophylaxis of Plasmodium vivax infection
  59. > eight years
  60. For the treatment of 1st and 2nd stage human African trypanosomiasis due to Trypanosoma brucei gambiense infection
  61. To be used for the treatment of Trypanosoma brucei gambiense infection
  62. To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection
  63. Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection
  64. Etanercept and infliximab are alternatives, including quality-assured biosimilars
  65. Including quality-assured biosimilars
  66. 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
  67. Epoetin alfa, beta and theta; darbepoetin alfa; and their quality-assured biosimilars are alternatives
  68. Alternatives are dalteparin and nadroparin, including their quality-assured biosimilars
  69. Acenocoumarol is an alternative
  70. Deferiprone is an alternative
  71. 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
  72. Polygeline, injectable solution, 3.5% is an alternative
  73. Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
  74. Alternatives are 4th level ATC chemical subgroup (D01AC Imidazole and triazole derivatives) excluding combinations
  75. > two months
  76. Alternatives are 4th level ATC chemical subgroup (D07AC Corticosteroids, potent (group III))
  77. Calcitriol and tacalcitol are alternatives
  78. Podophyllotoxin is an alternative
  79. Certolizumab pegol, etanercept, and infliximab, including quality-assured biosimilars, are alternatives
  80. Precipitated sulfur topical ointment is an alternative
  81. Atropine and cyclopentolate are alternatives
  82. Propanol is an alternative
  83. Iodine is an alternative
  84. Alternatives are 4th level ATC chemical subgroup (D08AE Phenol and derivatives)
  85. Alternatives are 4th level ATC chemical subgroup (A02BC Proton pump inhibitors) excluding combinations
  86. Alternatives are 4th level ATC chemical subgroup (A02BA H2-receptor antagonists) excluding combinations
  87. In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
  88. Insulin glargine, Insulin degludec, and insulin detemir, including quality-assured biosimilars, are alternatives
  89. Insulin lispro, Insulin aspart, and insulin glulisine, including quality-assured biosimilars, are alternatives
  90. Carbimazole is an alternative depending on local availability
  91. For use when alternative first-line treatment is not appropriate or available
  92. Exact type to be defined locally.
  93. Atracurium is an alternative
  94. Alternatives are 4th level ATC chemical subgroup (S01AE Fluoroquinolones)
  95. Alternatives are 4th level ATC chemical subgroup (S01HA Local anaesthetics) excluding cocaine and combinations
  96. Indometacin is an alternative
  97. Terbutaline is an alternative
  98. Ergocalciferol is an alternative
  99. Ofloxacin is an alternative
  100. Of any type for use as dental sealant
  101. Of any type for use as dental filling material

References

Further reading

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