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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[update].[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)
- Ibuprofen[note 4]
- Paracetamol[note 5] (acetaminophen)
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
- Carbamazepine
- Diazepam
- Lamotrigine[note 14]
- Levetiracetam
- Lorazepam[note 15]
- Magnesium sulfate[note 16]
- Midazolam[note 8]
- Phenobarbital
- Phenytoin
- Prednisolone
- Valproic acid (sodium valproate)[note 17]
Complementary:
- Ethosuximideα
- Levetiracetamα
- Valproic acid (sodium valproate)α[note 17]
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
- Ibuprofen
- Paracetamol (acetaminophen)[note 18]
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
- Amoxicillin
- Ampicillin
- Benzylpenicillin
- Cefotaxime[note 19]
- Ceftriaxone[note 20][note 21]
- Chloramphenicol[note 22]
- Gentamicin
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

Antifilarials
Antischistosomals and other antinematode medicines
Complementary:
Cysticidal medicines
Complementary:
Antibacterials
Access group antibiotics
- Amikacin
- Amoxicillin
- Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)
- Ampicillin
- Benzathine benzylpenicillin
- Benzylpenicillin
- Cefalexin
- Cefazolin[note 27]
- Chloramphenicol[note 28]
- Clindamycin
- Cloxacillin[note 29][note 30]
- Doxycycline[note 31]
- Gentamicin
- Metronidazole
- Nitrofurantoin
- Phenoxymethylpenicillin (penicillin V)
- Procaine benzylpenicillin[note 32]
- Sulfamethoxazole/trimethoprim (sulfamethoxazole + trimethoprim)
- Trimethoprim
Watch group antibiotics
- Azithromycin
- Cefixime
- Cefotaxime[note 33]
- Ceftriaxone[note 20][note 21]
- Cefuroxime
- Ciprofloxacin
- Clarithromycin[note 34]
- Piperacillin/tazobactam (piperacillin + tazobactam)
- Vancomycin[note 35]
Complementary:
Reserve group antibiotics
Complementary:
Antileprosy medicines
Antituberculosis medicines
- Amikacin
- Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)[note 37]
- Bedaquiline
- Clofazimine
- Cycloserine
- Delamanid
- Ethambutol
- Ethionamide[note 38]
- Isoniazid
- Isoniazid/pyrazinamide/rifampicin (isoniazid + pyrazinamide + rifampicin)
- Isoniazid/rifampicin (isoniazid + rifampicin)
- Isoniazid/rifapentine (isoniazid + rifapentine)
- Levofloxacin
- Linezolid
- Meropenem[note 39]
- Moxifloxacin
- Moxifloxacin
- P-aminosalicylate sodium
- Pyrazinamide
- Rifampicin
- Rifapentine
- Streptomycin
Antifungal medicines
- Amphotericin B
- Fluconazole
- Flucytosine
- Griseofulvin
- Itraconazole[note 40]
- Nystatin
- Voriconazole[note 41]
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
Medicines for prevention of HIV-related opportunistic infections
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
- Artemether[note 55]
- Artemether/lumefantrine (artemether + lumefantrine)
- Artesunate[note 55][note 56]
- Artesunate/amodiaquine (artesunate + amodiaquine)
- Artesunate/mefloquine (artesunate + mefloquine)
- Artesunate/pyronaridine tetraphosphate (artesunate + pyronaridine tetraphosphate)
- Artesunate + sulfadoxine/pyrimethamine (Co-packaged)
- Chloroquine[note 57]
- Dihydroartemisinin/piperaquine phosphate (dihydroartemisinin + piperaquine phosphate)
- Primaquine[note 58]
- Quinine[note 55]
Medicines for chemoprevention
- Amodiaquine + sulfadoxine/pyrimethamine (Co-packaged)
- Sulfadoxine/pyrimethamine (sulfadoxine + pyrimethamine)
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:
- Arsenic trioxideα
- Asparaginaseα[note 66]
- Bleomycinα
- Calcium folinate (leucovorin calcium)α
- Carboplatinα
- Cisplatinα
- Cyclophosphamideα
- Cytarabineα
- Dacarbazineα
- Dactinomycinα
- Daunorubicinα
- Doxorubicinα
- Doxorubicin (as pegylated liposomal)α
- Etoposideα
- Fluorouracilα
- Hydroxyurea (hydroxycarbamide)α
- Ifosfamideα
- Irinotecanα
- Mercaptopurineα
- Methotrexateα
- Oxaliplatinα
- Paclitaxelα
- Pegaspargaseα[note 66]
- Procarbazineα
- Realgar-Indigo naturalis formulationα
- Tioguanineα
- Vinblastineα
- Vincristineα
- Vinorelbineα
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:
- Deferoxamineα
- Hydroxyurea (hydroxycarbamide)α
Medicines for thalassaemias
Complementary:
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Blood products, coagulation factors and plasma substitutes
Blood and blood components
- Cryoprecipitate, pathogen-reduced[note 72]
- Fresh frozen plasma
- Platelets
- Red blood cells
- Whole blood
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 salts + zinc sulfate (Co-packaged)
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
- Tuberculin, purified protein derivative (PPD)
Sera, immunoglobulins and monoclonal antibodies
- Anti-rabies virus monoclonal antibodies[note 66]
- Antivenom immunoglobulin[note 94]
- 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
- 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
- Rotavirus vaccine
- Rubella vaccine
- Tetanus vaccine
- Tick-borne encephalitis vaccine
- Typhoid vaccine
- Varicella vaccine
- Yellow fever vaccine
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:
- Epinephrine (adrenaline)α
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:
- Alprostadil (prostaglandin E1)α[note 101]
- Beractantα
- Ibuprofenα[note 102]
- Poractant alfaα
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
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
- Budesonide[note 103]
- Epinephrine (adrenaline)
- Salbutamol (albuterol)[note 104]
Solutions correcting water, electrolyte and acid-base disturbances
Oral
Parenteral
Miscellaneous
Vitamins and minerals
- Ascorbic acid
- Colecalciferol[note 105]
- Iodine
- Multiple micronutrient powder
- Pyridoxine
- Retinol
- Riboflavin
- Thiamine
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
- Fluoride
- Glass ionomer cement
- Resin-based composite (low-viscosity)[note 109]
- Resin-based composite (high-viscosity)[note 110]
- Silver diamine fluoride
Notes
- 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
- Thiopental is an alternative
- No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
- Not in children less than three months.
- Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
- Hydromorphone and oxycodone are alternatives
- For the management of cancer pain
- May be used for buccal administration when solution for oromucosal administration is not available
- Dolasetron, granisetron, palonosetron, and tropisetron are alternatives
- Cetirizine and fexofenadine are alternatives
- There may be a role for sedating antihistamines for limited indications.
- Prednisone is an alternative
- Alternative formulations of activated charcoal may be used if granules are not available
- For use as adjunctive therapy for treatment-resistant partial or generalized seizures.
- For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders
- 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
- 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
- Third-generation cephalosporin of choice for use in hospitalized neonates
- Do not administer with calcium and avoid in infants with hyperbilirubinemia
- > 41 weeks corrected gestational age
- Only for the presumptive treatment of epidemic meningitis in children older than two years
- > three months
- Moxidectin is an alternative
- Arpraziquantel is an alternative
- For use when praziquantel treatment fails.
- > 1 month.
- Only for the presumptive treatment of epidemic meningitis in children older than two years.
- Cloxacillin, dicloxacillin, and flucloxacillin are preferred for oral administration due to better bioavailability
- Use in children <8 years only for life-threatening infections when no alternative exists.
- 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.
- Third-generation cephalosporin of choice for use in hospitalized neonates.
- Erythromycin is an alternative.
- Vancomycin powder for injection may also be used for oral administration
- 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
- Prothionamide is an alternative for multidrug-resistant tuberculosis
- Imipenem/cilastatin is an alternative
- 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
- For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis
- Anidulafungin and caspofungin are alternatives
- > six weeks
- > three years
- ≥ 4 weeks and ≥ 3 kg; ≥ 25 kg
- For use in second-line regimens in accordance with WHO treatment guidelines
- Severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
- For the treatment of cytomegalovirus retinitis (CMVr).
- Pangenotypic when used in combination with sofosbuvir
- Pangenotypic when used in combination with daclatasvir
- Proposed for deletion in 2027
- > 25 kg
- Tinidazole is an alternative
- 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
- For use in the management of severe malaria
- For pre-referral treatment of severe malaria only.
- For use only for the treatment of Plasmodium vivax infection
- For use to reduce the transmission of Plasmodium falciparum and for radical cure of Plasmodium vivax and Plasmodium ovale infections
- For use only for prophylaxis of Plasmodium vivax infection
- > eight years
- For the treatment of 1st and 2nd stage human African trypanosomiasis due to Trypanosoma brucei gambiense infection
- To be used for the treatment of Trypanosoma brucei gambiense infection
- To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection
- Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection
- Etanercept and infliximab are alternatives, including quality-assured biosimilars
- Including quality-assured biosimilars
- 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
- Epoetin alfa, beta and theta; darbepoetin alfa; and their quality-assured biosimilars are alternatives
- Alternatives are dalteparin and nadroparin, including their quality-assured biosimilars
- Acenocoumarol is an alternative
- Deferiprone is an alternative
- 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
- Polygeline, injectable solution, 3.5% is an alternative
- > two months
- Calcitriol and tacalcitol are alternatives
- Podophyllotoxin is an alternative
- Certolizumab pegol, etanercept, and infliximab, including quality-assured biosimilars, are alternatives
- Precipitated sulfur topical ointment is an alternative
- Atropine and cyclopentolate are alternatives
- Chlorothiazide and chlorthalidone are alternatives
- In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
- Insulin glargine, Insulin degludec, and insulin detemir, including quality-assured biosimilars, are alternatives
- Insulin lispro, Insulin aspart, and insulin glulisine, including quality-assured biosimilars, are alternatives
- Carbimazole is an alternative depending on local availability
- For use when alternative first-line treatment is not appropriate or available
- Exact type to be defined locally.
- Atracurium is an alternative
- Amikacin, kanamycin, netilmicin, and tobramycin are alternatives
- Chlortetracycline and oxytetracycline are alternatives
- Cyclopentolate hydrochloride or homatropine hydrobromide are alternatives only for the EMLc
- dinoprostone (prostaglandin E2) is an alternative
- Indometacin is an alternative
- Beclometasone, ciclesonide, fluticasone, and mometasone are alternatives
- Terbutaline is an alternative
- Ergocalciferol is an alternative
- For use for rheumatic fever, juvenile arthritis, Kawasaki disease
- Triamcinolone acetonide is an alternative
- Of any type for use as dental sealant
- Of any type for use as dental filling material
References
Further reading
External links
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