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2 | SENARAI UBAT BAGI PERMOHONAN PUKAL | ||||||||||||||||||||||||
3 | Surat-surat ini boleh dicapai melalaui Intranet Pharmacy: Dashboard » Community » Cawangan Pengurusan Formulari » Seksyen Ubat Khas | ||||||||||||||||||||||||
4 | Bil. | NAMA UBAT | INDIKASI | SYARAT TAMBAHAN | NO. RUJ. SURAT | TARIKH SURAT | CATATAN | ||||||||||||||||||
5 | 1 | Abacavir Sulfate 300mg tab | Retroviral disease with renal impairment | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | |||||||||||||||||||
6 | 2 | Amphotericin B Lipid Complex 50mg Injection | Invasive fungal infections | Dikhaskan untuk pesakit yang refractory, intolerant atau mempunyai toksisiti terhadap amphotericin B konvensional | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
7 | 3 | Anagrelide 0.5mg cap | Essential thrombocytosis | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | |||||||||||||||||||
8 | 4 | Azithromycin 250mg Tablet | Rhodococcus infection with U/L RVD positive | - | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
9 | 5 | Diltiazem SR 100mg Capsule | 1) Tacrolimus-sparing agent. 2) Anti-proteinuria in CKD | Dikhaskan untuk pesakit yang diberi diltiazem 20mg tetapi mempunyai beban ubat (pill burden) yang tinggi | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
10 | 6 | Eplerenone 50mg Tablet | Primary hyperaldosteronism | Dikhaskan untuk pesakit yang mengalami kesan advers dengan ubat sprinolactone | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
11 | 7 | Human Normal Globulin Injection | ABOI Transplant | - | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
12 | 8 | Human Normal Globulin (lvlG) lnj. | 1 . Myasthenia gravis/myasthenic crisis 2. Guillain Barre syndrome / acute inflammatory demyelinating neuropathy (AIDP) 3. Chronic inflammatory demyelinating neuropathy (CIDP) 4. Multifocal motor neuropathy 5. Systemic lupus erythematosus (SLE) | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | *indikasi Myasthenia Gravis dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
13 | 9 | Levofloxacin 500mg Tablet | Rhodococcus infection with U/L RVD positive | - | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
14 | 10 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Myasthenia gravis | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
15 | 11 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Systemic lupus erythematosus (SLE) | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | |||||||||||||||||||
16 | 12 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Neuromyelitis optica spectrum disorders (NMOSD) | Telah gagal / tidak sesuai menggunakan alternatif sedia ada iaitu Azathioprine | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
17 | 13 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Autoimmune Hepatitis | Dikhaskan untuk pesakit yang gagal / tidak dapat menggunakan rawatan dengan ubat steroid dan azathioprine. | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
18 | 14 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Non-Infectious Uveitis | Dikhaskan untuk pesakit yang gagal / tidak dapat menggunakan rawatan dengan ubat steroid atau cyclosporine. | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
19 | 15 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
20 | 16 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Interstitial Lung Disease in Systemic Sclerosis (Scleroderma) | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
21 | 17 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Polymyositis / Dermatomyositis | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
22 | 18 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Thyroid Eye Disease (also called Graves’ Orbitopathy [GO] or ophthalmopathy) | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
23 | 19 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Immune Thrombocytopenic Purpura | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
24 | 20 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Pemphigus Foliaceus | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
25 | 21 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | ANCA-Associated Vasculitis (AAV) | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
26 | 22 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Recalcitrant Bullous Pemphigoid | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
27 | 23 | Mycophenolate Mofetil (MMF) 250mg and/or 500mg Tablet | Pemphigus Vulgaris | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
28 | 24 | Rituximab 500mg/50ml Injection | Multiple sclerosis (relapsing remitting MS (RRMS), aggressive MS) | - | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
29 | 25 | Rituximab 500mg/50ml Injection | ABOI Transplant | - | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
30 | 26 | Rituximab 500mg/50ml Injection | Pemphigus Vulgaris & Pemphigus Foliaceus | Dikhaskan untuk pesakit yang gagal/tidak dapat menggunakan rawatan dengan ubat azathioprine atau mycophenolate | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
31 | 27 | Rituximab 500mg/50ml Injection | Lupus Nephritis (LN) | Dikhaskan untuk severe / refractory SLE | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
32 | 28 | Rituximab 500mg/50ml Injection | Myasthenia Gravis (MG) | ▪ Dikhaskan untuk MuSK-Ab+ MG yang tidak menunjukkan respons terhadap initial immunotherapy ▪ Dikhaskan untuk AChR-Ab+ MG yang gagal atau tidak dapat tolerate Immunosuppresive agents lain | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | *indikasi refractory MG dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
33 | 29 | Rituximab 500mg/50ml Injection | Neuromyelitis Optica Spectrum Disorder (NMOSD) | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
34 | 30 | Rituximab 500mg/50ml Injection | Membranous Nephropathy | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
35 | 31 | Rituximab 500mg/50ml Injection | Dermatomyositis | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
36 | 32 | Rituximab 500mg/50ml Injection | Immune Mediated Necrotising Myositis | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
37 | 33 | Rituximab 500mg/50ml Injection | Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | *indikasi refractory CIDP dikecualikan permohonan UKK (tarikh kemaskini: 12/9/24) | ||||||||||||||||||
38 | 34 | Rituximab 500mg/50ml Injection | Refractory NMDAR Encephalitis | Dikhaskan untuk pesakit yang tidak menunjukkan respon terhadap rawatan dengan IV Methylprednisolone dan IVIG | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
39 | 35 | Rituximab 500mg/50ml Injection | Nephrotic Syndrome | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
40 | 36 | Rituximab 500mg/50ml Injection | ANCA Vasculitis / CNS Vasculitis | - | KKM.600-34/4/15 Jld.4(65) | 3/4/2024 | |||||||||||||||||||
41 | 37 | Sildenafil 100mg tab | 1. Pulmonary arterial hypertension 2. Persistent pulmonary hypertension of newborn (PPHN) | - | KKM.600-34/4/15 Jld.4(65) | 2/3/2020 | |||||||||||||||||||
42 | 38 | Sildenafil 50mg tab | 1. Pulmonary arterial hypertension 2. Persistent pulmonary hypertension of newborn (PPHN) | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | |||||||||||||||||||
43 | 39 | Syrup Methadone 5mg/ml | Pain control in cancer | a) Dikhaskan untuk pesakit yang tidak mencapai kesan analgesia yang memadai dengan ubat opioid yang tersenarai dalam FUKKM. b) Dikhaskan untuk pesakit yang mengalami kesan advers dengan opioid yang tersenarai dalam FUKKM | KKM.600-34/4/15 Jld.4(30) | 23/11/2022 | |||||||||||||||||||
44 | 40 | Vigabatrin 500mg tab | lnfantile spasm | - | KKM.600-34/4/15 Jld.3(38) | 2/3/2020 | |||||||||||||||||||
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