[PDF] Tabela de Medicamentos Hospitalar do SiSau - HPM

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral

CODIGO BENEFICIO 95000003 MEDICAMENTOS 95011811 AAS 95011790 AAS 95011781 AAS 95011773 AAS 95011820 AAS 95011803 AAS 95011838 AAS

APRESENTAÇÃO

Laboratorio

Ad, 2 x 10 cprs, Ad, 50 x 10 cprs, emb, mult, Fracao de venda cprs, 500 mg, (1 x 4) Fracao de venda e,m, 500 mg, (1 x 10) Inf, 120 cprs, Inf, 20 x 10 cprs, emb, mult, Inf, 3 x 10 cprs,

SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS

COMP COMP COMP COMP COMP COMP COMP

0,45 0,46 0,45 0,46 0,30 0,33 0,32

9 10 11 12 13 14 15 16 17 18 19 20 21

95989501 ABELCET 95034544 ABILIFY 95137106 ABILIFY 95920579 ABILIFY 95989528 ABILIFY 95989536 ABILIFY 95989544 ABILIFY 95989552 ABILIFY 95130020 ABLOK 95130012 ABLOK 95130039 ABLOK 95130055 ABLOK PLUS 95130047 ABLOK PLUS

5mg/ml sus,inj,est, cart,1FA vd,inc,x2 10 mg, cart, 1 bl, x 10 cprs, 10 mg. cart. 1 bl. x 30 cprs. 15 mg, cart, 1 bl, x 10 cprs, 15 mg, cart, 3 bl, x 10 cprs, 20 mg, cart, 1 bl, x 10 cprs, 20 mg, cart, 3 bl, x 10 cprs, 30 mg, cart, 3 bl, x 10 cprs, 100 mg, cx, 30 cprs, 25 mg, cx, 30 cprs, 50 mg, cx, 30 cprs, 100 mg/25 mg, cx, 30 cprs, 50 mg/12,5 mg, cx, 30 cprs,

BAGO B-MS B-MS B-MS B-MS B-MS B-MS B-MS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS

F.A. CP COMP CPR COMP COMP COMP COMP CPR CPR CPR CPR CPR

1950,11 14,95 13,76 21,22 22,43 28,29 28,29 42,44 0,82 0,32 0,50 1,07 0,66

22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38

95920587 ABRILAR 95310010 ABSTEN S 95840010 ACARSAN 95200010 ACCOLATE 95130071 ACCUPRIL 95130063 ACCUPRIL 95049614 ACEBROFILINA - GENERICO 95007962 ACEBROFILINA - GENERICO 95025685 ACEBROFILINA - GENERICO 95025693 ACEBROFILINA - GENERICO 95011862 ACEBROFILINA - GENERICO 95989560 ACEBROFILINA - GENERICO 95989579 ACEBROFILINA - GENERICO 95989587 ACEBROFILINA - GENERICO 95989595 ACEBROFILINA - GENERICO 95989609 ACEBROFILINA - GENERICO 95200053 ACEBROFILINA - GENERICO

Xpe, 100 ml 1 mg, 2 str, x 10 cprs, Liq, vd, 80cc 20 mg, cx, 28 cprs, 10 mg,cx,28cprs,rev, 20 mg,cx,28cprs,rev, 10 mg/ml xpe, 120 ml 10 mg/ml xpe, ad, fr, 120 ml 10 mg/ml xpe, ct, fr, vd, amb, x 120 ml+ cp, med, 10 mg/ml xpe, cx, 50 fr, plas, amb, x 120 ml+ 50 cp, med, ( 10 mg/ml xpe, fr, vd, 120 ml+ cp, med, 10 mg/ml xpe, fr, vd, 120 ml+ cp, med, 10 mg/ml xpe, fr, vd, 120 ml+ dos, 25 mg/5 ml 120 ml+ copo med, 25 mg/5 ml xpe, fr, 120 ml 25 mg/5 ml xpe, fr, 120 ml 25 mg/5 ml xpe, inf, fr, 120 ml,

FARMOQUIMICA MEDLEY BIOSINTETICA ASTRAZENECA PFIZER PFIZER MEPHA-RATIOPHARM NEO QUIMICA PRATI DONADUZZI PRATI DONADUZZI FARMASA BIOSINTETICA MEDLEY EMS GERMED GEN - LEGRAND EUROFARMA

ML CPR ML CPR CPR CPR ML ML GOTA FR ML ML ML ML ML ML ML

0,26 0,46 0,09 2,22 1,53 2,55 0,12 15,08 0,01 8,84 0,11 0,11 0,13 0,09 0,09 0,10 0,09

1 2 3 4 5 6 7 8

UNIDADE Pco Unt Base A

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76

CODIGO BENEFICIO 95049606 ACEBROFILINA - GENERICO 95025723 ACEBROFILINA - GENERICO 95025731 ACEBROFILINA - GENERICO 95011870 ACEBROFILINA - GENERICO 95989617 ACEBROFILINA - GENERICO 95989625 ACEBROFILINA - GENERICO 95011854 ACEBROFILINA - GENERICO 95007970 ACEBROFILINA - GENERICO 95989633 ACEBROFILINA - GENERICO 95200061 ACEBROFILINA - GENERICO 95989641 ACEBROFILINA - GENERICO 95989650 ACEBROFILINA - GENERICO 95920595 ACECLOFENACO - GENERICO 95920609 ACECLOFENACO - GENERICO 95034609 ACECLOFENACO - GENERICO 95034617 ACECLOFENACO - GENERICO 95136991 ACECLOFENACO - GENERICO 95136983 ACECLOFENACO - GENERICO (*) 95137009 ACECLOFENACO - GENERICO (*) 95137017 ACECLOFENACO - GENERICO (*) 95126635 ACECLO-GRAN 95460012 ACEMEDROX 95136169 ACESYL 95840036 ACET TRIANC +GRAM +NEOM +NIST - GENERICO 95840028 ACET TRIANC +GRAM +NEOM +NIST - GENERICO 95025766 ACETAMIL 95043039 ACETAMIL 95025774 ACETAMIL 95046070 ACETATO DE DESMOPRESSINA - GENERIC 95045899 ACETATO DE CLOSTEBOL + SULFATO DE NEOM 95045902 ACETATO DE CLOSTEBOL + SULFATO DE NEOM 95034625 ACETATO DE DEXAMETASONA - GENERICO 95011889 ACETATO DE DEXAMETASONA - GENERICO 95008020 ACETATO DE DEXAMETASONA - GENERICO 95011897 ACETATO DE HIDROCORTISONA - GENERICO 95920625 ACETATO DE HIDROCORTISONA - GENERICO 95989749 ACETATO DE HIDROCORTISONA - GENERICO 95070397 ACETATO DE CIPROTERONA GENERICO

APRESENTAÇÃO 5 mg/ml xpe, 120 ml 5 mg/ml xpe, ct, fr, vd, amb, x 120 ml+ cp, med, 5 mg/ml xpe, cx, 50 fr, plas, amb, x 120 ml+ 50 cp, med, (e 5 mg/ml xpe, fr, vd, 120 ml+ cp, med, 5 mg/ml xpe, fr, vd, 120 ml+ cp, med, 5 mg/ml xpe, fr, vd, 120 ml+ dos, 5 mg/ml xpe, fr, vd, x 120 ml+ cp, med, 10 ml 5 mg/ml xpe, inf, fr, 120 ml 50 mg/5 ml 120 ml+ copo med, 50 mg/5 ml xpe, ad, fr, 120 ml, 50 mg/5 ml xpe, fr, 120 ml 50 mg/5 ml xpe, fr, 120 ml 100 mg, 1 str, x 12 cprs, 100 mg, 2 str, x 12 cprs, 15 mg/g creme derm, bisn, 30 g Creme bisn, 30 g 100 mg. 2 bl. x 6 cprs. rev. 100 mg. 2 bl. x 6 cprs. rev. 100 mg. 2 bl. x 6 cprs. rev. 100 mg. 4 bl. x 6 cprs. rev. 100 mg, 2 bl, x 6 cprs, rev, Cx, 5 cprs, 100 mg/ml sol, inj, cx, 50 amps, vd, amb, x 1 ml Creme bisn, 30 g, Pom, bisn, 30 g, 750 mg, cx, 25 bl, x 4 cprs, Gts, 200 mg/ml (fr, c/20 ml) Gts,200mg/mlfr,15 ml 0,1 mg/ml spray nasal 1 fr, 2,5 ml 5 mg/g+ 5 mg/g creme derm, bisn, 30 g 5 mg/g+ 5 mg/g creme vag, bisn, 45 g+ 8 aplic, 1 mg/g crem, derm, ct, bg, al, x 10 g 1 mg/g creme derm, bisn, 10 g 1 mg/g creme derm, cx, 100 bisn, 10 g (Hosp,) 10 mg/g creme derm, bisn, 20 g Creme bisn 30 g, Pom, bisn, 30 g 100 mg, bl, 20 cprs,

Laboratorio MEPHA-RATIOPHARM PRATI DONADUZZI PRATI DONADUZZI FARMASA BIOSINTETICA MEDLEY UNIAO QUIMICA NEO QUIMICA EMS EUROFARMA GERMED GEN - LEGRAND RANBAXY RANBAXY EMS GERMED GEN - LEGRAND EMS GERMED GERMED LEGRAND BUNKER CASULA E VASCONCELOS EUROFARMA EUROFARMA DUCTO DUCTO DUCTO BERGAMO MEDLEY MEDLEY PRATI DONADUZZI UNIAO QUIMICA PRATI DONADUZZI UNIAO QUIMICA ATIVUS ATIVUS BERGAMO

UNIDADE Pco Unt Base A ML 0,09 GOTA 0,00 FR 5,89 ML 0,08 ML 0,09 ML 0,09 ML 0,12 ML 11,12 ML 0,13 ML 0,13 ML 0,13 ML 0,13 CPR 1,41 CPR 2,64 G 0,41 G 0,41 CPR 1,35 CPR 1,41 CPR 1,43 ENV 1,32 COMP 2,90 CPR 1,17 AMP 6,64 G 0,60 G 0,55 CPR 0,25 GOTA 0,01 GOTA 0,00 DOSE 0,45 G 0,46 G 0,53 G 0,49 GRAMA 0,43 GRAMA 2,76 GRAMA 0,29 G 0,25 G 0,28 COMP 4,35

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114

CODIGO BENEFICIO APRESENTAÇÃO 95070389 ACETATO DE CIPROTERONA GENERICO 50 mg, bl, 20 cprs, 95049622 ACETATO DE CLOSTEBOL + SULFATO DE NEOMICINA - GENERICO 5 mg/g+ 5 mg/g creme derm, bisn, 30 g 95049630 ACETATO DE CLOSTEBOL + SULFATO DE NEOMICINA - GENERICO 5 mg/g+ 5 mg/g creme vag, bisn, 45 g+ 8 aplic, 95049649 ACETATO DE DESMOPRESSINA - GENERICO 0,1 mg/ml spray nasal 1 fr, 2,5 ml 95049657 ACETATO DE DESMOPRESSINA - GENERICO 0,1 mg/ml spray nasal1 fr, 5 ml 95049673 ACETATO DE DEXAMETASONA GENERICO 1 mg/g creme 10 g 95049665 ACETATO DE DEXAMETASONA GENERICO 1 mg/g creme derm, bisn, 10 g 95049690 ACETATO DE DEXAMETASONA GENERICO 1 mg/g creme derm, bisn, 10 g 95119132 ACETATO DE DEXAMETASONA - GENERICO (Restrito Hosp,) 1 mg/g creme derm, 10 g c/50 (hosp,) 95081194 ACETATO DE HIDROCORTISONA - GENERICO 10 mg/g creme derm, bisn, 15 g 95081186 ACETATO DE HIDROCORTISONA - GENERICO 10 mg/g creme derm, bisn, 30 g 95081208 ACETATO DE HIDROCORTISONA - GENERICO 10 mg/g creme derm, cx, 50 bisn, x 30 g (hosp,) 95450017 ACETATO DE PREDNISOLONA - GENERICO 1% fr, 5 ml, 95581260 ACETATO DE SODIO 2 mEq/ML - AMP 10 ML 95581278 ACETATO DE ZINCO 0,5 mEq/ML - AMP 2 ML 95920633 ACETICIL 100 mg, cx, 200 cprs, 95920641 ACETICIL 500 mg, cx, 500 cprs, 95011900 ACETILCISTEINA - GENERICO 10% sol, inj, 5 amps, vd, x 3 ml 95250042 ACETILCISTEINA - GENERICO 100 mg 16 x 5 g, 95025790 ACETILCISTEINA - GENERICO 100 mg, 10 envs, x 5 g 95012028 ACETILCISTEINA - GENERICO 100 mg, 16 envs, x 5 g 95094890 ACETILCISTEINA - GENERICO 100 mg, 16 envs, x 5 g 95025804 ACETILCISTEINA - GENERICO 100 mg, gran, 10 envs, x 5 g 95008047 ACETILCISTEINA - GENERICO 100 mg, gran, 16 envs, x 5 g 95011919 ACETILCISTEINA - GENERICO 100 mg, gran, 16 envs, x 5 g 95011935 ACETILCISTEINA - GENERICO 100 mg, gran, fracao 95008055 ACETILCISTEINA - GENERICO 100 mg/g gran, ct, 16 envs, x 5 g 95011927 ACETILCISTEINA - GENERICO 100mg,gran,60 x 5 g 95119140 ACETILCISTEINA - GENERICO 120 mg/g gran, ct, 200 envs, x 5 g (emb, mult,) 95049703 ACETILCISTEINA - GENERICO 120 mg/g gran, ct, c/16 envs, x 5 g 95012001 ACETILCISTEINA - GENERICO 20 mg/g gran, 16 envs, x 5 g 95043047 ACETILCISTEINA - GENERICO 20 mg/ml xpe, fr, 100 ml+ cp, med, 95008063 ACETILCISTEINA - GENERICO 20 mg/ml xpe, fr, vd, x 100 ml 95008071 ACETILCISTEINA - GENERICO 20 mg/ml xpe, fr, vd, x 150 ml 95008080 ACETILCISTEINA - GENERICO 20 mg/ml xpe, inf, fr, 120 ml 95008098 ACETILCISTEINA - GENERICO 20 mg/ml xpe, inf, fr, 120 ml 95008101 ACETILCISTEINA - GENERICO 20 mg/ml xpe, inf, fr, 120 ml 95034676 ACETILCISTEINA - GENERICO 20,0 mg/ml, xpe, ct, fr, vd, amb, x 100 ml,+ copo med,

Laboratorio BERGAMO MEDLEY MEDLEY BERGAMO BERGAMO TEUTO BRAS, EMS GERMED TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, ALCON B, BRAUN B, BRAUN CAZI CAZI UNIAO QUIMICA EUROFARMA GEN - LEGRAND GERMED GEN - LEGRAND EMS FARMASA EMS MEDLEY MEDLEY MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI BRAINFARMA FARMASA FARMASA EMS GERMED GEN - LEGRAND PRATI DONADUZZI

UNIDADE Pco Unt Base A COMP 2,30 G 0,46 G 0,53 JATO 0,90 JATO 0,97 G 0,49 G 0,49 G 0,49 GRAMA 0,32 G 0,37 G 0,33 G 0,30 GOTAS 0,14 AMP 1,50 AMP 0,81 CPR 0,09 CPR 0,13 AMP 1,61 ENV 0,79 ENV 0,79 ENV 0,52 ENV 0,67 ENV 0,74 ENV 0,53 ENV 0,64 ENV 0,48 ENV 0,60 ENV 0,48 ENV 1,03 ENV 1,89 ENV 0,78 ML 0,10 ML 3,56 ML 9,91 ML 14,54 ML 13,13 ML 13,88 ML 0,14

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152

CODIGO BENEFICIO 95094903 ACETILCISTEINA - GENERICO 95984011 ACETILCISTEINA - GENERICO 95094911 ACETILCISTEINA - GENERICO 95025839 ACETILCISTEINA - GENERICO 95008128 ACETILCISTEINA - GENERICO 95094920 ACETILCISTEINA - GENERICO 95011943 ACETILCISTEINA - GENERICO 95011951 ACETILCISTEINA - GENERICO 95008136 ACETILCISTEINA - GENERICO 95008110 ACETILCISTEINA - GENERICO 95011986 ACETILCISTEINA - GENERICO 95008144 ACETILCISTEINA - GENERICO 95008152 ACETILCISTEINA - GENERICO 95008160 ACETILCISTEINA - GENERICO 95081216 ACETILCISTEINA - GENERICO 95989765 ACETILCISTEINA - GENERICO 95025863 ACETILCISTEINA - GENERICO 95008195 ACETILCISTEINA - GENERICO 95008209 ACETILCISTEINA - GENERICO 95011960 ACETILCISTEINA - GENERICO 95011978 ACETILCISTEINA - GENERICO 95008217 ACETILCISTEINA - GENERICO 95025847 ACETILCISTEINA - GENERICO 95008179 ACETILCISTEINA - GENERICO 95008187 ACETILCISTEINA - GENERICO 95094938 ACETILCISTEINA - GENERICO 95250026 ACETILCISTEINA - GENERICO 95008233 ACETILCISTEINA - GENERICO 95330151 ACETOFEN 95012036 ACETOFLUX

APRESENTAÇÃO 20,0 mg/ml, xpe, ct, fr, vd, amb, x 150 ml, + copo med, 200 mg 16 x 5 g, 200 mg, 16 envs, x 5 g 200 mg, gran, 10 envs, x 5 g 200 mg, gran, 16 envs, x 5 g 200 mg, gran, 16 envs, x 5 g 200 mg, gran, 60 x 5 g 200 mg, gran, fracao 200 mg/g gran, ct, 16 envs, x 5 g 200mg,16envs,x5g 40 mg/g gran, 16 envs, x 5 g 40 mg/ml xpe, ad, fr, 120 ml 40 mg/ml xpe, ad, fr, 120 ml 40 mg/ml xpe, ad, fr, 120 ml 40 mg/ml xpe, ct, fr, vd, amb, x 120 ml+ cp, med, 600 mg 16 x 5 g, 600 mg, gran, 10 envs, x 5 g 600 mg, gran, 16 envs, x 5 g 600 mg, gran, 16 envs, x 5 g 600 mg, gran, 50 x 5 g 600 mg, gran, fracao 600 mg/g gran, ct, 16 envs, x 5 g 600mg,10envs,x5g 600mg,16envs,x5g 600mg,16envs,x5g Fracao Xpe 20 mg fr, 100 ml, Xpe, fr, 120 ml 200 mg/ml sol, oral 15 ml, 10 mg, bl, 14 cprs,

Laboratorio PRATI DONADUZZI EUROFARMA GERMED EMS FARMASA EMS MEDLEY MEDLEY MEDLEY GEN - LEGRAND PRATI DONADUZZI EMS GERMED GEN - LEGRAND PRATI DONADUZZI EUROFARMA EMS EMS FARMASA MEDLEY MEDLEY MEDLEY GEN - LEGRAND GERMED GEN - LEGRAND GEN - LEGRAND EUROFARMA UNIAO QUIMICA MEDLEY EMS

95012044 ACETOFLUX 95008241 ACETONIDA DE TRIANCINOLONA - GENER 95008250 ACETONIDA DE TRIANCINOLONA - GENER 95008268 ACETONIDA DE TRIANCINOLONA - GENER 95008276 ACETONIDA TRIANC, + GRAM, + NEOMICIN 95008284 ACETONIDA TRIANC, + GRAM, + NEOMICIN 95008306 ACETONIDA TRIANC, + GRAM, + NEOMICIN 95008314 ACETONIDA TRIANC, + GRAM, + NEOMICIN

10 mg, bl, 5 cprs, EMS 1 mg, pom, bucal bisn, 10 g PRATI DONADUZZI 1 mg/g bisn, 10 g GEN - LEGRAND 1 mg/g pom, bisn, 10 g GERMED 1 mg/g+ 2,5 mg/g+ 0,25 mg/g+ 100,000 U/G creme derm, bisn FARMASA 1 mg/g+ 2,5 mg/g+ 0,25 mg/g+ 100,000 U/G pom, derm, bisn, FARMASA 1,0+ 2,5+ 0,25 mg, pom, bisn, 30 g EMS Creme bisn, 30 g ARROW

UNIDADE Pco Unt Base A ML 0,10 COMP 0,89 ENV 0,56 ENV 0,78 ENV 0,61 ENV 0,80 ENV 0,54 ENV 0,54 ENV 0,67 ENV 0,60 ENV 0,87 ML 19,01 ML 17,49 ML 18,87 ML 0,16 ENV 1,97 ENV 1,49 ENV 1,44 ENV 1,29 ENV 1,20 ENV 1,20 ENV 1,49 ENV 1,94 ENV 1,45 ENV 1,53 UNID 0,72 ML 0,14 ML 0,12 GOTAS 0,03 COMP 1,10 COMP GRAMA GRAMA GRAMA GRAMA GRAMA GRAMA GRAMA

1,27 0,68 0,69 0,69 1,31 1,20 0,53 0,42

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190

CODIGO BENEFICIO APRESENTAÇÃO 95008322 ACETONIDA TRIANC, + GRAM, + NEOMICIN Creme bisn, 30 g 95008349 ACETONIDA TRIANC, + GRAM, + NEOMICIN Pom, bisn, 30 g 95094946 ACETONIDA TRIANC, + GRAM, + NEOMICINA + NISTATINA - GENERICO Pom, bisn, 30 g 95920684 ACFOL 5 mg, cx, 40 cprs, 95920692 ACFOL 5 mg, gts, fr, 10 ml 95049762 ACICLOVIR - GENERICO (*) 200 mg, 2 bl, x 5 cprs, 95920706 ACICLOVIR - GENERICO (*) 200 mg, 2 bl, x 5 cprs, 95920714 ACICLOVIR - GENERICO (*) 200 mg, 5 bl, x 5 cprs, 95049738 ACICLOVIR - GENERICO (*) 200 mg, com, ct, bl, al, plas, inc, x 30 95049746 ACICLOVIR - GENERICO (*) 200 mg, com, ct, bl, al, plas, inc, x 450 (emb, hosp,) 95049754 ACICLOVIR - GENERICO (*) 200 mg, com,ct, bl, al,plas, inc, x 10 95989790 ACICLOVIR - GENERICO (*) 200 mg, cx, 5 bl, x 5 cprs, 95049711 ACICLOVIR - GENERICO (*) 200 mg, fr, plast, 25 cprs, 95049770 ACICLOVIR - GENERICO (*) 200mg,5 bl,x5 cprs, 95049720 ACICLOVIR - GENERICO (*) 400 mg fr, plast, 30 cprs, 95400133 ACICLOVIR - GENERICO 200 mg, 2 bl, x 5 cprs, 95400141 ACICLOVIR - GENERICO 200 mg, 5 bl, x 5 cprs, 95043063 ACICLOVIR - GENERICO 200 mg, bl, 10 cprs, 95043055 ACICLOVIR - GENERICO 200 mg, bl, 25 cprs, 95400150 ACICLOVIR - GENERICO 400 mg, 5 bl, x 5 cprs, 95008373 ACICLOVIR - GENERICO 400 mg,1bl,x10 cprs, 95049797 ACICLOVIR - GENERICO 50 mg/g cr, derm, bisn, 10 g 95034684 ACICLOVIR - GENERICO 50 mg/g crem, derm, ct, bg, al, x 10 g 95012052 ACICLOVIR - GENERICO 50 mg/g creme bisn, 10 g 95025960 ACICLOVIR - GENERICO 50 mg/g creme bisn, 10 g 95008381 ACICLOVIR - GENERICO 50 mg/g creme derm, bisn, 10 g 95094954 ACICLOVIR - GENERICO 50 mg/g creme derm, bisn, 10 g 95920757 ACICLOVIR - GENERICO 50 mg/g creme derm, bisn, 10 g 95989838 ACICLOVIR - GENERICO 50 mg/g creme derm, bisn, 10 g cx, c/100 95094962 ACICLOVIR - GENERICO 50 mg/g creme derm, bisn, 10 gr, 95400095 ACICLOVIR - GENERICO 50 mg/g creme derm, cx, 1 bisn, 10 g, 95094970 ACICLOVIR - GENERICO 50 mg/g creme derm, x 10 g 95094989 ACICLOVIR - GENERICO 50 mg/g creme derm, x 10 g 95081224 ACICLOVIR - GENERICO Creme 10 g 95400109 ACICLOVIR - GENERICO Creme 50 mg/g bisn, 10 g 95400079 ACICLOVIR - GENERICO Creme 50 mg/g bisn, 10 g, 95008390 ACICLOVIR - GENERICO Creme bisn, 10 g 95008403 ACICLOVIR - GENERICO Creme bisn, 10 g

Laboratorio GERMED ARROW NEO QUIMICA CAZI CAZI MEPHA-RATIOPHARM RANBAXY RANBAXY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA MERCK MEPHA-RATIOPHARM MERCK RATIOPHARM RATIOPHARM BRAINFARMA BRAINFARMA RANBAXY RANBAXY MEPHA-RATIOPHARM PRATI DONADUZZI UNIAO QUIMICA DUCTO BLAUSIEGEL SANDOZ EMS PRATI DONADUZZI CIFARMA CRISTALIA ACHE BIOSINTETICA MULTILAB NEO QUIMICA TEUTO BRAS, GERMED GEN - LEGRAND

UNIDADE Pco Unt Base A GRAMA 0,52 G 0,42 G 0,54 CPR 0,18 GOTAS 0,03 COMP 3,88 CPR 1,95 CPR 1,62 COMP 1,92 COMP 0,87 COMP 2,23 COMP 2,32 COMP 2,59 COMP 2,69 COMP 3,93 CPR 3,88 CPR 2,69 CP 3,91 CP 2,84 CPR 3,25 COMP 3,90 G 1,31 G 1,17 GRAMA 1,67 UND 9,33 GRAMA 14,36 GRAMA 1,43 G 1,33 G 0,87 GRAMA 1,09 G 1,30 GRAMA 1,17 GRAMA 1,17 G 1,13 G 1,23 G 1,20 GRAMA 1,17 GRAMA 1,29

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228

CODIGO BENEFICIO APRESENTAÇÃO 95049789 ACICLOVIR - GENERICO Creme derm, 50 mg/g bisn, 10 g 95400087 ACICLOVIR - GENERICO Creme derm, bisn, 10 g, 95094997 ACICLOVIR - GENERICO (*) 200 mg, bl, 25 cprs, 95119159 ACICLOVIR - GENERICO (*) 200 mg, bl, 25 cprs, 95081232 ACICLOVIR - GENERICO (*) 200 mg, com, ct, bl, al, plas, inc, x 10 95119167 ACICLOVIR - GENERICO (*) 200 mg, com, ct, bl, al, plas, inc, x 280 (frac,) 95119175 ACICLOVIR - GENERICO (Restrito Hosp,) 250 mg, po liof, IV inj, cx, 50 FA x 20 ml (hosp,) 95119183 ACICLOVIR - GENERICO (Restrito Hosp,) 250 mg, po liof, IV inj, cx, c/5 FA x 20 ml (hosp,) 95008411 ACIDO ACETIL SALICILICO - GENERICO 100 mg, 100 cprs, 95989846 ACIDO ACETIL SALICILICO - GENERICO 100 mg, 20 bl, x 10 cprs, 95989854 ACIDO ACETIL SALICILICO - GENERICO 100 mg, 3 bl, x 10 cprs, 95330208 ACIDO ACETIL SALICILICO - GENERICO 500 mg, cx, 20 bl, x 10 cprs, 95081240 ACIDO FUSIDICO - GENERICO Creme 20 mg/g bisn, 15 g 95049819 ACIDO MEFENAMICO - GENERICO 500 mg, bl, 12 cprs, 95008420 ACIDO MEFENAMICO - GENERICO 500 mg, bl, 24 cprs, 95049800 ACIDO MEFENAMICO - GENERICO 500 mg, bl, 24 cprs, 95070400 ACIDO MEFENAMICO - GENERICO 500mg,2bl,x12cprs, 95070419 ACIDO MEFENAMICO - GENERICO 500mg,2bl,x12cprs, 95070427 ACIDO MEFENAMICO - GENERICO 500mg,2bl,x12cprs, 95119191 ACIDO TRANEXAMICO - GENERICO 250 mg, bl, 12 cprs, 95119205 ACIDO ZOLEDRONICO - GENERICO (ICMS 0%) (Restrito Hosp,) 4 mg, sol, inj, IV FA plast, inc, x 5 ml 95989862 ACINIC 500 mg, 30 cprs, LP 95989870 ACINIC 750 mg, 30 cprs, LP 95400168 ACIVERAL Creme tb, 10 g, 95400176 ACIVERAL (*) 200 mg, cx, 25 cprs 95008446 ACIVERAL (*) 400 mg, cx, 70 cprs, 95012079 ACIVIRAX 200 mg, 25 cprs, 95049827 ACIVIRAX Creme derm, bisn,10g 95898727 ACLASTA 5 mg, 100 ml 1 x 1 95119213 ACTEMRA (Restrito Hosp,) 20 mg/ml sol, inj, infus, IV ct, FA vd, inc, x 10 ml 95119221 ACTEMRA (Restrito Hosp,) 20 mg/ml sol, inj, infus, IV ct, FA vd, inc, x 4 ml 95480013 ACTICALCIN 100 UI inj, 5 amps, 95480021 ACTICALCIN 50 UI inj, 5 amps, 95750258 ACTIFEDRIN Cx, 20 cprs, 95750266 ACTIFEDRIN Vd, 100 ml, elixir 95620010 ACTILYSE rt, PA Fr, amp, 50 mg, 95480072 ACTONEL 5 mg, bl, 14 cprs, rev, 95480099 ACTONEL 35 MG UMA VEZ POR SEMANA 35 mg 1 bl, al/pvc inc x 2 cprs, rev,

Laboratorio MERCK MEDLEY SANDOZ ACHE PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, TEUTO BRAS, EMS EMS EMS EMS NEO QUIMICA MEDLEY BIOSINTETICA MEDLEY EMS GERMED GEN - LEGRAND GEN - LEGRAND EUROFARMA BIOLAB SANUS BIOLAB SANUS BUNKER BUNKER BUNKER CIFARMA CIFARMA NOVARTIS ROCHE ROCHE TRB-PHARMA TRB-PHARMA FARMOQUIMICA FARMOQUIMICA BOEHRINGER INGELHEIM SANOFI-AVENTIS SANOFI-AVENTIS

UNIDADE Pco Unt Base A G 1,11 G 1,29 COMP 2,30 COMP 2,02 COMP 2,23 COMP 1,04 FA 42,73 FA 42,73 COMP 0,16 COMP 0,14 COMP 0,15 CPR 0,13 G 1,31 COMP 0,44 COMP 0,43 COMP 0,44 COMP 0,44 COMP 0,44 COMP 0,44 COMP 1,69 FA 606,91 COMP 1,17 COMP 1,18 G 1,52 CPR 1,95 COMP 3,60 COMP 1,56 G 1,14 FR 1167,11 X FA 1315,13 FA 526,05 AP 27,54 AP 15,67 CPR 0,32 ML 0,07 FA 1379,57 X CPR 75,25 CPR 38,89

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266

CODIGO BENEFICIO 95180010 ACTOS 95180028 ACTOS 95180036 ACTOS 95160019 ACTPARIN 95160027 ACTPARIN 95670017 ACULAR 95034692 ACULAR 95095004 ACULAR 95670025 ACULAR 95590358 AD ELEMENT 95130101 ADALAT 95130110 ADALAT 95130128 ADALAT 95130136 ADALAT 95130098 ADALAT 95012117 ADALAT 95008489 ADAPALENO - GENERICO 95008497 ADAPALENO - GENERICO 95008500 ADAPALENO - GENERICO 95008519 ADAPALENO - GENERICO 95610081 ADEFORTE 95610073 ADEFORTE 95110011 ADENOCARD 95989889 ADENOCARD 95610103 ADEROGIL D3 95610111 ADEROGIL D3 95920838 AD-MUC 95136967 ADNAX 95920846 ADOLESS 95989897 ADPREX 95580026 ADRENOPLASMA 95580018 ADRENOPLASMA 95270019 ADRENOXIL 95989919 ADRENYL 95064273 ADRIBLASTINA RD 95064281 ADRIBLASTINA RD 95989927 ADVIL 95070435 ADVIL

APRESENTAÇÃO 15 mg, fr, 15 cprs, 30 mg, fr, 15 cprs, 45 mg, fr, 15 cprs, 5,000 UI 0,25 ml cx, 25 amps, 5,000 UI 5 ml cx, 50 FA Col, 5 ml LS fr, 10 ml LS fr, 5 ml SC 12 flac, AMP x 2 ML Fr, 60 caps, gel, Oros 20 mg, fr, 15 cprs, Oros 30 mg, fr, 15 cprs, Oros 60 mg, fr, 15 cprs, Retard 10 mg, fr, 30 cprs, Retard 20 mg, bl, x 30 cprs, 1 mg/g gel bisn, 30 g 1 mg/g gel bisn, 30 g 1 mg/g gel derm, bisn, poliet, 30 g 1 mg/g gel, bisn, 30 g Amp, 3 ml Fr, 15 ml 3 mg/ml 2 amps, x 2 ml 3 mg/ml 50 amps, x 2 ml Cx, 3 amps, Gts, fr, 10 ml, Pom, bisn, 10 g Fr. 20 ml 28 cprs, Cx, 30 caps, Fr, 500 ml, c/equipo Fr, 500 ml, s/equipo 5 mg, 5 x 1 cc Xpe, 100 ml 10 mg, fr, amp, 50 mg, fr, amp, 1 bl, 4 cprs, 200 mg, cx, 2 bl, x 10 cprs, (20 cprs,)

Laboratorio ABBOTT ABBOTT ABBOTT BERGAMO BERGAMO ALLERGAN ALLERGAN ALLERGAN ALLERGAN DARROW BAYER BAYER BAYER BAYER BAYER BAYER EMS GEN - LEGRAND BIOSINTETICA GERMED GROSS GROSS LIBBS LIBBS SANOFI-AVENTIS SANOFI-AVENTIS BIOLAB SANUS COSMED FARMOQUIMICA HEBRON CLIMAX CLIMAX CLIMAX UCI-FARMA PFIZER PFIZER WYETH CONSUMER WYETH CONSUMER

UNIDADE Pco Unt Base A CPR 3,53 CPR 3,73 CPR 7,29 CPR 1,46 FA 5,50 GOTAS 0,40 GOTA 0,32 GOTAS 0,32 UND 3,14 AMP 6,32 CPR 0,35 CPR 3,08 CPR 3,76 CPR 5,54 CPR 0,48 COMP 0,80 GRAMA 32,77 GRAMA 31,64 GRAMA 30,62 GRAMA 31,64 AP 5,73 GOTAS 0,10 AP 15,87 AMP 11,18 AP 1,43 GOTAS 0,03 G 1,54 ML 0,41 CPR 0,78 CAPS 1,69 GOTA 0,09 FR 23,64 CPR 2,08 ML 0,09 FA 30,59 FA 127,09 COMP 0,60 COMP 0,75

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304

CODIGO BENEFICIO 95070478 ADVIL 95049860 ADVIL 95070460 ADVIL 95070451 ADVIL 95049894 ADVIL 95012150 AEROCORT S 95200070 AERODINI 95200096 AEROFLUX 95012168 AEROGOLD 95200100 AEROJET 95200134 AEROJET 95200118 AEROJET 95200142 AEROJET 95200126 AEROJET 95200169 AEROLIN 95200185 AEROLIN 95200193 AEROLIN 95094407 AEROLIN 95200215 AEROLIN 95200177 AEROLIN 95095012 AEROLIN 95200223 AEROLIN 95989951 AEROMED 95200240 AEROTAMOL 95200258 AEROTAMOL 95920870 AEROTRAT 95920889 AEROTRAT 95920897 AFBM 95095020 AFINITOR 95095039 AFINITOR 95480110 AFOPIC 95119230 AFOPIC (Restrito Hosp,) 95750290 AFRIN 95750304 AFRIN 95750282 AFRIN 95750312 AFRIN 95750320 AFRIN 95012192 AG DERM

APRESENTAÇÃO 200 mg, cx, 50 bl, x 2 cprs, (100 cprs,) 200 mg, fracao de venda 1 bl, 2 cprs, 400 mg, cx, 12 bl, x 3 caps, (36 caps,) 400 mg, cx, 8 capsulas 400 mg, fracao de venda 1 bl, 3 caps, gel mole Spray 50/100 mcg 200 doses Sol, oral fr, 120 ml Sol, vd, 120 ml, (edulito) Lata 200 doses Cx, 20 cprs, 2 mg, Cx, 20 cprs, 4 mg, Spray 200 doses Spray c/espacador 200 doses Xpe, fr, 100 ml 2 mg, 20 cprs, 4 mg, cx, 20 cprs, Inj, 0,5 mg, 5 amps, 1 ml, Sol, neb, 1 mg/ml 20 amps, plast, trans, x 2,5 ml Sol, neb, fr, 10 ml, Spray 200 doses Spray 200 doses c/espacador Xpe fr, 120 ml, - sugar free Xpe, vd, 120 ml 2 mg, cx, 20 cprs Xpe, cx, 1 fr, 120 ml, 2 mg, cx, 20 cprs, 2 mg/5 mlxpe,fr,100ml 500 UI+ 100 mg,+ 300 mg, fr, 30 caps, gel, mole 10 mg, 30 cp, 5 mg, 30 cp, 5 mg, 20 cprs 5 mg, bl, 100 cprs, (hosp,) Ad, 12 H fr, 10 ml, Ad, 12 H fr, 30 ml, Oft, 20 ml Ped, fr, 20 ml, Sol, natural fr, 30 ml 10 mg/g creme derm, 50 bisn, 50 g

Laboratorio WYETH CONSUMER WYETH CONSUMER WYETH CONSUMER WYETH CONSUMER WYETH CONSUMER GLENMARK TEUTO BRAS, GLAXOSMITHKLINE GLENMARK CHIESI CHIESI CHIESI CHIESI CHIESI GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE MEDQUIMICA ROYTON ROYTON CAZI CAZI SIGMA PHARMA NOVARTIS NOVARTIS TEUTO BRAS, TEUTO BRAS, MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP ASPEN PHARMA

UNIDADE Pco Unt Base A COMP 0,75 COMP 0,75 COMP 1,42 COMP 1,41 CAPS 1,42 DOSE 0,14 ML 0,05 ML 0,07 DOSE 0,11 CPR 0,14 CPR 0,20 DOSE 0,10 DOSE 0,12 ML 0,05 CPR 0,15 CPR 0,22 AP 1,75 AMP 0,50 GOTAS 0,05 DOSE 0,12 DOSE 0,12 ML 0,05 ML 0,05 CPR 0,19 ML 0,06 CPR 0,15 ML 0,06 CPR 0,62 COMP 340,22 COMP 170,11 CPR 0,28 COMP 0,25 GOTAS 0,03 GOTAS 0,02 GOTAS 0,01 GOTAS 0,02 GOTAS 0,01 GRAMA 0,21

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342

CODIGO BENEFICIO 95095047 AG DERM 95012184 AG DERM 95049916 AGAROL 95230017 AGASTEN 95230025 AGASTEN 95026010 AGE DERM - LOCAO OLEOSA 95026029 AGE DERM - LOCAO OLEOSA 95026037 AGE DERM - LOCAO OLEOSA 95026045 AGE DERM - LOCAO OLEOSA 95026053 AGE DERM - LOCAO OLEOSA 95026061 AGE DERM - OILGEL 95400192 AGENERASE 95400206 AGENERASE 95050051 AGIOLAX - FITOTERAPICO 95050035 AGIOLAX - FITOTERAPICO 95050043 AGIOLAX - FITOTERAPICO 95095055 AGLITIL 95095063 AGLITIL 95095071 AGLITIL 95095080 AGLITIL 95008535 AGLUCOSE 95008543 AGLUCOSE 95119248 AGRASTAT 95012206 AGREAL 95049924 AGUA P/ INJECAO 95041630 AGUA P/ INJECAO 95049959 AGUA P/ INJECAO 95049940 AGUA P/ INJECAO 95049932 AGUA P/ INJECAO 95580077 AGUA P/ INJECAO 95580085 AGUA P/ INJECAO 95580069 AGUA P/ INJECAO 95580093 AGUA P/ INJECAO 95580140 AGUA P/ INJECAO 95580123 AGUA P/ INJECAO 95580131 AGUA P/ INJECAO 95580158 AGUA P/ INJECAO 95119256 AGUA P/ INJECAO (Restrito Hosp,)

APRESENTAÇÃO 10 mg/g creme derm, bisn, 100 g, 10 mg/g creme derm, bisn, 50 g 240 ml morango Blister 15 cprs, Xpe, vd, 120 ml, 100 ml Almotolia ou Spray - cx, 24 (IPI incluso) 20 ml Almotolia - cx, 100 (IPI incluso) 200 ml Almotolia ou Spray - cx, 24 (IPI incluso) 25 ml Almotolia - cx, 100 (IPI incluso) 500 ml Almotolia - cx, 12 (IPI incluso) 100 g tb, cx, 24 (IPI incluso) 150 mg, 240 caps, Sol, oral 240 ml, Cx, 20 envs, x 5 g Tubo 100 g, Tubo 250 g, 15 mg, fr, 15 cprs, 30 mg, fr, 15 cprs, 30 mg, fr, 30 cprs, 45 mg, fr, 15 cprs, 100mg,3 bl,x10 cprs, 50 mg, 3 bl, x 10 cprs, 0,25 mg/ml sol, inj, FA vd, x 50 ml Cx, 20 cprs, 10 ml 50 amps, 25 amps, plas, inc, x 10 ml 3 ml 50 amps, 4 ml 50 amps, 5 ml 50 amps, Amp, 10 ml, Amp, 20 ml, Amp, 5 ml, Cx, 100 x 2 ml Cx, 100 x 20 ml plast, Cx, 100 x 20 ml vidro Cx, 200 x 10 ml plast, Cx, 200 x 5 ml plast, Cx, 100 x 10 ml plast,

Laboratorio ASPEN PHARMA ASPEN PHARMA JOHNSON & JOHNSON NOVARTIS NOVARTIS HELIANTO HELIANTO HELIANTO HELIANTO HELIANTO HELIANTO GLAXOSMITHKLINE GLAXOSMITHKLINE NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ASPEN SANOFI-AVENTIS NOVAFARMA ABL NOVAFARMA NOVAFARMA NOVAFARMA HALEX ISTAR HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA

UNIDADE Pco Unt Base A GRAMA 0,25 GRAMA 0,28 ML 0,04 CPR 0,88 ML 0,07 UND 1,12 FA 0,07 UND 1,89 AMP 0,10 FA 8,25 UND 1,12 CPR 3,35 ML 1,64 ENV 2,63 G 0,50 G 0,43 COMP 1,22 COMP 1,87 COMP 1,87 COMP 3,63 COMP 0,95 COMP 0,63 FA 654,42 COMP 2,19 AMP 0,84 AMP 0,42 AMP 0,59 AMP 0,54 AMP 0,64 AP 0,49 AP 0,70 AP 0,48 AP 0,33 AP 1,01 AP 1,17 AP 0,30 AP 0,23 AMP 0,54

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358

CODIGO BENEFICIO 95119264 AGUA P/ INJECAO (Restrito Hosp,) 95119272 AGUA P/ INJECAO (Restrito Hosp,) 95119280 AGUA P/ INJECAO (Restrito Hosp,) 95119299 AGUA P/ INJECAO (Restrito Hosp,) 95089845 AGUA PARA INJECAO 95580115 AGUA PARA INJECAO 95580107 AGUA PARA INJECAO 95085246 AGUA PARA INJECAO - BLOWPACK 95085254 AGUA PARA INJECAO - BLOWPACK 95085262 AGUA PARA INJECAO - BLOWPACK 95085289 AGUA PARA INJECAO - BLOWPACK 95085297 AGUA PARA INJECAO - BOLSAS SISTEMA FECHA 95085300 AGUA PARA INJECAO - BOLSAS SISTEMA FECHA 95085319 AGUA PARA INJECAO - BOLSAS SISTEMA FECHA 95085327 AGUA PARA INJECAO - BOLSAS SISTEMA FECHA 95085335 AGUA PARA INJECAO - BOLSAS SISTEMA FECHA

APRESENTAÇÃO Cx, 100 x 5 ml plast, Cx, 200 amp, plast, 10 ml Cx, 200 amp, plast, 20 ml Cx, 200 amp, plast, 5 ml 10 ml cx, 200 amp, plast, Inj, cx, 100 x 10 ml, Inj, cx, 100 x 5 ml, Cx, c/10 Bols PE 1000 ml Cx, c/20 Bols PE 500 ml Cx, c/40 Bols PE 250 ml Cx, c/60 Bols PE 100 ml 100 ml - cx, c/80 1000 ml - cx, c/12 125 ml - cx, c/80 250 ml - cx, c/40 500 ml - cx, c/20

Laboratorio HYPOFARMA HALEX ISTAR HALEX ISTAR HALEX ISTAR FARMACE HYPOFARMA HYPOFARMA HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR SANOBIOL SANOBIOL SANOBIOL SANOBIOL SANOBIOL

359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380

95085343 AGUA PARA INJECAO - FRASCO SISTEMA FECHA 95085432 AGUA PARA INJECAO - SISTEMA FECHADO 95085394 AGUA PARA INJECAO - SISTEMA FECHADO 95085408 AGUA PARA INJECAO - SISTEMA FECHADO 95085386 AGUA PARA INJECAO - SISTEMA FECHADO 95119302 AGUA PARA INJECAO (Restrito Hosp,) 95119310 AGUA PARA INJECAO (Restrito Hosp,) 95986766 AGUA PARA INJETAVEIS 95986774 AGUA PARA INJETAVEIS 95085440 AGUA PARA INJETAVEIS - BOLSA SISTEMA FEC 95085459 AGUA PARA INJETAVEIS - BOLSA SISTEMA FEC 95085467 AGUA PARA INJETAVEIS - BOLSA SISTEMA FEC 95083456 AGUA PARA IRRIGACAO 95083472 AGUA PURIFICADA 95083464 AGUA PURIFICADA 95920927 AIRCLIN 95070486 AIRES 95070494 AIRES 95070508 AIRES 95049967 AKINETON 95049975 AKINETON 95420029 ALBA 3

1000 ml - cx, c/12 500 ml cx, 24 frs, Bolsa - 1000 ml Bolsa - 250 ml Bolsa- 500 ml 10 ml cx. 200 amp. plast. 20 ml cx. 100 amp. plast. 10 ml 20 ml 1000 ml 250 ml 500 ml 2000 ml IRR - 1 x 2000 ml 1000 ml IRR - 1 x 1000 ml 500 ml IRR - 1 x 500 ml Spray nasal fr, 15 ml, (120 doses) 100 mg, gran, ct, 16 sach, papel/al/poliet, x 5 g 200 mg, gran, ct, 16 sach, papel/al/poliet, x 5 g 600 mg, gran, ct, 16 sach, papel/al/poliet, x 5 g 2 mg, cprs, 4 bl, amb, x 20 Retard cx, 2 bl, x 15 cprs, rev, 4 mg, Susp, fr, 10 ml, 400 mg,

SANOBIOL EQUIPLEX J,P, J,P, J,P, FARMACE FARMACE BEKER BEKER TEXON TEXON TEXON FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI ACHE EUROFARMA EUROFARMA EUROFARMA ABBOTT ABBOTT IQB

UNIDADE Pco Unt Base A AMP 0,42 AMP 0,47 AMP 0,68 AMP 0,46 AMP 0,41 AP 0,64 AP 0,51 UNID 7,11 UNID 5,11 UNID 4,61 UNID 4,81 BOLSA 4,62 BOLSA 6,84 BOLSA 4,61 BOLSA 4,43 BOLSA 4,91 FR FR UNID UNID UNID AMP AMP AMP AMP UNID UNID UNID ML ML ML DOSE ENV ENV ENV COMP COMP ML

6,84 5,07 6,95 4,62 5,12 0,41 0,58 0,33 0,46 7,65 4,96 5,50 0,01 0,02 0,03 0,35 0,83 0,92 2,05 0,26 0,48 0,75

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418

CODIGO BENEFICIO 95034757 ALBENDAZOL - GENERICO 95008578 ALBENDAZOL - GENERICO 95034773 ALBENDAZOL - GENERICO 95026088 ALBENDAZOL - GENERICO 95034730 ALBENDAZOL - GENERICO 95008608 ALBENDAZOL - GENERICO 95049983 ALBENDAZOL - GENERICO 95420118 ALBENDAZOL - GENERICO 95420100 ALBENDAZOL - GENERICO 95989960 ALBENDAZOL - GENERICO 95008624 ALBENDAZOL - GENERICO 95012214 ALBENDAZOL - GENERICO 95012222 ALBENDAZOL - GENERICO 95420037 ALBENDAZOL - GENERICO 95920960 ALBENDAZOL - GENERICO 95026096 ALBENDAZOL - GENERICO 95989978 ALBENDAZOL - GENERICO 95420045 ALBENDAZOL - GENERICO 95420061 ALBENDAZOL - GENERICO 95920978 ALBENDAZOL - GENERICO 95420053 ALBENDAZOL - GENERICO 95034749 ALBENDAZOL - GENERICO 95034765 ALBENDAZOL - GENERICO 95012249 ALBENDAZOL - GENERICO (*) 95012265 ALBENDAZOL - GENERICO (*) 95012230 ALBENDAZOL - GENERICO (*) 95012257 ALBENDAZOL - GENERICO (*) 95119329 ALBENDAZOL - GENERICO (Restrito Hosp,) 95119337 ALBENDAZOL - GENERICO (Restrito Hosp,) 95119345 ALBENDAZOL - GENERICO (Restrito Hosp,) 95420142 ALBENDROX 95420134 ALBENDROX 95420126 ALBENDROX 95420150 ALBENTEL 95420177 ALBENZONIL 95420185 ALBENZONIL 95420193 ALBENZONIL 95070028 ALBICON

APRESENTAÇÃO 200 mg, bl, 2 cprs, 200mg,bl,2cprs,mast, 200mg,bl,2cprs,mast, 40 mg/ml susp, 10 ml 40 mg/ml susp, 10 ml c/50 40 mg/ml susp, oral 200 fr, plast, 10 ml 40 mg/mlsusp,oral10ml 400 mg 100 cprs, 400 mg cprs, mast, 400 mg, 1 bl, x 1 cpr, 400 mg, 1 cpr, mast, 400 mg, 1 cpr, mast, 400 mg, 1 cpr, mast, 400 mg, bl, 1 cpr, mast, 400 mg, cx, 1 cpr, 400 mg, cx, bl, 1 cpr, 400 mg, stp, 1 cpr, Susp, 40 mg/ml fr, 10 ml Susp, 400 mg vd, 10 ml, Susp, 40mg/mlvd,10ml Susp, oral 40 mg/ml fr, 10 ml Susp, oral fr, 10 ml Susp, oral fr, 10 ml 200 mg, bl, 2 cprs, 200mg,bl,2cprs,mast, Susp, oral fr, 10 ml Susp, oral fr, 10 ml 40 mg/ml susp, 10 ml c/50 (hosp,) 40 mg/ml, sus, or, cx, 200 fr, plas, opc, x 10 ml, (hosp,) 400 mg, com, mast, ct, bl, al, plas, inc, x 80 (hosp,) 10 ml, susp, 200 mg, cx, 2 cprs, 400 mg, cx, 1 cpr Susp, fr, 10 ml 200 mg cx, 2 cprs, 400 mg, cx, 1 cpr, mast, Susp, 40 mg/ml vd, 10 ml, Cx, 50 sachets 3 g

Laboratorio GERMED EMS GEN - LEGRAND MEDLEY TEUTO BRAS, PRATI DONADUZZI MEPHA-RATIOPHARM PRATI DONADUZZI PRATI DONADUZZI GERMED MEDLEY EMS TEUTO BRAS, ABBOTT NEO QUIMICA DUCTO GEN - LEGRAND EMS NEO QUIMICA DUCTO TEUTO BRAS, GERMED GEN - LEGRAND GERMED EUROGENUS - LEGRAND GERMED EUROGENUS - LEGRAND TEUTO BRAS, PRATI DONADUZZI PRATI DONADUZZI ROYTON ROYTON ROYTON TEUTO BRAS, DUCTO DUCTO DUCTO CHIESI

UNIDADE Pco Unt Base A CP 1,86 COMP 1,87 CP 1,86 FR 4,52 ML 0,24 ML 1,12 ML 0,50 CPR 0,59 CPR 3,56 COMP 3,72 COMP 4,15 COMP 3,71 COMP 4,19 CPR 3,47 CPR 3,65 CPR 2,91 COMP 3,79 ML 0,48 ML 0,31 ML 0,26 ML 0,33 ML 0,25 ML 0,44 COMP 1,86 COMP 1,86 ML 0,25 ML 0,44 FR 2,41 FR 1,12 COMP 1,50 ML 0,43 CPR 1,13 CPR 3,20 ML 0,47 CPR 1,01 CPR 3,42 ML 0,39 ENV 1,31

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456

CODIGO BENEFICIO 95070010 ALBICON 95921036 ALBISTIN 95921044 ALBISTIN 95921052 ALBISTIN 95070036 ALBOCRESIL 95070044 ALBOCRESIL 95070052 ALBOCRESIL 95089748 ALBUMINA HUMANA 95089730 ALBUMINA HUMANA 95010025 ALCALONE PLUS 95010033 ALCA-LUFTAL 95921060 ALCYTAM 95921079 ALCYTAM 95100016 ALDACTONE 95100024 ALDACTONE 95100032 ALDACTONE 95049991 ALDARA 95130179 ALDAZIDA 95130195 ALDOMET 95100067 ALDOSTERIN 95034781 ALDOSTERIN 95119353 ALDOSTERIN (Restrito Hosp,) 95119361 ALDURAZYME 95480170 ALENDIL 95026118 ALENDIL CALCIO D 95026126 ALENDIL CALCIO D 95034803 ALENDRONATO DE SODIO - GENERICO 95008683 ALENDRONATO DE SODIO - GENERICO 95008691 ALENDRONATO DE SODIO - GENERICO 95008705 ALENDRONATO DE SODIO - GENERICO 95008713 ALENDRONATO DE SODIO - GENERICO 95008730 ALENDRONATO DE SODIO - GENERICO 95008748 ALENDRONATO DE SODIO - GENERICO 95034811 ALENDRONATO DE SODIO - GENERICO 95095098 ALENDRONATO DE SODIO - GENERICO 95095101 ALENDRONATO DE SODIO - GENERICO 95008764 ALENIA 95008772 ALENIA

APRESENTAÇÃO Laboratorio Po tb, 20 g, CHIESI 100,000 UI/ml susp, oral fr, 40 ml CAZI 25,000 UI/g creme vag, bisn, 60 g CAZI 500,000 UI cx, 16 drags, CAZI Cx, 6 ovulos NYCOMED PHARMA Gel bisn, 50 g, c/aplic, NYCOMED PHARMA Sol, fr, 12 ml, NYCOMED PHARMA Sol, Injetável frasco 10 ml - Concentração 20G/100ML 20% Sol, Injetável frasco 50 ml - Concentração 20G/100ML 20% Susp, oral fr, 240 ml, BUNKER Gel, fr, 120 ml, B-MS 20 mg, cx, 14 cprs, TORRENT 20 mg, cx, 28 cprs, TORRENT 100 mg, vd, 16 cprs, PFIZER 25 mg, 30 cprs, PFIZER 50 mg, 30 cprs, PFIZER Cart, 12 saches 250 mg, INTENDIS DO BRASIL 50 mg, 30 cprs, PFIZER 500 mg, blister 30 cprs, CELLOFARM 100 mg, Cprs, rev, 16 CELLOFARM 50 mg, 30 cprs, rev, CELLOFARM 25 mg, bl, 200 cprs, rev, ASPEN PHARMA 2,9 mg/5 ml sol, inj, FA x 5 ml GENZYME DO BRASIL 70 mg 8 cprs, FARMOQUIMICA 4 cprs, alendronato/30 cprs, calcio+ vit, D FARMOQUIMICA 4 cprs, alendronato/60 cprs, calcio+ vit, D FARMOQUIMICA 10 mg, 30 cprs, EUROFARMA 70 mg, 2 cprs, EMS 70 mg, 2 cprs, GERMED 70 mg, 2 cprs, GEN - LEGRAND 70 mg, 4 cprs, EMS 70 mg, 4 cprs, GERMED 70 mg, 4 cprs, GEN - LEGRAND 70 mg, 4 cprs, EUROFARMA 70 mg, bl, 4 cprs, rev, SANDOZ 70 mg, bl, 8 cprs, rev, SANDOZ 12 mcg + 400 mg. cap. gel. dura po inal. fr. plast. x 60 c/inalador BIOSINTETICA 12 mcg+ 400 mg, cap, gel dura po inal, fr, plast, x 60 BIOSINTETICA

UNIDADE Pco Unt Base A G 0,46 ML 0,35 G 0,30 CPR 1,13 CPR 1,55 G 0,29 GOTAS 0,06 FA 40,69 X FA 203,42 X ML 0,10 ML 0,13 CPR 2,29 CPR 1,69 CPR 1,41 CPR 0,66 CPR 1,04 ENV 15,63 CPR 0,86 CPR 1,24 CPR 0,83 CP 0,56 COMP 0,49 FA 1270,75 CPR 14,80 CPR 2,16 CPR 1,34 CP 1,84 COMP 9,82 COMP 16,52 COMP 17,74 COMP 8,54 COMP 8,29 COMP 8,29 CP 12,87 COMP 8,29 COMP 7,26 CAPS 1,43 CAPS 1,13

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494

CODIGO BENEFICIO 95095110 ALENIA 95095128 ALENIA 95921125 ALENIA 95990089 ALENIA 95921133 ALENIA 95095136 ALENIA 95095144 ALENIA 95034838 ALENTHUS 95034820 ALENTHUS 95921141 ALERFIN 95008780 ALERGALIV 95008799 ALERGALIV 95008802 ALERGALIV D 95095152 ALERGIDEX 95240012 ALERGO FILINAL 95050647 ALERGO FILINAL 95921184 ALERGOLON 95230050 ALERGONIL 95921192 ALERGONIL 95230084 ALERMINE 95230092 ALERMINE 95230114 ALETIR 95230122 ALETIR 95990097 ALEXA 95898735 ALFAEPOETINA HUMANA 95898743 ALFAEPOETINA HUMANA 95898751 ALFAEPOETINA HUMANA 95898760 ALFAEPOETINA HUMANA 95898778 ALFAEPOETINA HUMANA 95898786 ALFAEPOETINA HUMANA 95898794 ALFAEPOETINA HUMANA 95898808 ALFAEPOETINA HUMANA 95898816 ALFAEPOETINA HUMANA 95898824 ALFAEPOETINA HUMANA 95898832 ALFAEPOETINA HUMANA 95898840 ALFAEPOETINA HUMANA 95898859 ALFAEPOETINA HUMANA 95898867 ALFAEPOETINA HUMANA

RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN

APRESENTAÇÃO Laboratorio 12/400 mcg 15 caps, + inal, BIOSINTETICA 12/400 mcg 15 caps, refil BIOSINTETICA 6 mcg + 100 mcg cap. gel dura po inal. fr. plast. x 60 c/inalador BIOSINTETICA 6 mcg+ 200 mcg cap, gel, dura po inal, fr, plast, x 60 BIOSINTETICA 6 mcg+ 200 mcg cap, gel, dura po inal, fr, plast, x 60 c/in BIOSINTETICA 6/200 mcg 15 caps, + inal, BIOSINTETICA 6/200 mcg 15 caps, refil BIOSINTETICA 150 mg, bl, 15 caps, gel, dura MEDLEY 75 mg, bl, 15 caps, gel, dura MEDLEY 100 mcg 120 doses CHIESI 10 mg, 15 cprs, LEGRAND Xpe, 100 ml LEGRAND Xpe, fr, 60 ml LEGRAND Xpe, fr, pet, 120 ml NEO QUIMICA Exp, ad, vd, 100 ml, EUROFARMA Xpe, vd, 120 ml EUROFARMA 4 mg, cx, c/21 cprs, BIOLAB SANUS 2 mg cx, 1 bl, 20 cprs, DUCTO Sol, oralcx,1vd,100ml DUCTO 2 mg, cx, 20 cprs, ROYTON Xpe, cx, 1 fr, 100 ml, ROYTON Cx, 6 cprs, BUNKER Sol, oral fr, 75 ml, BUNKER 0,06 mg,+ 0,015 mg, 1 bl, x 24 cprs, rev, SIGMA PHARMA 1000 UI po liof, inj, cx, 1 FA vd, inc,+ dil, x 1 ml BLAUSIEGEL 1000 UI po liof, inj, cx, 12 FA vd, inc,+ dil, x 1 ml BLAUSIEGEL 1000 UI sol, inj, ct, 1 amp, vd, inc, x 1 ml BLAUSIEGEL 1000 UI sol, inj, ct, 1 ser, preench, x 0,5 ml BLAUSIEGEL 1000 UI sol, inj, ct, 12 amp, vd, inc, x 1 ml BLAUSIEGEL 1000 UI sol, inj, ct, 12 ser, preench, x 0,5 ml BLAUSIEGEL 1000 UI sol, inj, cx, 1 FA vd, inc, x 1 ml BLAUSIEGEL 1000 UI sol, inj, cx, 12 FA vd, inc, x 1 ml BLAUSIEGEL 10000 UI sol, inj, ct, 1 amp, vd, inc, x 1 ml BLAUSIEGEL 10000 UI sol, inj, ct, 1 ser, preench, x 1 ml BLAUSIEGEL 10000 UI sol, inj, ct, 12 amp, vd, inc, x 1 ml BLAUSIEGEL 10000 UI sol, inj, ct, 12 ser, preench, x 1 ml BLAUSIEGEL 10000 UI sol, inj, cx, 1 FA vd, inc, x 1 ml BLAUSIEGEL 10000 UI sol, inj, cx, 12 FA vd, inc, x 1 ml BLAUSIEGEL

UNIDADE Pco Unt Base A CAPS 1,43 CAPS 1,13 CPR 1,06 CAPS 0,84 CPR 1,25 CAPS 1,25 CAPS 0,84 CP 3,87 CP 2,48 DOSE 0,36 COMP 1,30 ML 17,90 ML 0,26 ML 0,12 ML 0,12 ML 0,10 CPR 0,92 CPR 0,22 ML 0,07 CPR 0,24 ML 0,10 CPR 2,41 ML 0,25 COMP 0,76 FR 37,95 FR 32,30 FR 37,95 FR 37,95 FR 33,24 FR 37,96 FR 37,95 FR 33,24 FR 345,42 FR 345,42 FR 314,31 FR 314,31 FR 345,42 FR 314,31

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532

CODIGO BENEFICIO 95898875 ALFAEPOETINA 95898883 ALFAEPOETINA 95898891 ALFAEPOETINA 95898905 ALFAEPOETINA 95898913 ALFAEPOETINA

HUMANA HUMANA HUMANA HUMANA HUMANA

RECOMBIN RECOMBIN RECOMBIN RECOMBIN RECOMBIN

95898921 ALFAEPOETINA HUMANA RECOMBIN 95898930 ALFAEPOETINA HUMANA RECOMBIN 95898948 ALFAEPOETINA HUMANA RECOMBIN 95898956 ALFAEPOETINA HUMANA RECOMBIN 95898964 ALFAEPOETINA HUMANA RECOMBIN 95898972 ALFAEPOETINA HUMANA RECOMBIN 95898980 ALFAEPOETINA HUMANA RECOMBIN 95898999 ALFAEPOETINA HUMANA RECOMBIN 95899006 ALFAEPOETINA HUMANA RECOMBIN 95899014 ALFAEPOETINA HUMANA RECOMBIN 95899022 ALFAEPOETINA HUMANA RECOMBIN 95899030 ALFAEPOETINA HUMANA RECOMBIN 95899049 ALFAEPOETINA HUMANA RECOMBIN 95899057 ALFAEPOETINA HUMANA RECOMBIN 95899065 ALFAEPOETINA HUMANA RECOMBIN 95899073 ALFAEPOETINA HUMANA RECOMBIN 95899081 ALFAEPOETINA HUMANA RECOMBIN 95899090 ALFAEPOETINA HUMANA RECOMBIN 95899103 ALFAEPOETINA HUMANA RECOMBIN 95899111 ALFAEPOETINA HUMANA RECOMBIN 95899120 ALFAEPOETINA HUMANA RECOMBIN 95899138 ALFAEPOETINA HUMANA RECOMBIN 95899146 ALFAEPOETINA HUMANA RECOMBIN 95064311 ALFAEPOETINA HUMANA RECOMBINANTE 95064303 ALFAEPOETINA HUMANA RECOMBINANTE 95990100 ALFAINTERFERON 2A (ICMS 0%) 95990119 ALFAINTERFERON 2A (ICMS 0%) 95990127 ALFAINTERFERON 2A (ICMS 0%) 95034846 ALFAINTERFERONA (ICMS 0%) 95034862 ALFAINTERFERONA (ICMS 0%) 95034854 ALFAINTERFERONA (ICMS 0%) 95984054 ALFAST 95990135 ALFAST

APRESENTAÇÃO 2000 UI po liof, inj, cx, 1 FA vd, inc,+ dil, x 1 ml 2000 UI po liof, inj, cx, 12 FA vd, inc,+ dil, x 1 ml 2000 UI sol, inj, ct, 1 amp, vd, inc,x 1 ml 2000 UI sol, inj, ct, 1 ser, preench, x 0,5 ml 2000 UI sol, inj, ct, 12 amp, vd, inc, x 1 ml

Laboratorio BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL

2000 UI sol, inj, ct, 12 ser, preench, x 0,5 ml 2000 UI sol, inj, cx, 1 FA vd, inc, x 1 ml 2000 UI sol, inj, cx, 12 FA vd, inc, x 1 ml 3000 UI po liof, inj, cx, 1 FA vd, inc,+ dil, x 1 ml 3000 UI po liof, inj, cx, 12 FA vd, inc,+ dil, x 1 ml 3000 UI sol, inj, ct, 1 amp, vd, inc, x 1 ml 3000 UI sol, inj, ct, 1 ser, preench, x 0,3 ml 3000 UI sol, inj, ct, 12 amp, vd, inc,x 1 ml 3000 UI sol, inj, ct, 12 ser, preench, x 0,3 ml 4000 UI po liof, inj, cx, 1 FA vd, inc,+ dil, x 1 ml 4000 UI po liof, inj, cx, 12 FA vd, inc,+ dil, x 1 ml 4000 UI sol, inj, ct, 1 amp, vd, inc, x 1 ml 4000 UI sol, inj, ct, 1 ser, preench, x 0,4 ml 4000 UI sol, inj, ct, 1 ser, preench, x 1 ml 4000 UI sol, inj, ct, 12 amp, vd, inc,x 1 ml 4000 UI sol, inj, ct, 12 ser, preench, x 0,4 ml 4000 UI sol, inj, ct, 12 ser, preench, x 1 ml 4000 UI sol, inj, cx, 1 FA vd, inc, x 1 ml 4000 UI sol, inj, cx, 12 FA vd, inc, x 1 ml 40000 UI sol, inj, ct, 1 amp, vd, inc, x 1 ml 40000 UI sol, inj, ct, 1 ser, preench, x 1 ml 40000 UI sol, inj, ct, 12 amp, vd, inc,x 1 ml 40000 UI sol, inj, ct, 12 ser, preench, x 1 ml 3000 UI/ml sol, inj, ct, 12 FA vd, inc, x 1 ml 3000 UI/ml sol, inj, ct, FA vd, inc, x 1 ml 3,000,000 UI FA 4,500,000 UI FA 9,000,000 UI FA 10,000,000 UI ml po liof, inj, 5 FA vd,+ amp, dil, 3,000,000 UI ml po liof, inj, 5 FA vd,+ amp, dil, 5,000,000 UI ml po liof, inj, 5 FA vd,+ amp, dil, 0,544 mg/ml - 10 amp, 5 ml, 0,544 mg/ml - 25 amp, 10 ml,

BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BIOSINTETICA BIOSINTETICA BIOSINTETICA CRISTALIA CRISTALIA

UNIDADE Pco Unt Base A FR 70,61 FR 70,63 FR 70,61 FR 70,61 FR 70,63 FR FR FR FA FA AP AP AP AP FA FA AP AP AP AP AP AP FA FA AP AP AP AP FA FA F,A, F,A, F,A, FR FR FR AMP AMP

70,63 70,61 70,63 77,70 77,69 77,70 77,70 77,69 77,69 120,36 120,36 120,36 120,36 120,36 120,36 120,36 120,36 120,36 120,36 931,99 931,99 932,00 X 932,00 X 82,38 82,40 66,41 106,55 198,62 231,99 81,61 122,01 24,74 28,64

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570

CODIGO BENEFICIO APRESENTAÇÃO 95034919 ALFRON 0,25 mg, 2 bl, x 10 cprs, 95034927 ALFRON 0,25 mg, 3 bl, x 10 cprs, 95034935 ALFRON 0,5 mg, 2 bl, x 10 cprs, 95034943 ALFRON 0,5 mg, 3 bl,x10 cprs, 95046305 ALFRON 1 mg, 1 bl, x 20 cprs, 95046291 ALFRON 1 mg, 2 bl, x 15 cprs, 95034889 ALFRON 2 mg, 2 bl, x 10 cprs, 95034900 ALFRON 2 mg, 3 bl, x 10 cprs, 95008810 ALGESTONA + ESTRADIOL - GENERICO 150+ 10 mg/ml sol, inj, IM amp, x 1 ml 95008829 ALGESTONA ACET, + ENANTATO DE ESTRADIOL 150+ 10 mg/ml amp, x 1 ml 95008837 ALGESTONA ACET, + ENANTATO DE ESTRADIOL 150+ 10 mg/ml sol, inj, IM amp, x 1 ml 95095160 ALGESTONA ACET, + ENANTATO DE ESTRADIOL - GENERICO 150 mg/ml + 10 mg/ml sol, inj, IM amp, vd, x 1 ml 95070516 ALGI-BUTAZOLON 20 cprs, 95070524 ALGI-BUTAZOLON GOTAS 20 ml 95921206 ALGICE Cx, 20 drags, 95330330 ALGIFLEX 200 mg, c/20 cprs, 95921214 ALGINAC 1 mg,+ 50 mg,+ 50 mg,+ 50 mg, 15 cprs, rev, 95330348 ALGINAC 1 mg+ 50 mg+ 50 mg+ 50 mg, 30 cprs, rev, 95330356 ALGINAC Sol, inj, cx, 3 amps, 1 ml,+ 3 amps, 2 ml, 95008845 ALGINAC (*) 1 mg,+ 50 mg,+ 50 mg,+ 50 mg, 15 cprs, rev, 95330372 ALGIRONA Gts, fr, 10 ml, 95330399 ALIDOR 500 mg, cx, 20 cprs, 95061240 ALIMAX 10,000 UI/ml sol, top spray ct, fr, vd, inc, neb, x 50 ml 95899154 ALIMTA 500 mg, fr, 50 ml 95089853 ALIMTA (Restrito Hosp,) 100 mg, fr, 50 ml 95420215 ALIN 400 mg, 1 cpr, mast, 95420223 ALIN 400 mg/ml susp, oral fr, 10 ml 95990143 ALIVE Sol, nasal got, x 30 ml 95921222 ALIVIAN 7,5 mg, cx, 10 cprs, 95089420 ALIVIUM 30 mg/ml susp, oral fr, plast, x 100 ml+ ser, dos, 95008853 ALIVIUM 400 mg, bl, 10 cprs, 95921230 ALIVIUM 50 mg/ml fr, plast, x 30 ml 95089438 ALIVIUM 50 mg/ml gts, fr, plast, x 20 ml 95008861 ALIVIUM 600 mg, 2 bl, x 5 cprs, 95008870 ALIVIUM 600 mg, bl, 4 cprs, 95540040 ALKERAN 2 mg, cx, 25 cprs, 95119370 ALKERAN (Restrito Hosp,) 50 mg, FA c/dil, sol, 95230157 ALLEGRA 120 mg, 10 cprs,

Laboratorio SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA GEN - LEGRAND GERMED EMS EUROFARMA DOVALLE DOVALLE CAZI EMS MERCK MERCK MERCK MERCK BUNKER SANOFI-AVENTIS CRISTALIA ELI LILLY ELI LILLY MILLET-ROUX MILLET-ROUX UNIAO QUIMICA CAZI MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP GLAXOSMITHKLINE GLAXOSMITHKLINE SANOFI-AVENTIS

UNIDADE Pco Unt Base A CP 0,17 CP 0,17 CP 0,34 CP 0,34 COMP 0,61 COMP 0,58 CP 1,21 CP 1,08 AMP 6,19 AMP 6,12 AMP 6,21 AMP 6,18 COMP 0,90 GOTA 0,02 CPR 0,51 CPR 0,49 CPR 1,14 CPR 1,07 AP 5,88 COMP 1,07 GOTAS 0,03 CPR 0,09 FR 167,98 FR 4265,86 X FR 1002,86 X CPR 4,38 ML 0,51 GOTA 0,01 CPR 1,46 ML 0,21 COMP 1,27 GOTAS 0,02 GOTAS 0,02 COMP 1,82 COMP 1,81 CPR 1,46 FA 114,00 CPR 3,40

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608

CODIGO BENEFICIO 95034951 ALLEGRA 95230149 ALLEGRA 95034960 ALLEGRA 95921249 ALLEGRA 95230173 ALLEGRA 95070532 ALLEGRA 95050680 ALLEGRA D 95050671 ALLEGRA D 95921265 ALLESTRA 20 95070540 ALLESTRA 20 95990151 ALLEXOFEDRIN 95990160 ALLEXOFEDRIN 95990178 ALOIS 95070559 ALOPURIMILIUM 95070567 ALOPURIMILIUM 95081690 ALOPURINOL - GENERICO 95050698 ALOPURINOL - GENERICO 95050710 ALOPURINOL - GENERICO 95026177 ALOPURINOL - GENERICO 95081704 ALOPURINOL - GENERICO 95050701 ALOPURINOL - GENERICO 95050728 ALOPURINOL - GENERICO 95720014 ALPHAGAN 95720022 ALPHAGAN 95043098 ALPHAGAN-P 95081712 ALPHAGAN-Z 95270035 ALPRAZOLAM - GENERICO 95012451 ALPRAZOLAM - GENERICO 95990194 ALPRAZOLAM - GENERICO 95990208 ALPRAZOLAM - GENERICO 95050809 ALPRAZOLAM - GENERICO 95050779 ALPRAZOLAM - GENERICO 95921273 ALPRAZOLAM - GENERICO 95990186 ALPRAZOLAM - GENERICO 95012427 ALPRAZOLAM - GENERICO 95012389 ALPRAZOLAM - GENERICO 95990216 ALPRAZOLAM - GENERICO 95012397 ALPRAZOLAM - GENERICO

APRESENTAÇÃO 120 mg, 5 cprs, 180 mg, 10 cprs, 180 mg, 5 cprs, 60 mg, 2 bl, x 5 cprs, rev, Inf, 30 mg, rev, 1 strip x 20 Ped, 6 mg/ml susp, oral fr, 60 ml+ ser, dos, 60 mg,+ 120 mg, 1 bl, x 6 cprs, 60 mg,+ 120 mg, 1 str, x 10 cprs, 75/20 mcg 21 drags, 75/20 mcg 3 bl, x 21 drags, 120 mg, 1 bl, x 10 cprs, rev, 180 mg, 1 bl, x 10 cprs, rev, 10 mg, cx, 30 cprs, 100 mg, cx, 30 cprs, 300 mg, cx, 30 cprs, 100 mg, bl, 30 cprs, 100 mg, com, ct, bl, al, plas, inc, x 30 100 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) 300 mg, 30 cprs, 300 mg, bl, 30 cprs, 300 mg, com, ct, bl, al, plas, inc, x 30 300 mg, com, ct, bl, al, plas, inc, x 500 (hosp,) Fr, 10 ml, Fr, 5 ml, Fr, 5 ml Fr, 5 ml 0,25 mg 2 bl, al, plas, x 10 cprs, 0,25 mg, 2 blist, x 10 cprs, 0,25 mg, 20 cprs, 0,25 mg, 20 cprs, 0,25 mg, bl, 20 cprs, 0,25 mg, bl, 30 cprs, 0,25 mg, cx, 20 cprs, 0,25mg,2bl,x 10cprs, 0,25mg,3 bl, x 10 cprs, 0,25mg,3bl,x10cprs, 0,5 mg, 2 bl, x 10 cprs, 0,5 mg, 3 bl, x 10 cprs,

Laboratorio SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS ACHE ACHE EMS EMS APSEN MILIAN MILIAN MEDLEY PRATI DONADUZZI PRATI DONADUZZI SANDOZ MEDLEY PRATI DONADUZZI PRATI DONADUZZI ALLERGAN ALLERGAN ALLERGAN ALLERGAN BIOSINTETICA GEN - LEGRAND EMS ARROW MEDLEY MEDLEY EUROFARMA GERMED GERMED EMS GERMED GERMED

UNIDADE Pco Unt Base A CP 3,40 CPR 5,18 CP 5,18 CPR 1,72 CPR 1,21 ML 0,26 COMP 3,05 COMP 3,16 CPR 0,71 COMP 0,58 COMP 2,44 COMP 3,42 COMP 1,84 COMP 0,29 COMP 0,53 COMP 0,19 COMP 0,18 COMP 0,12 CPR 0,51 COMP 0,56 COMP 0,54 COMP 0,23 GOTAS 0,44 GOTAS 0,55 GOTA 0,55 GOTA 0,29 CPR 0,26 COMP 0,16 COMP 0,28 COMP 0,22 COMP 0,28 COMP 0,28 CPR 0,20 COMP 0,20 COMP 0,16 COMP 0,27 COMP 0,38 COMP 0,37

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646

CODIGO BENEFICIO 95081720 ALPRAZOLAM - GENERICO 95050795 ALPRAZOLAM - GENERICO 95050787 ALPRAZOLAM - GENERICO 95081739 ALPRAZOLAM - GENERICO 95270043 ALPRAZOLAM - GENERICO 95012460 ALPRAZOLAM - GENERICO 95990232 ALPRAZOLAM - GENERICO 95990240 ALPRAZOLAM - GENERICO 95026185 ALPRAZOLAM - GENERICO 95921303 ALPRAZOLAM - GENERICO 95050825 ALPRAZOLAM - GENERICO 95050736 ALPRAZOLAM - GENERICO 95050817 ALPRAZOLAM - GENERICO 95990275 ALPRAZOLAM - GENERICO 95026193 ALPRAZOLAM - GENERICO 95050760 ALPRAZOLAM - GENERICO 95050744 ALPRAZOLAM - GENERICO 95921311 ALPRAZOLAM - GENERICO 95081747 ALPRAZOLAM - GENERICO 95990283 ALPRAZOLAM - GENERICO 95012354 ALPRAZOLAM - GENERICO 95012400 ALPRAZOLAM - GENERICO 95012443 ALPRAZOLAM - GENERICO 95012370 ALPRAZOLAM - GENERICO

APRESENTAÇÃO 0,5 mg, 3 bl, x 10 cprs, 0,5 mg, bl, 20 cprs, 0,5 mg, bl, 30 cprs, 0,5 mg, strip, al,/al, 30 cprs, 0,50 mg 2 bl, al, plas, x 10 cprs, 0,50 mg, 2 blist, x 10 cprs, 0,50 mg, 20 cprs, 0,50 mg, 20 cprs, 0,50 mg, bl, 20 cprs, 0,50 mg, cx, 20 cprs, 1 mg, 1 bl, x 20 cprs, 1 mg, 2 bl, x 15 cprs, 1 mg, 2 bl, x 15 cprs, 1 mg, 20 cprs, 1 mg, bl, 20 cprs, 1 mg, bl, 20 cprs, 1 mg, bl, 30 cprs, 1 mg, cx, 20 cprs, 1 mg, strip, al,/al 30 cprs, 1,0 mg, 20 cprs, 2 mg, 2 bl, x 10 cprs, 2 mg, 2 bl, x 10 cprs, 2 mg, 2 bl, x 10 cprs, 2 mg, 3 bl, x 10 cprs,

Laboratorio EMS MEDLEY MEDLEY ZYDUS BIOSINTETICA GEN - LEGRAND EMS ARROW SANDOZ EUROFARMA GERMED EMS GERMED EMS SANDOZ MEDLEY MEDLEY EUROFARMA ZYDUS ARROW EMS GERMED GEN - LEGRAND EMS

95012435 ALPRAZOLAM - GENERICO 95050752 ALPRAZOLAM - GENERICO 95026207 ALPRAZOLAM - GENERICO 95990305 ALPRAZOLAM (B1) - GENERICO 95990313 ALPRAZOLAM (B1) - GENERICO 95990321 ALPRAZOLAM (B1) - GENERICO 95008888 ALTIVA 95008896 ALTIVA 95921338 ALTROX 95921346 ALTROX 95921354 ALTROX 95008900 ALVESCO 95008918 ALVESCO 95012486 ALVESCO

2 mg, 3 bl, x 10 cprs, 2 mg, bl, 30 cprs, 2 mg, fr, vd, 30 cprs, 0,25 mg, 2 blist, x 10 cprs, 0,50 mg, 2 blist, x 10 cprs, 1,0 mg, 2 blist, x 10 cprs, 120 mg, bl, 10 cprs, 180 mg, bl, 10 cprs, 0,25 mg, cx, 20 cprs, 0,5 mg,cx, 20 cprs, 1 mg,cx, 20 cprs, 160 mcg/dose sol, inal, ct, fr, al/val, dos, x 120 doses 160 mcg/dose sol, inal, ct, fr, al/val, dos, x 60 doses 80 mcg/dose sol, inal, ct, fr, al/val, dos, x 120 doses

GERMED MEDLEY SANDOZ GEN - LEGRAND GEN - LEGRAND GEN - LEGRAND EUROFARMA EUROFARMA TORRENT TORRENT TORRENT NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA

UNIDADE Pco Unt Base A COMP 1,51 COMP 0,52 COMP 0,54 COMP 0,99 CPR 0,48 COMP 0,38 COMP 0,55 COMP 0,44 CPR 0,48 CPR 0,39 COMP 0,68 COMP 0,90 COMP 0,64 COMP 0,98 CPR 0,86 COMP 0,98 COMP 0,98 CPR 0,69 COMP 1,71 COMP 0,78 COMP 1,56 COMP 1,34 COMP 1,55 COMP 1,56 COMP COMP CPR COMP COMP COMP COMP COMP CPR CPR CPR DOSE DOSE DOSE

1,19 1,56 1,39 0,16 0,38 0,68 2,20 3,36 0,22 0,38 0,67 0,68 1,00 0,64

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 647 648 649 650 651 652 653 654 655 656 657 658 659 660 661 662 663 664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683 684

CODIGO BENEFICIO 95008926 ALVESCO 95034986 ALZEPINOL 95034994 ALZEPINOL 95076425 AMARYL 95430016 AMARYL 95076433 AMARYL 95430024 AMARYL 95430032 AMARYL 95061274 AMARYL FLEX 95061266 AMARYL FLEX 95035001 AMATO 95035010 AMATO 95035028 AMATO 95390073 AMBISOME 95990356 AMBISOME 95370013 AMBRA-SINTO T 95050833 AMBROFLUX 95050841 AMBROFLUX 95250107 AMBROL 95119388 AMICILON (Restrito Hosp,) 95119396 AMICILON (Restrito Hosp,) 95119400 AMICILON (Restrito Hosp,) 95012516 AMICOZOL 95095179 AMIDALIN

APRESENTAÇÃO 80 mcg/dose sol, inal, ct, fr, al/val, dos, x 60 doses 300 mg, bl, 20 cprs, rev, 600 mg, bl, 20 cprs, rev, 3 mg, 2 bl, x 15 cprs, 4 mg, 30 cprs, 6 mg, 2 bl, x 15 cprs, Cx, 30 cprs, 1 mg, Cx, 30 cprs, 2 mg, 1 mg, bl, 30 cprs,+ 500 mg, bl, 120 cprs, rev, 2 mg, bl, 30 cprs,+ 500 mg, bl, 120 cprs, rev, 100 mg, bl, 60 cprs, rev, 25mg, bl,60cprs,rev, 50mg,bl,60cprs,rev, 50 mg, inj, 10 FA Fracao de venda Susp, fr, 30 ml, 3 mg/mlxpe,fr,120ml 6mg/mlxpe,fr,120ml Ped, 100 ml 100 mg, cx, 50 amps, 2 ml 250 mg, cx, 50 amps, 2 ml 500 mg/ml sol, inj, cx, 50 amps, 2 ml 20 mg/g creme derm, bisn, 28 g Sol, oral spray fr, vd, x 25 ml (laranja)

Laboratorio NYCOMED PHARMA MEDLEY MEDLEY SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS EUROFARMA EUROFARMA EUROFARMA UNITED MEDICAL UNITED MEDICAL MEDLEY LUPER LUPER BRASTERAPICA ARISTON ARISTON ARISTON CELLOFARM SANDOZ

95095187 AMIDALIN 95100075 AMILORID 95008934 AMILORIDA + HIDROCLOROTIAZIDA - GENERICO 95008942 AMILORIDA + HIDROCLOROTIAZIDA - GENERICO 95200320 AMINOFILIN (AMINOFILINA) 95200347 AMINOFILINA 95200355 AMINOFILINA 95200339 AMINOFILINA 95990402 AMINOFILINA - GENERICO 95043101 AMINOFILINA - GENERICO 95990410 AMINOFILINA - GENERICO 95119418 AMINOFILINA - GENERICO 95044590 AMINOFILINA - GENERICO 95064338 AMINOFILINA - GENERICO

Sol, oral spray fr, vd, x 25 ml (menta) Cx,3 bl, x 10 cprs, 2,5+ 25 mg, bl, 30 cprs, 5+ 50 mg, bl, 30 cprs, 24 mg amp, 10 ml, 0,1 g x 20 cprs, 0,2 g, 20 cprs, Fr, gts, 10 ml, 100 mg, cx, 20 cprs, 200 mg, bl, 20 cprs, 200 mg, cx, 20 cprs, 24 mg/ml - cx, 100 amps, vd, x 10 ml 24mg/mlcx,100x10ml Sol, inj, 24 mg/ml cx, 50 fr, x 10 ml

SANDOZ NEO QUIMICA RANBAXY RANBAXY HALEX ISTAR NOVARTIS NOVARTIS NOVARTIS TEUTO BRAS, NEO QUIMICA TEUTO BRAS, FARMACE HYPOFARMA TEUTO BRAS,

UNIDADE Pco Unt Base A DOSE 0,95 CP 1,00 CP 1,92 COMP 2,07 CPR 1,82 COMP 4,00 CPR 0,49 CPR 0,94 COMP 0,12 COMP 0,23 CP 1,57 CP 0,39 CP 0,78 FA 1271,86 X UND 1271,85 X GOTAS 0,01 ML 0,12 ML 0,17 ML 0,10 FA 0,56 FA 2,03 FA 1,81 GRAMA 0,37 ML 0,65 ML CPR COMP COMP AP CPR CPR GOTAS COMP CP COMP AMP AMP AMP

0,65 0,39 0,15 0,25 0,90 0,23 0,26 0,03 0,13 0,16 0,15 0,58 0,43 0,55

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706 707 708 709 710 711 712 713 714 715 716 717 718 719 720 721 722

CODIGO BENEFICIO 95081763 AMINOFILINA SANDOZ 95081771 AMINOFILINA SANDOZ 95081755 AMINOFILINA SANDOZ 95590030 AMINOPED SOL, 95590021 AMINOPED SOL, 95590048 AMINOPED SOL, 95590013 AMINOPED SOL, 95064389 AMINOVEN 95064370 AMINOVEN 95064354 AMINOVEN 95064362 AMINOVEN 95064397 AMINOVEN 95110038 AMIOBAL 95110046 AMIOBAL 95921443 AMLOCOR 95921460 AMLOCOR 95921478 AMLOVASC 95130225 AMLOVASC 95921486 AMLOVASC 95130233 AMLOVASC 95041656 AMOXACIN 95041664 AMOXACIN 95041648 AMOXACIN 95041672 AMOXACIN 95041680 AMOXACIN 95050850 AMOXADENE 95035052 AMOXADENE 95035036 AMOXADENE 95370226 AMOX-EMS 95370234 AMOX-EMS 95921508 AMOXICILINA - GENERICO 95081780 AMOXICILINA - GENERICO 95050949 AMOXICILINA - GENERICO 95370544 AMOXICILINA - GENERICO 95921524 AMOXICILINA - GENERICO 95370587 AMOXICILINA - GENERICO 95370552 AMOXICILINA - GENERICO 95050876 AMOXICILINA - GENERICO

APRESENTAÇÃO 0,1 g x 20 cprs, 0,2 g, 20 cprs, Fr, gts, 10 ml, 10% 1 x 100 ml (fr, 300 ml) 10% 1 x 1000 ml 10% 1 x 250 ml (fr, 500 ml) 10% 1 x 50 ml (fr, 65 ml) 10% - 1 x 1000 ml 10% - 1 x 500 ml 10% inf, - 1 x 100 ml 10% inf, - 1 x 250 ml 15% - 1 x 1000 ml 100 mg cx, 30 cprs, 200 mg cx, 30 cprs, 10 mg cx, 30 cprs, 5 mg cx, 30 cprs, 10 mg, 20 cprs, 10 mg, 30 cprs, 5 mg, 20 cprs, 5 mg, 30 cprs, 250 mg/5 ml po susp, or, 150 ml 250 mg/5 ml po susp, or, 60 ml 500 mg, cx, 10 cprs, 500 mg, cx, 15 cprs, 500 mg/5 ml susp, or, vd, 150 ml 125 mg/5 ml po prep, extemp, fr, vd, x 150 ml 250 mg/5 ml po susp, oral 150 ml 500 mg, 3 bl, x 7 caps, gel, dura 250 mg susp, fr 150 ml 500 mg, cx, 21 cprs, 100 mg/ml po p/susp, fr, vd, 150 ml 100 mg/ml po p/susp, or, ct, fr, vd, amb, x 150 ml+ cp, 100 mg/ml po susp, or, fr, vd, amb, x 150 ml+ colher med, 125 mg/5 ml po p/susp, 1 fr, vd, 150 ml+ dos, 200 mg/5 ml po p/susp, 1 fr, vd, 100 ml+ dos, 250 mg, fr, 150 ml 250 mg/5 ml po p/susp, 1 fr, vd, 150 ml+ dos, 250 mg/5 ml po susp, 150 ml+ cp, medida

Laboratorio NOVARTIS NOVARTIS NOVARTIS FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI BALDACCI BALDACCI TORRENT TORRENT HEXAL HEXAL HEXAL HEXAL CAZI CAZI CAZI CAZI CAZI CIFARMA CIFARMA CIFARMA EMS EMS UNIAO QUIMICA PRATI DONADUZZI AUROBINDO PHARMA MEDLEY MEDLEY RANBAXY MEDLEY TEUTO BRAS,

UNIDADE Pco Unt Base A COMP 0,23 COMP 0,26 GOTA 0,03 AP 73,84 AP 60,54 AP 55,57 AP 21,14 ML 0,18 ML 0,17 ML 0,18 ML 0,18 ML 0,27 CPR 0,50 CPR 0,65 CPR 1,20 CPR 0,75 CPR 1,45 CPR 0,78 CPR 0,83 CPR 0,47 GOTA 0,08 GOTA 0,00 COMP 1,14 COMP 1,14 GOTA 0,03 ML 0,11 GOTA 0,01 CP 0,99 ML 0,17 CPR 1,23 ML 0,17 ML 0,14 ML 0,25 ML 0,11 ML 0,14 ML 0,11 ML 0,13 ML 0,12

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 723 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751 752 753 754 755 756 757 758 759 760

CODIGO BENEFICIO 95089470 AMOXICILINA - GENERICO 95921532 AMOXICILINA - GENERICO 95921540 AMOXICILINA - GENERICO 95921559 AMOXICILINA - GENERICO 95089489 AMOXICILINA - GENERICO 95990437 AMOXICILINA - GENERICO 95050892 AMOXICILINA - GENERICO 95050884 AMOXICILINA - GENERICO 95921567 AMOXICILINA - GENERICO 95050930 AMOXICILINA - GENERICO 95119426 AMOXICILINA - GENERICO 95035060 AMOXICILINA - GENERICO 95921575 AMOXICILINA - GENERICO 95370510 AMOXICILINA - GENERICO 95050868 AMOXICILINA - GENERICO 95119434 AMOXICILINA - GENERICO 95370420 AMOXICILINA - GENERICO 95370536 AMOXICILINA - GENERICO 95370331 AMOXICILINA - GENERICO 95095195 AMOXICILINA - GENERICO 95119442 AMOXICILINA - GENERICO 95370455 AMOXICILINA - GENERICO 95370340 AMOXICILINA - GENERICO 95026231 AMOXICILINA - GENERICO 95370528 AMOXICILINA - GENERICO 95095209 AMOXICILINA - GENERICO 95370463 AMOXICILINA - GENERICO 95921630 AMOXICILINA - GENERICO 95095217 AMOXICILINA - GENERICO 95050981 AMOXICILINA - GENERICO 95050973 AMOXICILINA - GENERICO 95070583 AMOXICILINA - GENERICO 95921648 AMOXICILINA - GENERICO 95050957 AMOXICILINA - GENERICO 95119450 AMOXICILINA - GENERICO 95370609 AMOXICILINA - GENERICO 95050965 AMOXICILINA - GENERICO 95095225 AMOXICILINA - GENERICO

APRESENTAÇÃO 250 mg/5 ml po susp, oral fr, 150 ml+ ser, dos, x 10 ml 250 mg/5 ml po susp, vd, 150 ml 400 mg, fr, 100 ml 400 mg/5 ml po p/susp, 1 fr, vd, 100 ml+ dos, 400 mg/5 ml po susp, oral fr, 100 ml+ ser, dos, x 10 ml 400mg,susp,fr,100ml 50 mg/ml po p/sus, or, ct, fr, plas, amb, x 150 ml+ cp, med, 50 mg/ml po p/sus, or, ct, fr, plas, amb, x 60 ml+ cp, med, 50 mg/ml po p/susp, fr, vd, 150 ml 50 mg/ml po susp, or, fr, vd, amb, x 150 ml+ colher med, 50 mg/ml po susp, oral fr, vd, amb, x 60 ml + cp, 50 mg/ml po susp, oral fr, x 150 ml 50 mg/ml po susp, oral fr, x 150 ml 500 mg, 1 bl, x 15caps, gel, dura 500 mg, 10 bl, x 10 caps, gel, dura (hosp,) 500 mg, 15 caps, 500 mg, 15 caps, gel, dura 500 mg, 2 bl, x 15 caps, gel, dura 500 mg, 2 bl, x 6 caps, 500 mg, 21 caps, 500 mg, 21 caps, 500 mg, 21 caps, gel, dura 500 mg, 3 bl, x 7 caps, 500 mg, 3 bl, x 7 cprs, 500 mg, 3 bl, x 7caps, gel, dura 500 mg, 30 caps, 500 mg, 30 caps, gel, dura 500 mg, bl, 15 caps, 500 mg, bl, 15 caps, gel, dura 500 mg, bl, 16 caps, gel, dura 500 mg, bl, 20 caps, gel, dura 500 mg, bl, 21 caps, 500 mg, bl, 21 caps, 500 mg, bl, 21 caps, gel, dura 500 mg, bl, 21 caps, gel, dura 500 mg, bl, 21 cprs, 500 mg, bl, 30 caps, gel, dura 500 mg, bl, 30 caps, gel, dura

Laboratorio BIOSINTETICA NEO QUIMICA EMS MEDLEY BIOSINTETICA GERMED PRATI DONADUZZI PRATI DONADUZZI UNIAO QUIMICA AUROBINDO PHARMA DUCTO LUPER BRAINFARMA MEDLEY TEUTO BRAS, MULTILAB EUROFARMA MEDLEY LUPER RATIOPHARM MULTILAB EUROFARMA LUPER GERMED MEDLEY RATIOPHARM EUROFARMA GERMED AUROBINDO PHARMA SANDOZ SANDOZ GEN - LEGRAND GERMED SANDOZ AUROBINDO PHARMA RANBAXY SANDOZ AUROBINDO PHARMA

UNIDADE Pco Unt Base A ML 1,49 ML 0,09 ML 0,20 ML 0,20 ML 1,68 ML 0,19 ML 0,11 ML 0,14 ML 0,12 ML 0,17 ML 0,12 GOTA 0,01 ML 0,13 CPR 1,07 CAPS 0,84 CAPS 1,17 CPR 0,74 CPR 1,01 CPR 0,98 CAPS 1,06 CAPS 1,10 CPR 0,72 CPR 0,98 CPR 0,39 CPR 1,06 CAPS 1,07 CPR 0,63 CPR 0,70 CAPS 1,43 CAPS 0,97 CAPS 1,00 COMP 0,93 CPR 0,69 CAPS 1,00 CAPS 0,50 CPR 0,93 CAPS 1,00 CAPS 1,23

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 761 762 763 764 765 766 767 768 769 770 771 772 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 795 796 797 798

CODIGO BENEFICIO 95990461 AMOXICILINA - GENERICO 95119469 AMOXICILINA - GENERICO 95050906 AMOXICILINA - GENERICO 95050914 AMOXICILINA - GENERICO 95050922 AMOXICILINA - GENERICO 95089446 AMOXICILINA - GENERICO 95089454 AMOXICILINA - GENERICO 95089462 AMOXICILINA - GENERICO 95370374 AMOXICILINA - GENERICO 95370366 AMOXICILINA - GENERICO 95990470 AMOXICILINA - GENERICO 95986790 AMOXICILINA - GENERICO 95986804 AMOXICILINA - GENERICO 95990488 AMOXICILINA - GENERICO 95012532 AMOXICILINA - GENERICO 95370560 AMOXICILINA - GENERICO 95012559 AMOXICILINA - GENERICO 95990496 AMOXICILINA - GENERICO 95370480 AMOXICILINA - GENERICO 95990500 AMOXICILINA - GENERICO 95990518 AMOXICILINA - GENERICO 95012540 AMOXICILINA - GENERICO 95370439 AMOXICILINA - GENERICO 95921664 AMOXICILINA - GENERICO 95370447 AMOXICILINA - GENERICO 95921672 AMOXICILINA - GENERICO 95370471 AMOXICILINA - GENERICO 95119477 AMOXICILINA - GENERICO 95095233 AMOXICILINA - GENERICO 95119485 AMOXICILINA - GENERICO 95119493 AMOXICILINA - GENERICO 95119507 AMOXICILINA - GENERICO (Restrito Hosp,) 95119515 AMOXICILINA - GENERICO (Restrito Hosp,) 95035125 AMOXICILINA + CLAVUL, - GENERICO 95990534 AMOXICILINA + CLAVUL, DE POT, - GENERICO 95095241 AMOXICILINA + CLAVUL, DE POT, - GENERICO 95095250 AMOXICILINA + CLAVUL, DE POT, - GENERICO 95370641 AMOXICILINA + CLAVUL, DE POT, - GENERICO

APRESENTAÇÃO Laboratorio 500 mg, bl, x 21 caps, gel, dura BRAINFARMA 500 mg, cap, gel, dura ct, bl, al, plas, inc, x 280 (frac,) PRATI DONADUZZI 500 mg, cap, gel, dura ct, bl, plas, inc, x 21 PRATI DONADUZZI 500 mg, cap, gel, dura ct, bl, plas, inc, x 210 (hosp,) PRATI DONADUZZI 500 mg, cap, gel, dura ct, bl, plas, inc, x 840 (hosp,) PRATI DONADUZZI 500 mg, cap, x 15 UNIAO QUIMICA 500 mg, cap, x 21 UNIAO QUIMICA 500 mg, cap, x 30 UNIAO QUIMICA 500 mg, cx, 15 caps, EMS 500 mg, cx, 21 caps, EMS 500 mg, cx, 21 caps, TEUTO BRAS, 500 mg, cx, 3 bl, x 5 caps, NEO QUIMICA 500 mg, cx, 3 bl, x 7 caps, NEO QUIMICA 500 mg, cx, 30 caps, TEUTO BRAS, 500 mg,6 bl, x 12 caps, EMS 500 mg/5 ml po p/susp, 1 fr, vd, 150 ml+ dos, MEDLEY 500mg,2bl,x15caps, EMS 875 mg 2 bl, x 7 cprs, rev, GEN - LEGRAND 875 mg ct c/14 cprs, EUROFARMA 875 mg, 14 cprs, rev, EMS 875 mg, 2 bl, x 7 cprs, rev, GERMED 875 mg, BD 5 bl, x 6 cprs, rev, EMS Susp, 125 mg/5 ml fr, vd, 150 ml EUROFARMA Susp, 250 mg/5 ml fr, 150 ml GERMED Susp, 250 mg/5 ml frs, vd, 150 ml, EUROFARMA Susp, 500 mg/5 ml fr, 150 ml EMS Susp, 500 mg/5 ml fr, vd, 150 ml, EUROFARMA Susp, oral 250 mg/150 ml MULTILAB Susp, oral 250 mg/5 ml fr, 150 ml RATIOPHARM Susp, oral 250 mg/60 ml MULTILAB Susp, oral 500 mg/150 ml MULTILAB 50 mg/ml po p/susp, or, cx, 50 fr, vd, amb, x 150 ml + 50 cp,PRATI med, (hosp,) DONADUZZI 500 mg, bl, 350 caps, gel, dura (hosp,) AUROBINDO PHARMA 1 g+ 200 mg, po liof, sol, inj, IV 10 FA vd, x 30 ml AUROBINDO PHARMA 1 g ct c/10 FA EUROFARMA 125 mg/5 ml fr, 100 ml SANDOZ 125 mg/5 ml fr, 75 ml SANDOZ 125 mg/5 ml, fr, 75 ml, EMS

UNIDADE Pco Unt Base A CAPS 1,05 CAPS 0,40 CAPS 0,65 CAPS 5,62 CAPS 0,35 CAPS 0,99 CAPS 0,98 CAPS 0,93 CPR 1,11 CPR 1,10 CAPS 0,59 CAPS 0,91 CAPS 0,83 CAPS 0,59 CAPS 0,93 ML 0,18 CAPS 1,08 COMP 1,64 CPR 2,10 COMP 2,09 COMP 1,98 COMP 1,75 ML 0,06 ML 0,08 ML 0,08 ML 0,18 ML 0,13 ML 0,12 ML 0,16 ML 0,15 ML 0,19 FRS 8,22 CAPS 1,15 FA 26,75 F,A, 25,65 ML 0,21 ML 0,21 ML 0,20

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 799 800 801 802 803 804 805 806 807 808 809 810 811 812 813 814 815 816 817 818 819 820 821 822 823 824 825 826 827 828 829 830 831 832 833 834 835 836

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95051082 AMOXICILINA + CLAVUL, DE POT, - GENERICO 25 mg/ml+ 6,25 mg/ml po susp, oral fr, vd, x 100 ml col, dos,SANDOZ 95051066 AMOXICILINA + CLAVUL, DE POT, - GENERICO 25 mg/ml+ 6,25 mg/ml po susp, oral fr, vd, x 75 ml col, dos, SANDOZ 95370749 AMOXICILINA + CLAVUL, DE POT, - GENERICO 250 mg, est, fr, 75 ml RANBAXY 95095268 AMOXICILINA + CLAVUL, DE POT, - GENERICO 250 mg/5 ml fr, 100 ml SANDOZ 95095276 AMOXICILINA + CLAVUL, DE POT, - GENERICO 250 mg/5 ml fr, 75 ml SANDOZ 95370650 AMOXICILINA + CLAVUL, DE POT, - GENERICO 250 mg/5 ml, fr, 75 ml, EMS 95119523 AMOXICILINA + CLAVUL, DE POT, - GENERICO 400 + 57,5 mg/5 ml susp, oral fr, 70 ml SANDOZ 95095284 AMOXICILINA + CLAVUL, DE POT, - GENERICO 400 mg, + 57 mg/5 ml po susp, oral fr, vd, x 70 ml BIOSINTETICA 95008977 AMOXICILINA + CLAVUL, DE POT, - GENERICO 400 mg,+ 57,5 mg/5 ml fr, 70 ml RANBAXY 95051015 AMOXICILINA + CLAVUL, DE POT, - GENERICO 400+ 57 mg, susp, fr, 70 ml EMS 95051074 AMOXICILINA + CLAVUL, DE POT, - GENERICO 50 mg/ml+ 12,5 mg/ml po susp, oral fr, vd, x 75 ml col, dos, SANDOZ 95921680 AMOXICILINA + CLAVUL, DE POT, - GENERICO 50 mg/ml+ 12,5 mg/ml po susp, oral fr, x 75 ml BRAINFARMA 95051090 AMOXICILINA + CLAVUL, DE POT, - GENERICO 50 mg/ml+ 6,25 mg/ml po susp, oral fr, vd, x 100 ml col, dos,SANDOZ 95370668 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg cx, 12 cprs, EMS 95370676 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg cx, 18 cprs, EMS 95370730 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg, 3 bl, x 6 cprs, RANBAXY 95370722 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg, bl, 6 cprs, RANBAXY 95921699 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg,+ 125 mg, 1 str, x 6 cprs, rev, BRAINFARMA 95921702 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg,+ 125 mg, 18 cprs, MEPHA-RATIOPHARM 95921710 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg,+ 125 mg, 3 str, x 6 cprs, rev, BRAINFARMA 95921729 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg,+ 125 mg, 6 cprs, MEPHA-RATIOPHARM 95070621 AMOXICILINA + CLAVUL, DE POT, - GENERICO 500 mg/125 mg,12 cprs, rev, SANDOZ 95095292 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg, + 125 mg, 14 cprs, rev, SANDOZ 95026258 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg,+ 125 mg, 2 bl, x 7 cprs, RANBAXY 95070648 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg,+ 125 mg, 20 cprs, rev, SANDOZ 95026266 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg,+ 125 mg, 3 bl, x 4 cprs, RANBAXY 95070591 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg,+ 125 mg, fr, vd, 12 cprs, rev, EUROFARMA 95070605 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg,+ 125 mg, fr, vd, 14 cprs, rev, EUROFARMA 95070613 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg,+ 125 mg, fr, vd, 20 cprs, rev, EUROFARMA 95070630 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875 mg/125 mg 12 cprs, rev, SANDOZ 95050990 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875+ 125 mg, 2 bl, x 6 cprs, rev, EMS 95051023 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875+ 125 mg, 2 bl, x 6 cprs, rev, GERMED 95051040 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875+ 125 mg, 2 bl, x 6 cprs, rev, GEN - LEGRAND 95051007 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875+ 125 mg, 2 bl, x 7 cprs, rev, EMS 95051031 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875+ 125 mg, 2 bl, x 7 cprs, rev, GERMED 95051058 AMOXICILINA + CLAVUL, DE POT, - GENERICO 875+ 236 mg, 2 bl, x 7 cprs, rev, GEN - LEGRAND 95921745 AMOXICILINA + CLAVUL, DE POT, - GENERICO Susp, 250 mg/5 ml+ 62,5 mg/5 ml fr, x 75 ml MEPHA-RATIOPHARM 95119531 AMOXICILINA + CLAVUL, DE POT, - GENERICO (Restrito Hosp,) 1 g ct c/10 FA EUROFARMA

UNIDADE Pco Unt Base A ML 0,16 ML 0,16 ML 0,37 ML 0,38 ML 0,38 ML 0,42 ML 0,45 ML 0,65 GOTA 0,03 ML 0,65 ML 0,29 ML 0,42 ML 0,29 CPR 3,29 CPR 3,28 CPR 2,84 CPR 2,87 CPR 3,32 CPR 3,31 CPR 3,33 CPR 3,16 COMP 2,93 COMP 5,48 CPR 4,09 COMP 5,37 CPR 3,02 COMP 4,26 COMP 5,00 COMP 5,37 COMP 6,06 COMP 5,37 COMP 5,37 COMP 5,37 COMP 5,55 COMP 5,55 COMP 5,55 ML 0,43 FA 25,65

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869 870 871 872 873 874

CODIGO BENEFICIO 95012630 AMOXICILINA + CLAVUL, G - GENERICO 95012621 AMOXICILINA + CLAVUL, G - GENERICO 95370773 AMOXICILINA GERMED - GENERICO 95370765 AMOXICILINA GERMED - GENERICO 95370781 AMOXICILINA GERMED - GENERICO 95370870 AMOXIL 95370854 AMOXIL 95370838 AMOXIL 95370889 AMOXIL 95370919 AMOXIL BD 95370927 AMOXIL BD 95370935 AMOXIL BD 95370900 AMOXIL BD 95370960 AMOXINA 95370943 AMOXINA 95008985 AMOXINA 95083480 AMOXIPEN 95371028 AMOXITAN 95371036 AMOXITAN 95371176 AMPICILASE 95012680 AMPICILASE 95371281 AMPICILINA - GENERICO 95371290 AMPICILINA - GENERICO 95070664 AMPICILINA - GENERICO 95070656 AMPICILINA - GENERICO 95051112 AMPICILINA - GENERICO 95371303 AMPICILINA - GENERICO 95371354 AMPICILINA - GENERICO 95081810 AMPICILINA - GENERICO 95012699 AMPICILINA - GENERICO 95051120 AMPICILINA - GENERICO 95051147 AMPICILINA - GENERICO 95051139 AMPICILINA - GENERICO 95081798 AMPICILINA - GENERICO 95081801 AMPICILINA - GENERICO 95083499 AMPICILINA - GENERICO 95371273 AMPICILINA - GENERICO 95371257 AMPICILINA - GENERICO

APRESENTAÇÃO Laboratorio 1000 mg,+ 200 mg, 50 FA CELLOFARM 500 mg,+ 100 mg, 50 FA CELLOFARM 500 mg, cx, 15 caps, GERMED 500 mg, cx, 21 caps, GERMED Susp, oral fr, 150 ml, GERMED 125 mg, susp, 150 ml GLAXOSMITHKLINE 250 mg, susp, 150 ml, GLAXOSMITHKLINE 500 mg, 15 caps, GLAXOSMITHKLINE 500 mg, susp, 150 ml GLAXOSMITHKLINE 200 mg, fr, 100 ml GLAXOSMITHKLINE 400 mg, fr, 100 ml GLAXOSMITHKLINE 875 mg, 20 cprs, rev, GLAXOSMITHKLINE 875 mg, 7 bl, x 2 cprs, rev, GLAXOSMITHKLINE 250 mg susp, fr, 60 ml HEXAL 500 mg, cx, 12 caps, HEXAL 500 mg, cx, 21 caps, HEXAL 500 mg, cx, 200 caps, BIOCHIMICO 250 mg/5 ml po p/ susp,fr, 150 ml, BUNKER 500 mg cx, 12 caps, BUNKER 250 mg/5 ml, po susp, 60 ml TEUTO BRAS, 500 mg, 10 caps, TEUTO BRAS, 250 mg/5 ml susp, oral (3 g) fr, 60 ml EMS 250 mg/5 ml susp, oral (7,5 g) fr, 150 ml EMS 50 mg/ml po susp, or, fr, vd, x 150 ml+ ser, dosad, MEDLEY 50 mg/ml po susp, or, fr, vd, x 60 ml+ ser, dosad, MEDLEY 50 mg/ml sus, or, ct, fr, plas, amb, x 150 ml+ cp, med, PRATI DONADUZZI 500 mg 2 bl, x 6 caps, LUPER 500 mg, 1 bl, x 12 EUROFARMA 500 mg, 10 cßps, MULTILAB 500 mg, 6 bl, x 8 cprs, EMS 500 mg, bl, 12 caps, gel, dura SANDOZ 500 mg, bl, 18 caps, gel dura SANDOZ 500 mg, bl, 24 caps, gel, dura SANDOZ 500 mg, cap, gel dura ct, bl, al, plas, inc, x 12 PRATI DONADUZZI 500 mg, cap, gel dura ct, bl, al, plas, inc, x 21 PRATI DONADUZZI 500 mg, cap, gel, dura ct, bl, al, plas, inc, x 480 (40x12) (hosp,) PRATI DONADUZZI 500 mg, cx, 12 cprs, EMS 500 mg, cx, 24 cprs, EMS

UNIDADE Pco Unt Base A FA 25,17 FA 15,07 CPR 0,70 CPR 0,69 ML 0,08 ML 0,20 ML 0,28 CPR 2,36 ML 0,41 ML 0,21 ML 0,23 CPR 2,15 CPR 2,31 ML 0,20 CPR 1,20 CAPS 0,95 CAPS 0,26 ML 0,19 CPR 2,35 ML 0,23 CAPS 1,70 ML 0,17 ML 0,19 ML 0,10 ML 0,10 ML 0,11 CPR 1,02 CPR 1,13 CAPS 0,74 COMP 0,97 CAPS 1,12 CAPS 1,12 CAPS 1,24 CAPS 1,13 CAPS 1,00 CAPS 0,42 CPR 1,27 CPR 1,24

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892 893 894 895 896 897 898 899 900 901 902 903 904 905 906 907 908 909 910 911 912

CODIGO BENEFICIO 95371265 AMPICILINA - GENERICO 95921761 AMPICILINA - GENERICO 95921770 AMPICILINA - GENERICO 95990542 AMPICILINA - GENERICO 95035176 AMPICILINA + SULBACTAM - GENERICO 95035150 AMPICILINA + SULBACTAM - GENERICO 95089861 AMPICILINA + SULBACTAM - GENERICO 95035184 AMPICILINA + SULBACTAM - GENERICO 95035168 AMPICILINA + SULBACTAM - GENERICO 95089870 AMPICILINA + SULBACTAM - GENERICO 95119540 AMPICILINA G - GENERICO (Restrito Hosp,) 95064435 AMPICILINA SODICA - GENERICO 95064443 AMPICILINA SODICA - GENERICO 95064427 AMPICILINA SODICA - GENERICO 95119558 AMPICILINA SODICA - GENERICO 95119566 AMPICILINA SODICA - GENERICO 95119574 AMPICILINA SODICA - GENERICO 95138005 AMPICILINA SODICA - GENERICO (Restrito Hosp.) 95035192 AMPICILINA SODICA + SULBACTAM SODICA - G 95119582 AMPICILINA SODICA G - GENERICO (Restrito Hosp,) 95371478 AMPICIMAX 95371451 AMPICIMAX 95008993 AMPILOZIN 95921796 AMPILOZIN 95371630 AMPLACILINA 95371591 AMPLACILINA 95371575 AMPLACILINA 95012753 AMPLACIN 95012737 AMPLACIN 95012745 AMPLACIN 95012729 AMPLACIN 95371648 AMPLAMOX 95371656 AMPLAMOX 95371672 AMPLAMOX 95371680 AMPLAMOX 95371664 AMPLAMOX 95051155 AMPLAMOX AC 95026274 AMPLATIL

APRESENTAÇÃO 500 mg, cx, 6 cprs, Po susp, 250/5 ml, fr, 150 ml, Po susp, 250/5 ml, fr, 60 ml, Susp, 250 mg, fr, 60 ml 1 g+ 0,5 g po sol, inj, 20 FA vd, x 30 ml (hosp,) 1 g+ 0,5 g po sol, inj, 30 FA vd, x 30 ml (hosp,) 1,5 g po inj, ct, 10 FA 2 g+ 1 g po sol, inj, 20 FA vd, x 30 ml (hosp,) 2 g+ 1 g po sol, inj, 30 FA vd, x 30 ml (hosp,) 3 g po inj, ct, 10 FA 500 mg, 100 caps, gel, dura (hosp,) 1 g 12 FA 1 g 50 FA (hosp,) 1 g FA 1 g po inj, DP c/50 + 50 amp, dil, 3 ml 500 mg, po inj, DP c/50 + 50 amps, dil, 2 ml 500 mg, po p/sol, inj, ct 12 FA 500 mg. po inj. DP c/50 + 50 amps. dil. 2 ml (hosp.) 1,0 g+ 0,5 g po p/sol, inj, cx, 20 FA vd, x 3,2 ml 1 g po sol, inj, 50 FA vd, x 10 ml (hosp,) 250 mg, susp, fr, 60 ml, 500 mg, cx, 10 caps, 500mg,cx,bl,10 caps, Po susp, oral 250 mg/ml vd, 60 ml 1 g cx, 25 FA+ dil, 3 ml, 500 mg, cart, 12 caps, Susp, fr, 60 ml, 250 mg, 60 ml 500 mg, 12 caps, 500 mg, 24 caps, 500 mg, 6 caps, 125 mg/5 ml susp, oral fr, 150 ml 250 mg/5 ml susp, oral fr, 150 ml 500 mg cx, 21 caps, 500 mg cx, 30 caps, 500 mg/5 ml susp, oral fr, 150 ml 1 g+ 200 mg, po inj, x 10 FA 1 g po inj, cx, 50 FA

Laboratorio EMS NEO QUIMICA NEO QUIMICA EUROFARMA AUROBINDO PHARMA AUROBINDO PHARMA ABL AUROBINDO PHARMA AUROBINDO PHARMA ABL ASPEN PHARMA AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA TEUTO BRAS, TEUTO BRAS, AUROBINDO PHARMA TEUTO BRAS. NOVAFARMA ASPEN PHARMA ROYTON ROYTON DUCTO DUCTO EUROFARMA EUROFARMA EUROFARMA CIFARMA CIFARMA CIFARMA CIFARMA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS UNIAO QUIMICA NOVAFARMA

UNIDADE Pco Unt Base A CPR 1,27 ML 0,16 ML 0,14 ML 0,17 FA 16,45 FA 16,45 FA 16,45 FA 28,99 FA 28,99 FA 28,99 CAPS 0,68 FA 5,15 FA 5,13 FA 5,12 FA 6,04 FA 1,67 FA 1,78 COMP 1,87 FA 15,97 FA 3,07 ML 0,25 CPR 1,70 CAPS 1,15 ML 0,18 AP 8,50 CPR 1,22 ML 0,16 ML 0,21 CAPS 1,44 CAPS 1,32 CAPS 1,56 ML 0,11 ML 0,16 CPR 1,46 CPR 1,10 ML 0,25 FA 23,51 FA 3,26

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 913 914 915 916 917 918 919 920 921 922 923 924 925 926 927 928 929 930 931 932 933 934 935 936 937 938 939 940 941 942 943 944 945 946 947 948 949 951

CODIGO BENEFICIO 95026282 AMPLATIL 95280030 AMPLICTIL 95280049 AMPLICTIL 95280022 AMPLICTIL 95986812 AMPLIMED 95986820 AMPLIMED 95410015 AMPLIUM 95410023 AMPLIUM 95410031 AMPLIUM 95371826 AMPLOCILIN 95371800 AMPLOCILIN 95095306 AMPLOGIN 95081828 AMPLOSPEC 95081836 AMPLOSPEC 95290036 AMYTRIL 95290044 AMYTRIL 95290052 AMYTRIL 95250140 ANABRON XAROPE 95250131 ANABRON XAROPE 95026290 ANADOR 95026304 ANADOR 95026312 ANADOR 95136622 ANADOR 95026339 ANADOR 95136630 ANADOR 95026347 ANADOR 95026355 ANADOR 95330410 ANADOR 95070672 ANADOR PRT 95046046 ANADOR PRT 95009027 ANAEROCID 95009035 ANAEROCID 95012800 ANAEROCID (*) 95012818 ANAEROCID (*) 95290060 ANAFRANIL 95290079 ANAFRANIL 95290095 ANAFRANIL 95330534 ANALGESIN

APRESENTAÇÃO 500 mg, po inj, cx, 50 FA 100 mg, est, 20 cprs, 25 mg cprs, rev, ct 2 bl al plas inc x 10 Gts, fr, 20 ml, 250 mg, po susp, vd, 60 ml 500 mg, cx, 12 caps, 500 mg, cx, 4 cprs, 500 mg, cx, 8 cprs, G creme bisn, 80 g, c/ 14 aplic, 1 g cx, 50 FA 500 mg, cart, 10 bl, x 10 caps, 20 mg/g + 30 mg/g creme vag, bisn, 35 g + 7 aplic, 1 g cx, 1 fr,+ 1 amp, 1 g cx, 50 frs, 25 mg, 20 cprs, 25 mg, cx, 20 bl, x 10 cprs, 75 mg cx, 2 bl, x 10 cprs, Ad, vd, 100 ml, Ped, vd, 100 ml, 500 mg, cprs, bl, x 24 500 mg, cprs, ct, bl, x 120 500 mg, cprs, ct, bl, x 512 Fracao (120) bl, c/2 cprs, Fracao (120) bl, c/8 cprs, Fracao (240) bl, c/4 Fracao (512) bl, c/4 cprs, Fracao (512) bl, c/8 cprs, Sol, oral 500 mg, 1 fr,20 ml 750 mg, bl, 256 cprs, (emb, mult,) 750 mg, bl, 4 cprs, 20 mg/g creme vag, bisn, 20 g+ 3 aplic, 20 mg/g creme vag, bisn, 40 g+ 7 aplic, 300 mg, 2 bl, x 8 caps, 300 mg,2 bl, x 15 caps, 10 mg, 20 drags, 25 mg, 20 drags, SR 75 mg, div, 20 CE Ad, 100 cprs,

Laboratorio NOVAFARMA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS MEDQUIMICA MEDQUIMICA FARMASA FARMASA FARMASA CELLOFARM CELLOFARM GALLIA BIOCHIMICO BIOCHIMICO CRISTALIA CRISTALIA CRISTALIA MILLET-ROUX MILLET-ROUX BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA NOVARTIS NOVARTIS NOVARTIS TEUTO BRAS,

UNIDADE Pco Unt Base A FA 2,94 CPR 0,30 CPR 0,20 GOTAS 0,01 ML 0,23 CAPS 1,46 CPR 1,30 CPR 1,21 G 0,30 AP 3,11 CPR 0,65 G 0,41 FA 5,96 FA 5,36 CPR 0,56 CPR 0,51 CPR 1,61 ML 0,13 ML 0,09 CPR 0,50 CPR 0,56 CPR 0,56 CPR 1,12 CPR 0,49 CPR 0,56 CPR 0,56 CPR 0,49 GOTAS 0,03 COMP 0,35 COMP 0,35 GRAMA 22,70 GRAMA 35,76 COMP 1,85 COMP 1,95 CPR 0,45 CPR 1,16 AP 2,48 CPR 0,24

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 952 953 954 955 956 957 958 959 960 961 962 963 964 965 966 967 968 969 970 971 972 973 974 975 976 977 978 979 980 981 982 983 984 985 986 987 988 989

CODIGO BENEFICIO 95330542 ANALGESIN 95070680 ANALVERIN 95070699 ANALVERIN 95070702 ANALVERIN PLUS 95070710 ANALVERIN PLUS 95490027 ANANDRON 95330607 ANANGOR 95089497 ANANGOR 95330615 ANANGOR 95660038 ANARTRIT 95840060 ANASEPTIL 95051163 ANASTROL 95921826 ANASTROL 95095314 ANASTROLIBBS 95035230 ANATEN 95035222 ANATEN 95400214 ANCLOMAX - ACICLOVIR 95400222 ANCLOMAX - ACICLOVIR 95110119 ANCORON 95110100 ANCORON 95035249 ANCORON 95110097 ANCORON 95110089 ANCORON 95780017 ANDANTOL 95051171 ANDELUX 95780025 ANDOLBA 95119590 ANDROCORTIL 95041699 ANDROCORTIL 95041702 ANDROCORTIL 95899162 ANDROCORTIL 95119604 ANDROCORTIL 95041710 ANDROCORTIL 95119612 ANDROCORTIL (Restrito Hosp,) 95921877 ANDROFLOXIN 95921893 ANDROLIP 95921885 ANDROLIP 95012842 ANENTAL 95012834 ANENTAL

APRESENTAÇÃO Inf, 200 cprs, 20 cprs, Gts, 10 ml 20 drags, Gts, 20 ml 50 mg, 4 bl, al, plast, x 15 cprs, 50 mg bl, 10 caps, gel, dura 50 mg/ml 2 ml sol inj, 6 FA 50 mg/ml, sol, inj, 6 FA 1 ml, 20 mg, cx, 12 caps, Po tubo plast, c/10 g 1 mg, bl, x 28 cprs, rev, Fracao de venda 1 mg, 28 cprs, rev, or, 5,0 mg,+ 25 mg, bl, 30 caps, gel dura 5,0 mg,+ 50 mg, bl, 30 caps, gel dura 2 bl, 200 mg x 10 cprs, 2 bl, 400 mg, x 10 cprs 100 mg, cx, 20 cprs, 200 mg, cx, 20 cprs, Gts, susp, fr, 30 ml Sol, inj, 50 x 3 ml, Sol, inj, 6 x 3 ml, Geleia bisn, 40 g, 50mg,bl,20 cprs, Cx, 43 g, 100 mg, FA + amp, di, 2 ml (hosp,) 100 mg, po liof, inj, c/1 c/dil, 100 mg, po liof, inj, s/dil, x 50 frs, 500 mg po liof, inj, c/1 500 mg, FA + amp, di, 4 ml 500 mg, po liof, inj, s/dil, x 50 frs, 100 mg, po liof, inj, c/1 c/dil, (hosp,) 400 mg, cx, 14 cprs, 10 mg,cx,10cprs,rev, 10mg,cx,30cprs,rev, 1000 mg, 25 FA po p/sol, inj, 500 mg, po inj, cx, 25 FA

Laboratorio TEUTO BRAS, DOVALLE DOVALLE DOVALLE DOVALLE SANOFI-AVENTIS BIOSINTETICA BIOSINTETICA BIOSINTETICA HEXAL FARMASA LIBRA LIBRA LIBBS EUROFARMA EUROFARMA BLAUSIEGEL BLAUSIEGEL LIBBS LIBBS LIBBS LIBBS LIBBS ACHE SANDOZ EUROFARMA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, CELLOFARM CELLOFARM

UNIDADE Pco Unt Base A CPR 0,09 COMP 0,27 GOTA 0,02 DRAG 0,75 GOTA 0,04 CPR 5,30 CPR 3,01 FA 7,81 AP 5,48 CPR 0,63 G 0,76 COMP 18,35 UND 12,20 COMP 15,33 CP 1,44 CP 1,70 CPR 3,58 CPR 6,58 CPR 0,52 CPR 0,98 GOTA 0,06 AP 2,36 AP 2,47 G 0,25 COMP 3,83 G 0,39 FA 2,48 FA 2,48 FA 2,25 FA 5,57 FA 5,57 FA 5,42 FA 2,48 CPR 1,65 CPR 1,77 CPR 0,99 FA 16,70 FA 12,72

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 990 991 992 993 994 997 1000 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1019 1020 1021 1022 1023 1024 1025 1026 1027 1028 1029 1030 1031

CODIGO BENEFICIO 95035265 ANESEVO 95035273 ANESEVO 95074309 ANESEVO 95730010 ANESTALCON 95990585 ANESTESIA 95730028 ANESTESICO 95921915 ANFLAT 95921923 ANFLAT 95640053 ANFLENE 95640061 ANFLENE 95044604 ANFORICIN B 95012850 ANFOTERIN 95921931 ANFUGINE 95390120 ANFUGITARIN 95095322 ANGIO II 95095330 ANGIO II 95095349 ANGIO II 95921940 ANGIODARONA 95130268 ANGIOLONG 95130276 ANGIOLONG 95130292 ANGIOLONG AP 95130306 ANGIOLONG AP 95130284 ANGIOLONG AP 95095357 ANGIOLOT 95130314 ANGIOPRIL 95130322 ANGIOPRIL 95130330 ANGIOPRIL 95130390 ANGIPRESS 95130373 ANGIPRESS 95130381 ANGIPRESS 95110127 ANGYTON 95026363 ANI - PEDIALYTE 95026371 ANI - PEDIALYTE 95026380 ANI - PEDIALYTE 95026398 ANI - PEDIALYTE 95026401 ANI - PEDIALYTE 95026410 ANI - PEDIALYTE 95026428 ANI - PEDIALYTE

APRESENTAÇÃO Fr, vd, x 100 ml Fr, vd, x 250 ml Fr, vd, x 50 ml Fr, 5 ml, Isothane (isoflurano) - 6 frascos 100 ml 10 ml, 40 mg, cx, 20 cprs, 75 mg, gts, fr, 10 ml 10 mg, 15 caps, 20 mg, 15 caps, 50 mg, 25 fr, ap,+ 25 ap, 10 ml Creme vag, bisn, 60 g+ 10 aplic, Cr, vag, bisn, 80 g Creme vag, bisn, 80 g+ aplic, 160 mg, ct, bl, al/al x 30 cprs, rev, 320 mg, ct, bl, al/al x 30 cprs, rev, 80 mg, ct, bl, al/al x 30 cprs, rev, 200 mg, cx, 20 cprs, 30 mg, cx, 50 cprs, 60 mg, cx, 50 cprs, 180 mg, cx, 20 caps, 300 mg, cx, 10 caps, 90 mg, cx, 20 caps, Cx, 2 bl, x 10 drags, 10 mg cx, 30 cprs, 20 mg cx, 30 cprs, 5 mg cx, 30 cprs, Cx, 28 cprs, 100 mg, Cx, 28 cprs, 25 mg, Cx, 28 cprs, 50 mg, 200 mg, cx, 20 cprs, Pedialyte 45 po laranja - cx, 1 env, Pedialyte 45 sol, cereja - fr, 500 ml Pedialyte 45 sol, coco - fr, 500 ml Pedialyte 45 sol, guarana - fr, 500 ml Pedialyte 45 sol, maca - fr, 500 ml Pedialyte 45 sol, pessego - fr, 500 ml Pedialyte 45 sol, tutti-frutti - fr, 500 ml

Laboratorio BIOCHIMICO BIOCHIMICO BIOCHIMICO ALCON BAXTER ALLERGAN CAZI CAZI TEUTO BRAS, TEUTO BRAS, CRISTALIA TEUTO BRAS, BLAUSIEGEL BLAUSIEGEL MEDLEY MEDLEY MEDLEY CAZI CHIESI CHIESI CHIESI CHIESI CHIESI NEO QUIMICA DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS BIOSINTETICA BIOSINTETICA BIOSINTETICA ROYTON ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT

UNIDADE Pco Unt Base A ML 4,47 ML 4,47 ML 4,47 GOTAS 0,05 ML 0,71 GOTAS 0,03 CPR 0,43 GOTAS 0,03 CPR 0,28 CPR 0,41 FA 17,20 GRAMA 0,57 G 0,18 G 0,24 COMP 2,00 COMP 1,96 COMP 2,00 CPR 0,81 CPR 0,24 CPR 0,46 CPR 1,97 CPR 3,37 CPR 1,21 DRAG 1,06 CPR 0,72 CPR 0,93 CPR 0,40 CPR 0,79 CPR 0,31 CPR 0,48 CPR 1,00 ENV 4,47 FR 12,52 FR 12,52 FR 12,52 FR 12,52 FR 11,24 FR 12,52

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1032 1033 1034 1035 1036 1037 1038 1039 1040 1041 1042 1043 1045 1046 1047 1048 1049 1051 1052 1053 1054 1055 1056 1057 1058 1059 1060 1061 1069 1075 1077 1078 1079 1082 1083 1091 1092 1096

CODIGO BENEFICIO 95026436 ANI - PEDIALYTE 95026444 ANI - PEDIALYTE 95026452 ANI - PEDIALYTE 95921958 ANLO 95041737 ANLO 95921966 ANLO 95041729 ANLO 95130403 ANLODIBAL 95130411 ANLODIBAL 95012877 ANNITA 95012885 ANNITA 95012869 ANNITA 95921974 ANOXOLAM 95921982 ANOXOLAM 95020039 ANSENTRON (ONDANSETRONA) 95020047 ANSENTRON (ONDANSETRONA) 95270051 ANSILIVE 95270060 ANSIOPAX 95009060 ANSIRAX 95270086 ANSITEC 95270078 ANSITEC 95030085 ANTAK 95030093 ANTAK 95030115 ANTAK 95030131 ANTAK 95030140 ANTAK 95030158 ANTAK 95030107 ANTAK 95990690 ANTIBIOTICOS 95030174 ANTIDIN 95136916 ANTIETANOL 95330658 ANTIFEBRIN 95330666 ANTIFEBRIN 95320032 ANTIGERON 95320059 ANTIGERON 95110151 ANTITENSIN 95110143 ANTITENSIN 95400230 ANTIVIRAX

APRESENTAÇÃO Pedialyte 90 po - cx, 1 env, Pedialyte 90 sol, - fr, 500 ml Pedialyte sol, - fr, 500 ml 10 mg, 3 bl, x 10 cprs, 10 mg, 7 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 7 bl, x 10 cprs, 10 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 20 mg/ml susp, 45 ml 20mg/mlsusp,100 ml 500 mg, cx, 6 cprs, 1 mg, cx, 20 cprs, 2 mg, cx, 20 cprs, 4 mg, inj, cx, 1 amp, x 2 ml, 8 mg, inj, cx, 1 amp, x 4 ml, 20 drags, Cx, 20 caps, 2 mg, 20 cprs, 10 mg, 20 cprs, 5 mg, 20 cprs, 150 mg, 10 cprs, 150 mg, 20 cprs, 150 mg, eferv, 10 cprs, 300 mg, 10 cprs, 300 mg, 20 cprs, Sol, inj, cx, 5 amps, x 2 ml, Xarope fr, 120 ml Klaricid IV 500 mg/FA (cx, c/ 1 unid,) 300 mg, cx, 16 cprs, Cx, 20 cprs, 100 mg, cx, 200 cprs, 500 mg, cx, 100 cprs, 25 mg, cx, 30 cprs, AP 75 mg, cx, 30 cprs, 40 mg, cx, 40 cprs, 80 mg, cx, 20 cprs, Creme 10 g

Laboratorio ABBOTT ABBOTT ABBOTT SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA BALDACCI BALDACCI FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA NEO QUIMICA NEO QUIMICA BIOSINTETICA BIOSINTETICA LIBBS HEBRON TEUTO BRAS, LIBBS LIBBS GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE ABBOTT TEUTO BRAS, SANOFI-AVENTIS ROYTON ROYTON FARMASA FARMASA TEUTO BRAS, TEUTO BRAS, EMS

UNIDADE Pco Unt Base A FR 4,73 FR 12,79 FR 11,24 CPR 1,23 COMP 0,83 CPR 0,67 COMP 0,46 CPR 2,27 CPR 1,10 ML 0,45 ML 0,42 COMP 8,09 CPR 0,51 CPR 0,80 AP 47,99 AP 98,07 CPR 0,35 CPR 1,69 COMP 0,48 CPR 1,39 CPR 0,78 CPR 2,21 CPR 2,09 CPR 3,69 CPR 4,54 CPR 4,36 AP 2,06 ML 0,28 F,A, 129,50 CPR 1,54 CPR 0,27 CPR 0,09 CPR 0,20 CPR 0,13 CPR 0,31 CPR 0,13 CPR 0,20 G 1,70

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1097 1098 1099 1100 1101 1102 1103 1104 1105 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 1116 1117 1118 1119 1120 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134

CODIGO BENEFICIO 95400249 ANTIVIRAX (*) 95095365 ANTIVIRAX (*) 95089500 ANTUX 95260030 ANTUX 95260048 ANTUX 95320067 ANZEMET IV 95130438 AORTEN 95070729 APIDRA 95070737 APIDRA 95070745 APIDRA SOLOSTAR 95990720 APLAUSE 95160094 APLICAV 95160108 APLICAV 95160116 APLICAV 95012923 APRAZ 95012958 APRAZ 95012940 APRAZ 95012931 APRAZ 95130454 APRESOLINA 95130462 APRESOLINA 95095373 APROVEL 95012966 APROVEL 95012974 APROVEL 95095381 APROVEL 95012982 APROVEL 95012990 APROVEL 95013008 APROZIDE 95013016 APROZIDE 95013024 APROZIDE 95013032 APROZIDE 95540075 ARACYTIN 95540105 ARACYTIN CS 95540091 ARACYTIN CS 95922091 ARADOIS 95119108 ARADOIS 95095390 ARADOIS 95922105 ARADOIS 95051180 ARADOIS

APRESENTAÇÃO 1 x 30 cprs, 200 mg, bl, 25 cprs, Gotas 10 ml Sol, oral fr, 20 ml, Xpe fr, 120 ml, 100 mg/5 ml sol, inj,amp, vd, x 5 ml Cx, 30 cprs, 25 mg, 100 UI/ml sol, inj, 1 carp, vd, x 3 ml 100 UI/ml sol, inj, 1 FA vd, x 10 ml 100 UI/mlsol,inj,1carp,vd,inc,x3 ml+1sist,aplic,plas, 20 mg cx, 30 cprs, 10 mcg, est, 1 ser, 20 mcg, est, 1 ser, 5 mcg, est, 1 ser, 0,25 mg, bl, 30 cprs, 0,5 mg, bl, 30 cprs, 1,0 mg, bl, 30 cprs, 2,0 mg, bl, 30 cprs, 25 mg, 20 drags, 50 mg, 20 drags, 150 mg, bl, 30 cprs, rev, 150 mg,14 cprs, 150 mg,2 x 14 cprs, 300 mg, bl, 30 cprs, rev, 300 mg,14 cprs, 300 mg,2 x 14 cprs, 150 mg, 14 cprs, 150 mg, 28 cprs, 300 mg, 14 cprs, 300 mg, 28 cprs, Cx, 1 fr, 100 mg,+ 1 amp, dil, 1 g, sol, inj, FA plast, 500 mg, sol, inj, FA plast 100 mg, 2 bl, x 15 cprs, rev, 100 mg, bl, 60 cprs, rev, 25 mg, bl, 60 cprs, rev, 25mg,bl,30cprs,rev, 50 mg, 60 cprs, rev,

Laboratorio EMS EMS ACHE ACHE ACHE SANOFI-AVENTIS BRASTERAPICA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS MARJAN LIBBS LIBBS LIBBS MANTECORP MANTECORP MANTECORP MANTECORP NOVARTIS NOVARTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS PFIZER PFIZER PFIZER BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS

UNIDADE Pco Unt Base A CPR 2,18 COMP 2,01 GOTAS 0,04 GOTAS 0,05 ML 0,15 AP 139,62 CPR 0,35 UI 0,07 UI 0,07 UI 0,07 COMP 1,55 AP 32,34 AP 46,19 AP 21,04 COMP 0,35 COMP 0,68 COMP 1,21 COMP 2,03 CPR 0,20 CPR 0,28 COMP 3,28 COMP 3,41 COMP 3,10 COMP 3,28 COMP 3,41 COMP 3,10 COMP 3,03 COMP 2,76 COMP 3,03 COMP 2,76 AP 7,41 AP 82,79 AP 41,39 CPR 1,92 COMP 1,22 COMP 0,55 CPR 0,72 COMP 0,91

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1135 1136 1137 1138 1139 1140 1141 1142 1143 1144 1145 1146 1147 1148 1149 1150 1151 1152 1153 1154 1155 1156 1157 1158 1159 1160 1161 1162 1163 1164 1165 1166 1167 1168 1169 1170 1171 1172

CODIGO BENEFICIO 95086234 ARADOIS 95130551 ARADOIS 95119116 ARADOIS H 95119124 ARADOIS H 95150013 ARAMIN 95640096 ARAVA 95640088 ARAVA 95650016 ARCALION 95650024 ARCALION 95660097 ARCOXIA 95660062 ARCOXIA 95660100 ARCOXIA 95660070 ARCOXIA 95130578 ARELIX 95220011 ARES 95922130 ARFLEX 95990755 ARFLEX 95690018 ARGIROL 95009078 ARICILINA 95064494 ARIFENICOL 95119620 ARIFENICOL (Restrito Hosp,) 95085475 ARISCORTEN (Restrito Hosp,) 95085491 ARISCORTEN (Restrito Hosp,) 95085505 ARISCORTEN (Restrito Hosp,) 95085521 ARISCORTEN (Restrito Hosp,) 95009086 ARISTOPRAMIDA 95009094 ARISTOPRAMIDA 95091106 ARIXTRA 95094644 ARIXTRA (Restrito Hosp,) 95900012 ARMOGLOBULINA - P I,V, 95560050 AROMASIN 95290109 AROPAX 95290117 AROPAX 95035290 AROTIN 95035281 AROTIN 95026460 AROVIT 95026479 AROVIT 95026487 AROVIT (*)

APRESENTAÇÃO Laboratorio 50 mg, bl, 90 cprs, rev, BIOLAB SANUS 50 mg, cx, 30 cprs, BIOLAB SANUS 100 mg, + 25 mg, bl, 60 cprs, rev, BIOLAB SANUS 50 mg, + 12,5 mg, bl, 90 cprs, rev, BIOLAB SANUS 10 mg, cx, 50 amps, 1 ml CRISTALIA 100 mg bl, 3 cprs, rev, SANOFI-AVENTIS 20 mg fr, 30 cprs, rev, SANOFI-AVENTIS Cx, 20 drags, SERVIER Cx, 60 drags, SERVIER 60 mg cx, 2 bl, x 7 cprs, MERCK SHARP & DOHME 60 mg, cx, 1 bl, 7 cprs, MERCK SHARP & DOHME 90 mg cx, 2 bl, x 7 cprs, MERCK SHARP & DOHME 90 mg, cx, 1 bl, 7 cprs, MERCK SHARP & DOHME 6 mg, cx, 20 caps, SANOFI-AVENTIS 0,25 mg/ml sol, inal, 20 ml UNIAO QUIMICA Cx, 12 cprs, DIFFUCAP - CHEMOBRAS Retard 200 mg, cx, 6 caps, DIFFUCAP - CHEMOBRAS 10% 5 ml ALLERGAN Cx, 50 FA ARISTON 1000 mg, po inj, cx, 100 FA vd, ARISTON 1000 mg, po liof, inj, cx, 50 FA vd, inc, + 50 dil, amp, plas, xARISTON 5 ml 100 mg, po liof, inj, cx, 100 FA vd, inc, ARISTON 100 mg. po inj. cx. 50 FA vd. inc. ARISTON 500 mg, po liof, inj, cx, 100 FA vd, inc, ARISTON 500 mg. po inj. cx. 50 FA vd. inc. ARISTON Cx, 100 amps, 2 ml ARISTON Inj, cx, 120 amps, plast, 2 ml ARISTON 7,5 mg, x 0,6 ml c/2 ser, preench, GLAXOSMITHKLINE 2,5 mg, x 0,5 ml c/2 seringas preench, GLAXOSMITHKLINE 1,0 g, po liof, ct FA+ dil, 20 ml, ZLB BEHRING 25 mg, cx, 30 drags, PFIZER 20 mg, 2 bl, x 10 GLAXOSMITHKLINE 20 mg, 3 bl, x 10 GLAXOSMITHKLINE 20 mg, 20 cprs, rev, SANDOZ 20 mg, 3 bl, x 10 cprs, rev, SANDOZ Vd, 20 ml, 150000 UI/ml, (sol, oral) BAYER Vd, 30 drags, 50000 UI BAYER Cx, 25 amps, (1ml,) 300000 UI (emb, mult,) BAYER

UNIDADE Pco Unt Base A CPR 0,76 CPR 1,23 COMP 1,31 COMP 0,74 AP 3,43 CPR 50,20 CPR 10,04 CPR 1,25 CPR 1,25 CPR 4,50 CPR 4,57 CPR 5,01 CPR 5,10 CPR 0,90 DOSE 0,03 CPR 3,00 CAPS 3,16 GOTAS 0,07 FA 4,35 FA 3,15 FA 3,43 FA 3,73 FA 3,22 FA 8,14 FA 7,39 AMP 0,51 AMP 0,37 UNID 37,08 FR 13,18 AP 224,16 CPR 20,79 CPR 4,73 CPR 2,81 CP 1,23 CP 1,23 FR 5,21 CPR 0,16 AMP 1,07

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1173 1174 1175 1176 1177 1178 1179 1180 1181 1182 1183 1184 1185 1186 1187 1188 1189 1190 1191 1192 1193 1194 1195 1196 1197 1198 1199 1200 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210

CODIGO BENEFICIO 95136940 AROVIT VITA 95136959 AROVIT VITA (*) 95051198 ARPADOL 95051210 ARTANE 95051201 ARTANE 95922148 ARTEMIDIS 35 95922164 ARTINIZONA 95922172 ARTINIZONA 95660127 ARTREN 95013091 ARTRINID 95660194 ARTRINID 95136177 ARTRINID 95660186 ARTRINID 95660178 ARTRINID 95990771 ARTROLIVE 95640118 ARTROSIL 95640126 ARTROSIL 95660208 ASALIT 95660216 ASALIT 95420258 ASCARIDIL 95420274 ASCARIDIL 95230181 ASDRON 95230203 ASDRON 95230190 ASDRON 95986928 ASEROPRIN 95990798 ASID 95922202 ASMAFIN 95922210 ASMAFLUX 95230211 ASMALERGIN 95922237 ASMANON 95200428 ASMAPEN 95200436 ASMAPEN 95200444 ASMAPEN 95230254 ASMAX 95230246 ASMAX 95230238 ASMAX 95986936 AS-MED 95986952 AS-MED

APRESENTAÇÃO 150000 UI/ml sol. oral x 20 ml 300000 UI/ml inj. 25 amps. x 1 ml 400 mg, cx, 30 cprs, rev, 2 mg, ct, 2 bl, x 15 cprs, 5 mg, ct, 2 bl, x 15 cprs, 0,035mg,+2mg,1bl,x21 cprs, 20 mg, cx, 20 cprs, 5 mg, cx, 20 cprs, Cx, 10 caps, 100 mg, po liof, cx, 50 FA 50 mg, cx, 24 caps, 50 mg/ml sol, inj, 50 FA vd, x 2 ml (hosp,) Inj, 100 mg, 50 amps, 2 ml, Inj, 100 mg, 6 amps, 2 ml, Cart, fr, 30 caps, 160 mg, bl, 20 caps, 320 mg, bl, 20 caps, Cx, 10 supositorios Enema-3 g, po cx, 1 env, c/fr, diluente Ad, 100 env, 1 cpr , Inf, 100 env, 1 cpr, Cx, 20 cprs, Gts, fr, 30 ml Xpe, fr, 100 ml 50 mg, cx, 100 cprs, 40 mg, cx, 10 cprs, 240 mg, gts, fr, 10 ml 0,4 mg/ml fr, c/ 120 ml Xpe, 100 ml, 20 mg, 0,2mg,xpe,fr,150 ml 100 mg cx, 1 bl, x 20 cprs, 200 mg cx, 2 bl, x 10 cprs, Inj, cx, 50 amps, 10 ml 20 cprs, Gts, fr, 30 ml Xpe, fr, 100 ml Ad, 500 mg, cx, 200 cprs, Inf, 100 mg, cx, 200 cprs,

Laboratorio BAYER BAYER APSEN APSEN APSEN SIGMA PHARMA TEUTO BRAS, TEUTO BRAS, MERCK UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA ACHE ACHE ACHE MERCK MERCK JANSSEN - CILAG JANSSEN - CILAG MARJAN MARJAN MARJAN ITACA LEGRAND CAZI OSORIO DE MORAES MERCK CAZI NEO QUIMICA NEO QUIMICA NEO QUIMICA ATIVUS ATIVUS ATIVUS MEDQUIMICA MEDQUIMICA

UNIDADE Pco Unt Base A COMP 5,21 COMP 1,07 COMP 1,49 COMP 0,23 COMP 0,26 CPR 0,52 CPR 0,55 CPR 0,30 CPR 1,31 FA 6,26 CPR 0,98 FA 1,76 AP 1,71 AP 1,80 CAPS 1,70 CPR 1,54 CPR 2,52 UND 2,58 ENV 34,83 CPR 1,60 CPR 1,69 CPR 1,45 GOTAS 0,08 ML 0,38 COMP 1,85 COMP 1,36 GOTAS 0,03 ML 0,05 ML 0,24 ML 0,20 CPR 0,19 CPR 0,27 AP 1,53 CPR 1,11 GOTAS 0,05 ML 0,25 COMP 0,23 COMP 0,09

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1211 1212 1213 1214 1215 1216 1217 1218 1219 1220 1221 1222 1223 1224 1225 1226 1227 1228 1229 1230 1231 1232 1233 1234 1235 1236 1237 1238 1239 1240 1241 1242 1243 1244 1245 1246 1247 1248

CODIGO BENEFICIO 95986944 AS-MED 95230262 ASMEN 95230270 ASMEN 95230289 ASMIFEN 95230297 ASMIFEN 95230300 ASMOFEN 95230327 ASMOFEN 95330720 ASPIRINA 95095403 ASPIRINA 95051236 ASPIRINA 95330712 ASPIRINA 95922253 ASPIRINA 95051228 ASPIRINA 95095411 ASPIRINA 95922261 ASPIRINA PREVENT 95371931 ASSEPIUM 95371915 ASSEPIUM 95026533 ASSEPTIC 95026541 ASSERT 95922270 ASSERT 95026550 ASSERT 95990801 ASTRO 95990810 ASTRO 95986960 ASTRO 95009116 ASTRO 95990828 ASTRO 95013105 ASTRO 95035320 ASTRO 95130616 ATACAND 95130594 ATACAND 95130608 ATACAND 95130586 ATACAND 95095420 ATACAND COMB 95095438 ATACAND COMB 95095446 ATACAND COMB 95095454 ATACAND COMB 95130624 ATACAND HCT 95130632 ATACAND HCT

APRESENTAÇÃO Laboratorio Inf,100mg,cx,100cprs, MEDQUIMICA Cx, 2 blister 10 cprs, CHIESI Xpe, fr, 100 ml, CHIESI Cx, 20 cprs, BUNKER Xpe fr, 100 ml, BUNKER Cx, 20 cprs, TEUTO BRAS, Sol, oral fr, 30 ml TEUTO BRAS, 100 infantil cx, 10 bl x 10 cprs, BAYER 500 mg, 60 bl, x 4 cprs, BAYER Adulto 10 bl, x 10 cprs, BAYER Adulto 2 bl, x 10 cprs, BAYER Adulto24bl,x10cprs, BAYER Fracao de venda ad, (10 cprs,) BAYER Fracao de venda inf, BAYER 300 mg, x 30 cprs, BAYER Fr, 100 ml, susp, GROSS Fr, 50 ml, susp, GROSS 10 mg/ml sol, top, fr, vd, 30 ml NEO QUIMICA 100 mg, bl, 20 cprs, rev, EUROFARMA 50 mg, 20 cprs, EUROFARMA 50 mg, bl 28 cprs, rev, EUROFARMA 500 mg, 2 cprs, EUROFARMA 500 mg, 3 cprs, EUROFARMA 500 mg, 5 cprs, EUROFARMA 500 mg, 60 cprs, EUROFARMA 600 mg, 1 fr,+ dil, EUROFARMA 900 mg, po susp, oral fr, plast,+ flac, sol, dil, x 12 ml+ EUROFARMA Pulso 500 mg, 9 cprs, rev, EUROFARMA 16 mg, 20 cprs, ASTRAZENECA 16 mg, 30 cprs, ASTRAZENECA 8 mg, 20 cprs, ASTRAZENECA 8 mg, 30 cprs, ASTRAZENECA 16 mg, cprs, + 2,5 mg, cprs, lib, prolong, ct, bl, al/al x 10 cprs, ASTRAZENECA 16 mg, cprs, + 2,5 mg, cprs, lib, prolong, ct, bl, al/al x 30 cprs, ASTRAZENECA 16 mg, cprs, + 5 mg, cprs, lib, prolong, ct, bl, al/al x 10 cprs,ASTRAZENECA 16 mg, cprs, + 5 mg, cprs, lib, prolong, ct, bl, al/al x 30 cprs,ASTRAZENECA 16 mg/12,5 mg, 20 cprs, ASTRAZENECA 16 mg/12,5 mg, 30 cprs, ASTRAZENECA

UNIDADE Pco Unt Base A COMP 0,08 CPR 1,48 ML 0,31 CPR 0,70 ML 0,14 CPR 0,60 GOTAS 0,03 CPR 0,26 COMP 0,45 COMP 0,45 CPR 0,38 CPR 0,37 COMP 0,46 COMP 2,60 CPR 1,04 ML 0,09 ML 0,10 GOTA 0,01 CPR 2,57 CPR 2,05 CPR 1,27 COMP 3,26 COMP 3,26 COMP 3,26 COMP 3,20 F,A, 21,80 ML 2,59 CP 4,57 CPR 3,34 CPR 3,04 CPR 3,10 CPR 2,81 COMP 2,64 COMP 2,64 COMP 3,12 COMP 3,12 CPR 3,01 CPR 2,74

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1249 1250 1251 1252 1253 1254 1255 1256 1257 1258 1259 1260 1261 1262 1263 1264 1265 1266 1267 1268 1269 1270 1271 1272 1273 1274 1275 1276 1277 1278 1279 1280 1281 1282 1283 1284 1285 1286

CODIGO BENEFICIO 95922296 ATACAND HCT 95922288 ATACAND HCT 95922300 ATECARD 95922318 ATECARD 95013121 ATENALON 95013113 ATENALON 95922326 ATENEGRAN 95922334 ATENEGRAN 95922342 ATENEGRAN 95120033 ATENEO 95120041 ATENEO 95095462 ATENEUM 95095470 ATENEUM 95095489 ATENEUM 95120050 ATENOBAL 95120068 ATENOBAL 95120076 ATENOBAL 95120092 ATENOL 95120106 ATENOL 95026568 ATENOLOL - GENERICO

APRESENTAÇÃO 8mg/12,5 mg,20cprs, 8mg/12,5mg,30cprs, 100 mg, cx, 30 cprs, 50 mg, cx, 30 cprs, 100 mg, cx, 28 cprs, 50 mg, cx, 28 cprs, 100 mg, 2 bl, x 14 cprs, 25 mg, 2 bl, x 14 cprs, 50 mg, 2 bl, x 14 cprs, 100 mg cx, 2 bl, x 14 cprs, 50 mg cx, 2 bl, x 14 cprs, 100 mg, cx, 3 bl, x 10 cprs, 25 mg, cx, bl, 30 cprs, 50 mg, cx, 2 bl, x 15 cprs, 100 mg cx, 30 cprs, 25 mg cx, 30 cprs, 50 mg cx, 30 cprs, 100 mg, 28 cprs, 25 mg, cx, 28 cprs, 100 mg 30 cprs,

Laboratorio ASTRAZENECA ASTRAZENECA CAZI CAZI BRASTERAPICA BRASTERAPICA LEGRAND LEGRAND LEGRAND NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA BALDACCI BALDACCI BALDACCI ASTRAZENECA ASTRAZENECA SANDOZ

95990836 ATENOLOL 95051309 ATENOLOL 95990879 ATENOLOL 95026576 ATENOLOL 95051384 ATENOLOL 95051350 ATENOLOL 95009140 ATENOLOL 95051287 ATENOLOL 95051295 ATENOLOL 95922377 ATENOLOL 95990844 ATENOLOL 95035362 ATENOLOL 95013164 ATENOLOL 95013172 ATENOLOL 95026592 ATENOLOL 95035354 ATENOLOL 95922407 ATENOLOL 95922415 ATENOLOL

100 mg 30 cprs, 100 mg, 30 cprs, 100 mg, 30 cprs, 100 mg, 60 cprs, 100 mg, bl, 14 cprs, 100 mg, bl, 28 cprs, 100 mg, bl, 3 x 10 cprs, 100 mg, com, ct, bl, al, plas, inc, x 30 100 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 100 mg,3 bl,x10 cprs, 100 mg,3 bl,x10 cprs, 100mg, 3bl,x10 cprs, 100mg, 6bl, x 10 cprs, 100mg,9bl,x10cprs, 25 mg 30 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 2 bl, x 15 cprs,

BIOSINTETICA MEPHA-RATIOPHARM CRISTALIA SANDOZ AUROBINDO PHARMA AUROBINDO PHARMA RANBAXY PRATI DONADUZZI PRATI DONADUZZI MEDLEY EMS GEN - LEGRAND EMS EMS SANDOZ GEN - LEGRAND GERMED MEDLEY

GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO

UNIDADE Pco Unt Base A CPR 2,65 CPR 2,65 CPR 1,14 CPR 0,72 COMP 0,42 COMP 0,27 CPR 0,61 CPR 0,36 CPR 0,34 CPR 1,07 CPR 0,70 COMP 0,68 COMP 0,34 COMP 0,38 CPR 0,80 CPR 0,26 CPR 0,50 CPR 1,90 CPR 0,71 CPR 0,70 COMP COMP COMP CPR COMP COMP COMP COMP COMP CPR COMP CP COMP COMP CPR CP CPR CPR

0,72 0,82 0,73 0,53 1,08 0,57 0,60 0,70 0,29 0,82 0,82 0,67 0,75 0,62 0,28 0,28 0,26 0,29

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1287 1288 1289 1290 1291 1292 1293 1294 1295 1296 1297 1298 1299 1300 1301 1302 1303 1304 1305 1306 1307 1308 1309 1310 1311 1312 1313 1314 1315 1316 1317 1318 1319 1320 1321 1322 1323 1324

CODIGO BENEFICIO 95990909 ATENOLOL - GENERICO 95051317 ATENOLOL - GENERICO 95990917 ATENOLOL - GENERICO 95035338 ATENOLOL - GENERICO 95026606 ATENOLOL - GENERICO 95051368 ATENOLOL - GENERICO 95051341 ATENOLOL - GENERICO 95009167 ATENOLOL - GENERICO 95051244 ATENOLOL - GENERICO 95051252 ATENOLOL - GENERICO 95922431 ATENOLOL - GENERICO 95026622 ATENOLOL - GENERICO 95922440 ATENOLOL - GENERICO 95035346 ATENOLOL - GENERICO 95922466 ATENOLOL - GENERICO 95990941 ATENOLOL - GENERICO 95013180 ATENOLOL - GENERICO 95051325 ATENOLOL - GENERICO 95013130 ATENOLOL - GENERICO 95026630 ATENOLOL - GENERICO 95051376 ATENOLOL - GENERICO 95051333 ATENOLOL - GENERICO 95009183 ATENOLOL - GENERICO 95051260 ATENOLOL - GENERICO 95051279 ATENOLOL - GENERICO 95990950 ATENOLOL + CLORTALIDONA - GENERICO 95990968 ATENOLOL + CLORTALIDONA - GENERICO 95922490 ATENOLOL + CLORTALIDONA - GENERICO 95026649 ATENOLOL + CLORTALIDONA - GENERICO 95990976 ATENOLOL + CLORTALIDONA - GENERICO 95990984 ATENOLOL + CLORTALIDONA - GENERICO 95922512 ATENOLOL + CLORTALIDONA - GENERICO 95026665 ATENOLOL + CLORTALIDONA - GENERICO 95120173 ATENOLOL - GENERICO 95069011 ATENOLOL - GENERICO 95119639 ATENOLOL - GENERICO (Restrito Hosp,) 95119647 ATENOLOL - GENERICO (Restrito Hosp,) 95119655 ATENOLOL - GENERICO (Restrito Hosp,)

APRESENTAÇÃO 25 mg, 2 bl, x 15 cprs, 25 mg, 30 cprs, 25 mg, 30 cprs, 25 mg, 4 bl, x 15 cprs, 25 mg, 60 cprs, 25 mg, bl, 14 cprs, 25 mg, bl, 28 cprs, 25 mg, bl, 3 x 10 cprs, 25 mg, com, ct, bl, al, plas, inc, x 30 25 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 50 mg 2 bl, x 15 cprs, 50 mg 30 cprs, 50 mg 30 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 30 cprs, 50 mg, 30 cprs, 50 mg, 4 bl, x 15 cprs, 50 mg, 60 cprs, 50 mg, bl, 14 cprs, 50 mg, bl, 28 cprs, 50 mg, bl, 3 x 10 cprs, 50 mg, com, ct, bl, al, plas, inc, x 30 50 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 100 mg,+ 25 mg, bl, 30 cprs, 100/25 mg, 1 bl, x 30 cprs, 100/25 mg, 2 bl, x 15 100+ 25 mg, 9 bl, x 10 cprs, 50 mg,+ 12,5 mg, bl, 30 cprs, 50/12,5 mg, 1 bl, x 30 cprs, 50/12,5 mg, 2 bl, x 15 50+ 12,5 mg, 9 bl, x 10 cprs, 100 mg, cx, 28 cprs, 50 mg, 30 cprs, 100 mg, bl, 300 cprs, rev, (hosp,) 100 mg, bl, 600 cprs, rev, (hosp,) 25 mg, bl, 300 cprs, rev, (hosp,)

Laboratorio EMS MEPHA-RATIOPHARM CRISTALIA EMS SANDOZ AUROBINDO PHARMA AUROBINDO PHARMA RANBAXY PRATI DONADUZZI PRATI DONADUZZI EMS SANDOZ CRISTALIA GEN - LEGRAND MEDLEY GERMED TEUTO BRAS, MEPHA-RATIOPHARM EMS SANDOZ AUROBINDO PHARMA AUROBINDO PHARMA RANBAXY PRATI DONADUZZI PRATI DONADUZZI BIOSINTETICA GERMED EMS EMS BIOSINTETICA GERMED EMS EMS TEUTO BRAS, CRISTALIA ACCORD ACCORD ACCORD

UNIDADE Pco Unt Base A COMP 0,29 COMP 0,29 COMP 0,29 CP 0,27 CPR 0,22 COMP 0,41 COMP 0,19 COMP 0,24 COMP 0,34 COMP 0,12 CPR 0,47 CPR 0,41 CPR 0,46 CP 0,38 CPR 0,48 COMP 0,37 COMP 0,37 COMP 0,47 COMP 0,42 CPR 0,30 COMP 0,63 COMP 0,34 COMP 0,34 COMP 0,47 COMP 0,14 COMP 0,81 COMP 0,77 CPR 0,88 CPR 0,79 COMP 0,50 COMP 0,52 CPR 0,55 CPR 0,49 CPR 0,58 CPR 0,46 COMP 0,95 COMP 0,95 COMP 0,36

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1325 1326 1327 1328 1329 1330 1331 1332 1333 1334 1335 1336 1337 1338 1339 1340 1341 1342 1343 1344 1345 1346 1347 1348 1349 1350 1351 1352 1353 1354 1355 1356 1357 1358 1359 1360 1361 1362

CODIGO BENEFICIO 95119663 ATENOLOL - GENERICO (Restrito Hosp,) 95119671 ATENOLOL - GENERICO (Restrito Hosp,) 95119680 ATENOLOL - GENERICO (Restrito Hosp,) 95136193 ATENOLOL + CLORTALIDONA - GENERICO (Restrito Hosp,) 95136185 ATENOLOL + CLORTALIDONA - GENERICO (Restrito Hosp,) 95081275 ATENOPRESS 95081283 ATENOPRESS 95081259 ATENOPRESS 95081291 ATENOPRESS 95081267 ATENOPRESS 95081305 ATENOPRESS 95922520 ATENORESE 95922539 ATENORESE 95120335 ATENORIC 95013199 ATENORM 95922555 ATENOTON 95130713 ATENSINA 95130705 ATENSINA 95130721 ATENSINA 95120351 ATEPRESS 95120343 ATEPRESS 95780033 ATINAC 95780050 ATINAC 95780041 ATINAC 95013237 ATLANSIL 95013229 ATLANSIL 95013210 ATLANSIL 95013202 ATLANSIL 95009191 ATMOS 95009205 ATMOS 95009213 ATMOS 95899170 ATROFARMA 95020055 ATROPIN (ATROPINA) 95020071 ATROPINA 95020063 ATROPINA 95899189 ATROPION 95899197 ATROPION 95136207 ATROPION (*)

APRESENTAÇÃO 25 mg, bl, 600 cprs, rev, (hosp,) 50 mg, bl, 300 cprs, rev, (hosp,) 50 mg, bl, 600 cprs, rev, (hosp,) 100 mg, + 25 mg, bl, 60 cprs, (hosp,) 50 mg, + 12,5 mg, bl, 60 cprs, (hosp,) 100 mg, bl, al, plas, inc, x 28 cprs, 100 mg, bl, al, plas, inc, x 30 cprs, 25 mg, bl, al, plas, inc, x 28 cprs, 25 mg, bl, al, plas, inc, x 30 cprs, 50 mg, bl, al, plas, inc, x 28 cprs, 50 mg, bl, al, plas, inc, x 30 cprs, 100/25 mg, cx, 30 cprs, 50/12,5 mg, cx, 30 cprs, 100/25 mg cx, 2 bl, x 14 cprs, 50 mg, 28 cprs, 50 mg, cx, 28 cprs, 100 mcg, 30 cprs, 150 mcg, 30 cprs, 200 mcg, 30 cprs, 100 mg, cx, 28 cprs, 50 mg, cx, 28 cprs, 10 mg, 12 cprs, 10 mg, 6 cprs, Xpe, fr, 100 ml 100 mg 20 cprs, 200 mg, 20 cprs, Inj, cx, 50 amps, 3 ml, (emb, hosp,) Inj, cx, 6 amps, 3 ml, 2,5 mg,+ 10mg, str, 30 caps, gel, dura 5 mg,+ 10 mg, str, 30 caps, gel, dura 5 mg,+ 20 mg, str, 30 caps, gel, dura 0,25 mg/ml cx, 100 amps, vd, x 1 ml 0,25 mg amp, 1 ml, 0,5% fr, 5 ml 1% fr, 5 ml, 0,25 mg, cx, 100 amps, 1 ml 0,50 mg, cx, 100 amps, 1 ml 0,50 mg, cx, 100 amps, 1 ml

Laboratorio ACCORD ACCORD ACCORD TEUTO BRAS, TEUTO BRAS, HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL NEO QUIMICA CIFARMA ROYTON BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM TEUTO BRAS, TEUTO BRAS, DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS EUROFARMA EUROFARMA EUROFARMA FARMACE HALEX ISTAR ALLERGAN ALLERGAN ARISTON ARISTON ARISTON

UNIDADE Pco Unt Base A COMP 0,36 COMP 0,55 COMP 0,55 COMP 0,64 COMP 0,44 COMP 0,89 COMP 0,84 COMP 0,45 COMP 0,42 COMP 0,58 COMP 0,55 CPR 0,93 CPR 0,57 CPR 1,33 COMP 0,44 CPR 0,32 CPR 0,15 CPR 0,18 CPR 0,23 CPR 1,01 CPR 0,64 CPR 1,79 CPR 2,02 ML 0,15 COMP 0,54 COMP 1,03 AMP 1,81 AMP 2,08 CAPS 1,54 CAPS 2,33 CAPS 2,33 AMP 0,47 AP 0,73 GOTAS 0,05 GOTAS 0,06 AMP 0,47 AMP 0,46 AMP 0,47

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 1379 1380 1381 1382 1383 1384 1385 1386 1387 1388 1389 1390 1391 1392 1393 1394 1395 1396 1397 1398 1399 1400

CODIGO BENEFICIO 95200487 ATROVENT 95200479 ATROVENT 95095497 ATROVENT N 95070753 ATROVERAN 95070761 ATROVERAN COMPOSTO 95070788 ATROVERAN PLUS 95095500 ATROVERAN PLUS 95095519 ATROVEX 95991000 ATROVEX 95991018 ATROVEX 95991026 ATROVEX 95013245 ATURGYL 95991034 AURAM 95991042 AURAM 95074325 AUROPENNZ 95074317 AUROPENNZ 95074333 AUROPENNZ 95074341 AUROPENNZ 95290141 AURORIX 95290150 AURORIX 95119698 AUROTAZ-P 95119701 AUROTAZ-P 95991050 AVADEN 95372016 AVALOX 95371990 AVALOX 95372008 AVALOX 95070796 AVAMYS 95922652 AVANDAMET 95922660 AVANDAMET 95922679 AVANDAMET 95130730 AVAPRO 95064516 AVASTIN 95064508 AVASTIN 95922687 AVICIS 95051392 AVIRAL 95064524 AVONEX 95125809 AVONEX BIOSET 95013253 AXEPEN

APRESENTAÇÃO Aerossol 15 ml, (bocal) Sol, p/inal, fr, 20 ml, 20 mcg/dose aer, dosif, fr, 10 ml + bocal (200 doses) Liq, 30 ml Fracao 1 env, x 6 cprs, 500 mg,+ 10 mg, disp, 25 bl, x 6 cprs, rev, Fracao de venda (1 bl, x 6) Cx, 100 cprs, rev, Cx, 20 cprs, rev, Gts, fr, 20 ml Gts, fr, 25 ml 0,5 mg/ml c/15 ml 300mg,2bl,x10 cprs, 600mg,2 bl,x10 cprs, 1 g+ 0,5 g po sol, inj, 20 FA vd, x 30 ml (hosp,) 1 g+ 0,5 g po sol, inj, 30 FA vd, x 30 ml (hosp,) 2 g+ 0,5 g po sol, inj, 20 FA vd, x 30 ml (hosp,) 2 g+ 0,5 g po sol, inj, 30 FA vd, x 30 ml (hosp,) 150 mg, 30 cprs, 300 mg, 30 cprs, 2 g + 0,25 g po liof, sol, inj, IV ct, FA vd, x 30 ml 4 g + 0,5 g po liof, sol, inj, IV ct, FA vd, x 40 ml 1 bl, c/28 cprs, rev, 400 mg 1 bolsa plast, 250 ml, 400 mg 5 cprs, 400 mg 7 cprs, Spray nasal 27,5 mcg 120 doses 2 mg,+ 500 mg, 14 cprs, 2 mg,+ 500 mg, 28 cprs, 4 mg,+ 500 mg, 28 cprs, 150 mg, 2 bl, x 14 cprs, 25 mg/ml sol, inj, p/inf, IV FA vd, x 16 ml 25 mg/ml sol, inj, p/inf, IV FA vd, x 4 ml Sol, top, capilar fr, 100 ml,+ aplic, 200 mg, cx, 5 bl, x 5 cprs, 60 mcg/ml sol, inj, 4 bl, c/ser, preench, x 0,5 ml+ ag, 30 mcg FA Kit po liof,+ ser, dil+ 1 ag, x 4 envs, 500 mg, cx, 20 bl, x 10 caps,

Laboratorio BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM COSMED COSMED COSMED COSMED MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA SANOFI-AVENTIS ACHE ACHE AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA ROCHE ROCHE AUROBINDO PHARMA AUROBINDO PHARMA SCHERING BAYER BAYER BAYER GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE B-MS ROCHE ROCHE GALDERMA MEDLEY BIOGEN IDEC BIOGEN IDEC CELLOFARM

UNIDADE Pco Unt Base A DOSE 0,08 GOTAS 0,03 DOSE 0,09 GOTA 0,02 COMP 0,43 COMP 0,65 COMP 0,65 COMP 0,44 CPR 0,44 GOTA 0,01 GOTA 0,01 GOTA 0,03 COMP 0,96 COMP 1,81 FA 17,31 FA 17,31 FA 30,51 FA 30,51 CPR 2,13 CPR 4,35 FA 44,00 FA 70,44 COMP 1,33 UND 151,10 CPR 21,70 CPR 19,61 JATO 0,26 CPR 2,97 CPR 2,98 CPR 5,95 CPR 3,52 FA 4657,85 X FA 1202,99 X ML 1,00 COMP 3,71 FA 950,28 FA 3896,22 CAPS 0,70

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1428 1429 1430 1431 1432 1433 1434 1435 1436 1437 1438

CODIGO BENEFICIO 95035427 AXEPEN 95372040 AXETIL CEFUROXIMA - GENERICO 95372032 AXETIL CEFUROXIMA - GENERICO 95372059 AXETIL CEFUROXIMA - GENERICO 95051406 AXETIL CEFUROXIMA - GENERICO 95372024 AXETIL CEFUROXIMA - GENERICO 95991085 AXETIL CEFUROXIMA - GENERICO 95030255 AXID 95372067 AZACTAM 95372075 AZACTAM 95899200 AZANEM 95899219 AZANEM 95780068 AZELAST 95044612 AZEUS 95119710 AZEUS (Restrito Hosp,) 95372091 AZI 95372083 AZI 95922695 AZI 95009230 AZI 95922709 AZI 95922717 AZI 95922725 AZI 95922733 AZI 95051422 AZI PULSO 95013261 AZICERIO 95013270 AZICERIO 95013288 AZICERIO 95045015 AZIDROMIC 95922768 AZIDROMIC 95372148 AZIMIX 95372156 AZIMIX 95991093 AZINOSTIL 95013296 AZIPRATA 95013300 AZIPRATA 95013318 AZIPRATA 95010181 AZIRAM 95984135 AZITRAX 95984143 AZITRAX

APRESENTAÇÃO 500mg,15 caps,dura 125 mg/5 ml fr, 50 ml 250 mg, bl, 10 cprs, 250 mg/5 ml fr, 50 ml 500 mg, 10 cprs, rev, 500 mg, bl, 10 cprs, Susp, 250 mg/5 ml fr, 50 ml 150 mg, 20 caps, 0,5 g, inj, 1 FA dil, 1,0 g, inj, 1 FA dil, 1 g cx, FA 500 mg, cx, FA+ agua 3 ml Sol, nasal fr, 10 ml, 1 g po sol, inj, IM/IV FA vd, (hosp,) 500 mg, po sol, inj, FA vd, (hosp,) 1000 mg, bl, 1 cpr, 500 mg, bl, 3 cprs, 500 mg, cx, 5 cprs, Susp, oral 600 mg, Susp, oral ad/ped, 1500 mg, Susp, oral ped, 900 mg, Susp, SD 1500 mg Susp, SD 900 mg 500 mg, 1 bl, x 9 cprs, rev, Bisn, 50 g Pote 150 g Pote 400 g 1 g cx, 1 cpr, 500 mg, cx, 3 cprs, 500 mg, 2 cprs, rev, 500 mg, 3 cprs, rev, 500 mg, 1 bl, x 3 cprs, Bisn, 50 g Pote 100 g Pote 400 g 60 mg/ml susp. oral 150 ml - hortela 1000 mg, 1 cpr, rev, 1000 mg, 2 cprs,rev,

Laboratorio CELLOFARM RANBAXY RANBAXY RANBAXY MEPHA-RATIOPHARM RANBAXY MEPHA-RATIOPHARM FARMOQUIMICA B-MS B-MS BIOCHIMICO BIOCHIMICO SIGMA PHARMA NOVAFARMA NOVAFARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA VIC PHARMA VIC PHARMA VIC PHARMA ROYTON ROYTON ATIVUS ATIVUS EMS VIC PHARMA VIC PHARMA VIC PHARMA UNIAO QUIMICA FARMOQUIMICA FARMOQUIMICA

UNIDADE Pco Unt Base A CP 0,59 ML 0,37 CPR 3,93 ML 0,80 COMP 5,63 CPR 5,37 ML 0,90 CPR 2,14 AP 65,37 AP 105,78 FA 107,46 FA 54,20 GOTAS 0,09 FA 97,46 FA 46,12 CPR 20,67 CPR 6,65 CPR 6,44 GOTA 0,00 ML 3,10 ML 2,73 ML 2,17 ML 1,65 COMP 4,55 GRAMA 0,51 GRAMA 0,51 GRAMA 0,51 COMP 19,68 CPR 7,03 CPR 10,96 CPR 8,38 COMP 9,89 GRAMA 0,32 GRAMA 0,21 GRAMA 0,12 ML 0,08 COMP 24,75 COMP 24,79

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1439 1440 1441 1442 1443 1444 1445 1446 1447 1448 1449 1450 1451 1452 1453 1454 1455 1456 1457 1458 1459 1460 1461 1462 1463 1464 1465 1466 1467 1468 1469 1470 1471 1472 1473 1474 1475 1476

CODIGO BENEFICIO 95372202 AZITRAX 95095527 AZITRIN 95095535 AZITRIN 95372300 AZITROGRAN 95095543 AZITROLAB 95986979 AZITROMED 95986987 AZITROMED 95986995 AZITROMED 95987002 AZITROMED 95013326 AZITROMICINA 95051503 AZITROMICINA 95051511 AZITROMICINA 95051538 AZITROMICINA 95051520 AZITROMICINA 95070834 AZITROMICINA 95922784 AZITROMICINA 95922806 AZITROMICINA 95922814 AZITROMICINA 95051430 AZITROMICINA 95051449 AZITROMICINA 95026703 AZITROMICINA 95922822 AZITROMICINA 95043152 AZITROMICINA 95070800 AZITROMICINA 95070818 AZITROMICINA 95043144 AZITROMICINA 95070826 AZITROMICINA 95051554 AZITROMICINA 95051562 AZITROMICINA 95051570 AZITROMICINA 95051457 AZITROMICINA 95051465 AZITROMICINA 95051473 AZITROMICINA 95051589 AZITROMICINA 95009248 AZITROMICINA 95991107 AZITROMICINA 95051481 AZITROMICINA 95051490 AZITROMICINA

GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO

APRESENTAÇÃO Laboratorio UNIDADE Pco Unt Base A 500 mg, cx, 3 cprs, FARMOQUIMICA CPR 7,68 Cx, 2 cprs, DELTA COMP 6,88 Cx, 3 cprs, DELTA COMP 6,46 500 mg, cx, 3 cprs, LEGRAND CPR 10,69 1 g 1 cpr, MULTILAB COMP 14,99 500 mg, cx, 2 cprs, MEDQUIMICA COMP 7,98 500 mg, cx, 3 cprs, MEDQUIMICA COMP 5,74 600 mg, po susp, vd, 15 ml c/dil, MEDQUIMICA FR 19,97 900 mg, po susp, vd, 22,5 ml c/dil, MEDQUIMICA FR 18,49 1 g bl, 1 cpr, GERMED COMP 13,54 1 g com, rev, ct, bl, al, plas, leit, x 1 PRATI DONADUZZI COMP 10,07 1 g com, rev, ct, bl, al, plas, leit, x 150 (hosp,) PRATI DONADUZZI COMP 2,87 40 mg/ml po sus, or, ct, fr,plas,opc, x 15ml+ dil,fr, plas,opc, xPRATI 8ml+ DONADUZZI ser,dosad,(600 mg,) COMP 1,03 40 mg/ml po sus, or, ct,fr,plas,opc,x 22,5 ml+ dil,fr,plas,opc,PRATI x 12ml+ser,dosad,(900 DONADUZZI mg,) COMP 0,84 40mg/ml po sus,or,cx,50fr,plas,opc,x15ml+50 dil,fr,plas,x8ml+50ser,dosad,(hosp,)(600 PRATI DONADUZZI mg) FR 11,09 500 mg, 1 bl, x 2 cprs, RANBAXY CPR 9,77 500 mg, 1 bl, x 3 cprs, RANBAXY CPR 9,48 500 mg, 1 bl, x 3 cprs, MEPHA-RATIOPHARM CPR 7,59 500 mg, 2 cprs, rev, TEUTO BRAS, COMP 5,65 500 mg, 3 cprs, rev, TEUTO BRAS, COMP 5,02 500 mg, 5 bl, x 6 cprs, rev, EMS CPR 12,20 500 mg, bl, 2 cprs, EMS CPR 8,02 500 mg, bl, 2 cprs, rev, EUROFARMA CP 6,83 500 mg, bl, 2 cprs, rev, NEO QUIMICA COMP 11,81 500 mg, bl, 3 cprs, rev, NEO QUIMICA COMP 12,01 500 mg, bl, 60 cprs, rev, EUROFARMA CP 3,55 500 mg, com, rev, ct, bl, al, plas, inc, x 120 (hosp,) PRATI DONADUZZI COMP 2,41 500 mg, com, rev, ct, bl, al, plas, inc, x 3 PRATI DONADUZZI COMP 6,29 500 mg, com, rev, ct, bl, al, plas, inc, x 450 (hosp,) PRATI DONADUZZI COMP 2,09 500 mg,bl, 2cprs,rev, SANDOZ COMP 6,25 500mg, bl, 2 cprs,rev, MEDLEY COMP 8,02 500mg, bl, 3 cprs,rev, MEDLEY COMP 8,01 500mg, bl, 5 cprs,rev, MEDLEY COMP 7,91 500mg,bl, 3 cprs,rev, SANDOZ COMP 6,26 500mg,bl, 3cprs,rev, FARMASA COMP 11,65 500mg,bl,3cprs, rev, EUROFARMA COMP 6,63 Po ext, 600 mg, fr, x 15 ml NEO QUIMICA ML 1,68 Po ext, 900 mg, fr, x 22 ml NEO QUIMICA ML 1,41

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1477 1478 1479 1480 1481 1482 1483 1484 1485 1486 1487 1488 1489 1490 1491 1492 1493 1494 1495 1496 1497 1498 1499 1500 1501 1502 1503 1504 1505 1506 1507 1508 1509 1510 1511 1512 1513 1514

CODIGO BENEFICIO 95095551 AZITROMICINA - GENERICO 95372326 AZITROMICINA - GENERICO 95081852 AZITROMICINA - GENERICO 95081844 AZITROMICINA - GENERICO 95095560 AZITROMICINA - GENERICO 95372334 AZITROMICINA - GENERICO 95372342 AZITROMICINA - GENERICO 95013334 AZITRON 95119728 AZITRON 95013342 AZITRON 95013350 AZITRON 95013369 AZITRON 95013385 AZITRON GU 95013377 AZITRON GU 95991123 AZITROSOL 95991131 AZOMICIN 95720049 AZOPT 95095578 AZORGA 95991158 AZTREONAM - GENERICO 95991166 AZUKON MR 95991832 AZUL DE METILENO 95007792 AZUL DE TRYPAN (VISION BLUE)

APRESENTAÇÃO 1 g com, rev, ct, bl, al, plas, inc, x 50 (frac,) 500 mg, bl, 3 cprs, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 5 cprs, rev, 500 mg, com, rev, ct, bl, al, plas, inc, x 150 (frac,) Susp, oral 600 mg po+ dil, 9 ml fr, 15 ml Susp, oral 900 mg po+ dil, 12 ml fr, 15 ml 250 mg, 6 cprs, 480 cprs, (hosp,) 500 mg, 3 cprs, 600 mg, po p/susp, 900 mg, po p/susp, 1000 mg, 1 cpr, 1000 mg, 2 cprs, 600mg,po,susp,15ml 600 mg, 15 ml po p/susp, 5 ml 5 ml (original) 1 g 10 FA+ dil 3 ml 30 mg, cx, 30 cprs, AMPOLA 2%/ 2ML

AMP C/ 0,5 ML 95660232 AZULFIN 500 mg, cprs, rev, GR x 60 95991174 AZULIX 1 mg, cx, 30 cprs, 95991182 AZULIX 2 mg, cx, 30 cprs, 95064532 B PLATIN-CARBOPLATINA 10 mg/ml sol, inj, FA vd, x 15 ml 95119736 B PLATIN-CARBOPLATINA (Restrito Hosp,) 10 mg/ml sol, inj, FA vd, amb, x 45 ml 95119744 B PLATIN-CARBOPLATINA (Restrito Hosp,) 10 mg/ml sol, inj, FA vd, amb, x 5 ml 95580360 BABYDRAX Cx, 4 envs, 27,9 g, po 95580379 BABYDRAX Cx, 50 envs, 27,9 g, po 95009264 BACFAR F Cx, 10 cprs, 95922857 BACIGEN 5 mg,+ 250 UI pom, bisn, 20 g 95070842 BACITRACINA ZINCICA + SULFATO DE NEOMICINA - GENERICO Pom, derm, bisn, 15 g 95070850 BACITRACINA ZINCICA + SULFATO DE NEOMICINA - GENERICO Pom, derm, bisn, 50 g 95070869 BACITRACINA ZINCICA + SULFATO DE NEOMICINA - GENERICO Pom, derm, cx, 50 bisn, 15 g (hosp,) 95922865 BACLON 10 mg, 20 cprs, 95051597 BACRIS 4%+ 0,8% sol, oral fr, 50 ml 95035435 BACROCIN Pomada 1 bisn, 15 g

Laboratorio PRATI DONADUZZI EMS FARMASA EUROFARMA PRATI DONADUZZI EMS EMS CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA LUPER BRASTERAPICA ALCON ALCON EUROFARMA TORRENT

APSEN TORRENT TORRENT BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL UNIAO QUIMICA UNIAO QUIMICA ELOFAR CAZI TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, UNIAO QUIMICA CRISTALIA VALEANT

UNIDADE Pco Unt Base A COMP 4,35 CPR 12,31 COMP 11,65 COMP 5,67 COMP 2,56 ML 1,87 ML 2,30 COMP 3,12 COMP 4,93 COMP 5,48 ML 1,39 ML 1,77 COMP 16,98 COMP 17,01 ML 2,04 ML 1,33 GOTAS 0,44 GOTAS 45,26 F,A, 64,07 COMP 0,43 AMP 16,31 AMP 55,69 CPR 0,96 COMP 0,46 COMP 0,80 FA 213,16 FA 643,04 FA 71,45 ENV 2,88 ENV 2,80 COMP 1,17 G 0,45 G 0,42 G 0,27 G 0,38 CPR 0,90 ML 0,35 G 2,13

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1515 1516 1517 1518 1519 1520 1521 1522 1523 1524 1525 1526 1527 1528 1529 1530 1531 1532 1533 1534 1535 1536 1537 1538 1539 1540 1541 1542 1543 1544 1545 1546 1547 1548 1549 1550 1551 1552

CODIGO BENEFICIO 95026711 BAC-SULFITRIN 95083529 BAC-SULFITRIN 95922873 BAC-SULFITRIN 95922881 BAC-SULFITRIN 95035443 BACTERACIN 95372598 BACTERACIN 95372601 BACTERACIN 95372580 BACTERACIN 95372652 BACTERINIL 95372679 BACTOCILIN 95013393 BACTOCIN 95991190 BACTOMAX 95991204 BACTOMAX 95119752 BACTOMAX (Restrito Hosp,) 95119760 BACTOMAX (Restrito Hosp,) 95372709 BACTRIM 95372725 BACTRIM 95372733 BACTRIM 95372717 BACTRIM 95372741 BACTRIM F 95372750 BACTRIM F 95991212 BACTROBAN 95130756 BALCOR 95035451 BALCOR 95130764 BALCOR 95035478 BALCOR 95130748 BALCOR 95035460 BALCOR 95922890 BALCOR 95130772 BALCOR E,V, 95130780 BALCOR E,V, 95130802 BALCOR RETARD 95035516 BALCOR RETARD 95130810 BALCOR RETARD 95035494 BALCOR RETARD 95130829 BALCOR RETARD 95035508 BALCOR RETARD 95130799 BALCOR RETARD

APRESENTAÇÃO Cx, 2 bl, x 10 cprs, Sol, inj, cx, 50 amps, 5 ml Susp, cx, 1 vd, 100 ml Susp, cx, 1 vd, 50 ml 40 e 8 mg/ml susp, ped, 100 ml c/50 Env, 12 cprs, F bl, 10 cprs, Susp, vd, 100 ml 250 mg, po p/ susp, fr, 60 ml, 500 mg, cx, 50 frs,+ dil, 3 ml 20 mg/g creme derm, bisn, 15 g 200 mg, po liof, 1 fr,+ 1 amp, 3 ml 400 mg, po liof, 1 fr,+ 1 amp, 3 ml 200 mg, po liof, 10 fr, + 10 amp, dil, x 3 ml 400 mg, po liof, 10 fr, + 10 amp, dil, x 3 ml Cx, 20 cprs, IV cx, 50 amps, 5 ml, (HOSP,) Susp, ped, fr, 50 ml, Vd, 100 ml, susp, ped, Cx, 10 cprs, Susp, 100 ml Pomada tb, 15 g, 30 mg, cx, 20 cprs, 30 mg, cx, 30 cprs, 30 mg, cx, 50 cprs, 30 mg, cx, 60 cprs, 60 mg, cx, 24 cprs, 60 mg, cx, 30 cprs, 60 mg, cx, 60 cprs, 25 mg, cx, po liof,+dil, x 5 ml, 50 mg, cx, po liof,+ dil, x 10 ml, 120 mg, cx, 20 caps, 120 mg, cx, 30 caps, 180 mg, cx, 20 caps, 180 mg, cx, 30 caps, 300 mg cx, 20 caps, 300 mg, cx, 30 caps, 90 mg, cx, 20 caps,

Laboratorio DUCTO NEO QUIMICA DUCTO DUCTO TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, LUPER CELLOFARM BUNKER CRISTALIA CRISTALIA CRISTALIA CRISTALIA ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE GLAXOSMITHKLINE BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI

UNIDADE Pco Unt Base A CPR 0,41 Amp 1,79 ML 0,09 ML 0,09 FR 1,97 CPR 0,58 CPR 1,13 ML 0,11 ML 0,25 AP 1,90 GRAMA 1,86 F,A, 198,76 F,A, 400,32 FA 205,69 FA 395,20 CPR 0,79 AP 1,79 ML 0,10 ML 0,12 CPR 1,55 ML 0,24 G 2,08 CPR 0,29 CP 0,26 CPR 0,27 CP 0,27 CPR 0,53 CP 0,46 CPR 0,34 AP 17,10 AP 23,36 CPR 1,26 CP 1,25 CPR 1,86 CP 1,83 CPR 1,95 CP 2,18 CPR 1,01

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1553 1554 1555 1556 1557 1558 1559 1560 1561 1562 1563 1564 1565 1566 1567 1568 1569 1570 1571 1572 1573 1574 1575 1576 1577 1578 1579 1580 1581 1582 1583 1584 1585 1586 1587 1588 1589 1590

CODIGO BENEFICIO 95035486 BALCOR RETARD 95530045 BALUROL 95089519 BAMBAIR 95089527 BAMBAIR 95922903 BAMBEC 95200509 BAMIFIX 95200517 BAMIFIX 95035524 BARACLUDE 95035532 BARACLUDE 95330895 BARALGIN M 95330879 BARALGIN M 95330909 BARALGIN M 95136215 BARIOGEL (Restrito Hosp,) 95136223 BARIOGEL (Restrito Hosp,) 95372822 BATROX 95095586 BECARVE 95095594 BECARVE 95095608 BECARVE 95095616 BECARVE 95095624 BECARVE 95095632 BECARVE 95095640 BECARVE 95095659 BECARVE 95540156 BECENUN INJET, 95083537 BECLONATO 95083545 BECLONATO 95013415 BECLORT 95210040 BECLOSOL 95450050 BECORTEM 95450041 BECORTEM 95987045 BEDFORDALPROST 95610189 BEDOZIL 95610170 BEDOZIL 95610200 BEDOZIL 95610197 BEDOZIL 95260072 BELACODID 95260080 BELACODID 95260099 BELACODID

APRESENTAÇÃO 90 mg, cx, 30 caps, 400 mg, 20 caps, 1,0 mg/ml sol, or, fr, plast, amb, x 120 ml+ ser, dosad, 1,0 mg/ml sol, or, fr, plast, amb, x 60 ml+ ser, dos, Xpe, fr, 100 ml, Cx, 20 drags, 300 mg, Cx, 20 drags, 600 mg, 0,5 mg, fr, plast, x 30 cprs, rev, 1 mg, fr, plast,x30 cprs, rev, 500 mg, 2 bl, x 10 cprs Sol, oral fr, gotas 10 ml, Sol, oral fr, gotas 20 ml, Geleia 100% 10 copos 150 ml Geleia 100% 10 copos 200 ml 50 ml susp, cx, 50 frs, 12,5 mg, bl, al/al 15 cprs, 12,5 mg, bl, al/al 30 cprs, 25 mg, bl, al/al 15 cprs, 25 mg, bl, al/al 30 cprs, 3,125 mg, bl, al/al 15 cprs, 3,125 mg, bl, al/al 30 cprs, 6,25 mg, bl, al/al 15 cprs, 6,25 mg, bl, al/al 30 cprs, Cx, 10 fr, amp, c/dil, 100 mg, Susp, inj, 1 amp, 1 ml+ seringa Susp, inj, cx, 50 amps 1 ml 250 mcg/dose sol, aer, spray ct, lt, al, x 200 doses Nasal aquoso fr, 200 doses 20 mg cx, 400 cprs, 5 mg cx, 400 cprs, 500 mcg/ml sol, inj, ct, fr, amp, vd, inc, x 1 ml 1000 mg, cx, 10 amps, 1000 mg, cx, 50 amps, 5000 mg, cx, 10 amps, 5000 mg, cx, 50 amps, 5 x 2 cc Gts, 10 cc Xpe, 120 cc

Laboratorio BALDACCI BALDACCI MANTECORP MANTECORP ASTRAZENECA CHIESI CHIESI B-MS B-MS GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE CRISTALIA CRISTALIA BERGAMO MEDLEY MEDLEY MEDLEY MEDLEY MEDLEY MEDLEY MEDLEY MEDLEY B-MS NEO QUIMICA NEO QUIMICA GLENMARK GLAXOSMITHKLINE BERGAMO BERGAMO OPEM BUNKER BUNKER BUNKER BUNKER CLIMAX CLIMAX CLIMAX

UNIDADE Pco Unt Base A CP 0,96 CPR 0,86 ML 0,20 ML 0,23 ML 0,23 CPR 0,97 CPR 1,55 CP 25,72 CP 25,72 CPR 0,29 GOTAS 0,02 GOTAS 0,02 UNID 10,46 UNID 11,63 ML 0,09 COMP 1,81 COMP 1,81 COMP 2,03 COMP 2,03 COMP 1,46 COMP 1,46 COMP 1,63 COMP 1,63 AP 198,60 AMP 10,31 Amp 15,33 DOSE 0,17 DOSE 0,18 CPR 0,61 CPR 0,32 F,A, 810,00 AP 2,85 AP 2,27 AP 6,62 AP 4,42 AP 6,26 GOTAS 0,10 ML 0,13

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1591 1592 1593 1594 1595 1596 1597 1598 1599 1600 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1612 1613 1614 1615 1616 1617 1618 1619 1620 1621 1622 1623 1624 1625 1626 1627 1628

CODIGO BENEFICIO 95009280 BELARA 95922938 BELUP 95922946 BELUP 95922962 BENCLAMIN 95372881 BENECTRIN (*) 95009299 BENECTRIN (*) 95372865 BENECTRIN (*) 95991298 BENEGEL 95923004 BENEGRIPE 95991301 BENEPAX 95991310 BENEPAX 95991328 BENEPAX 95013466 BENEROC 95013458 BENEROC 95013474 BENEROC 95026720 BENERVA 95923012 BENEUM 95035567 BENEUM 95009310 BENEVRAN (*) 95051627 BENEVRAN DRAGEAS 95051635 BENEVRAN GEL 95051643 BENEVRAN GOTAS 95660305 BENFLOGIN 95660313 BENFLOGIN 95084690 BENICAR HCT 95095667 BENICAR HCT 95084703 BENICARANLO 95084711 BENICARANLO 95084720 BENICARANLO 95095675 BENOFLEX P 95095683 BENOFLEX P 95095691 BENOFLEX P 95051651 BENORMAL 95020128 BENTYL 95051678 BENZAPEN G 95009329 BENZAPEN G 95051660 BENZAPEN G 95013490 BENZATRON

APRESENTAÇÃO Laboratorio 2 mg,+ 0,03 mg, bl, 21 cprs, JANSSEN - CILAG 100ml LUPER 20 drags, LUPER 5 mg, cx, 20 cprs, CAZI Cx, 20 cprs LEGRAND F - bl, 10 cprs, LEGRAND Susp, fr, 100 ml, LEGRAND Pom, 1 x 20 g LEGRAND Fracao - 1 bl, x 6 cprs, rev, COSMED 20 mg, cx, 20 cprs, rev, APSEN 20 mg, cx, 30 cprs, rev, APSEN 30 mg, cx, 20 cprs, rev, APSEN Complex cx, 3 bl, x 10 drags, BAYER Fr, 100 drags, BAYER Juniorsol,oralfr,20 ml BAYER Vd, 30 cprs, rev, 300 mg, BAYER 300 mg, 30 cprs, rev, TEUTO BRAS, 300 mg, 50 cprs, rev, TEUTO BRAS, Gts, fr, 20 ml LEGRAND 2 bl, x 10 drags, LEGRAND Bisn, 60 g LEGRAND Fr, 20 ml LEGRAND Cx, 20 drags, ACHE Gts, fr, 20 ml, ACHE 20 mg,+ 12,5 mg, cx, 20 cprs, DAIICHI SANKYO 40 mg, + 12,5 mg, bl, al/al x 20 cprs, rev, DAIICHI SANKYO 20 mg,+ 5 mg, cx, 7 cprs, DAIICHI SANKYO 40 mg,+ 10 mg, cx, 7 cprs, DAIICHI SANKYO 40 mg,+ 5 mg, cx, 7 cprs, DAIICHI SANKYO 35 mg, + 450 mg, + 50 mg, ct, bl, al, plas, lar, x 12 cprs, SANOFI-AVENTIS 35 mg, + 450 mg, + 50 mg, ct, bl, al, plas, lar, x 120 cprs, (mult,) SANOFI-AVENTIS Fracao de venda (4 cprs,) SANOFI-AVENTIS 20 bl, 10 drags, CRISTALIA Gts, 15 ml, MEDLEY 400,000 UI inj, 50 FA+ dil, 2 ml TEUTO BRAS, 400,000 UI po inj, SD 50 FA TEUTO BRAS, Po sol, inj, 400,000 UI cx, 50 fr,+ dil, TEUTO BRAS, 1,200,000 UI cx, 50 FA+ dil, x 5 ml ARISTON

UNIDADE Pco Unt Base A COMP 1,27 ML 0,15 CPR 0,78 CPR 0,26 CPR 0,68 COMP 1,43 ML 0,11 G 0,39 CPR 0,78 COMP 1,55 COMP 1,52 COMP 2,28 DRAG 0,39 DRAG 0,15 GOTA 0,02 CPR 0,50 CPR 0,50 CP 0,45 GOTAS 0,03 DRAG 0,60 G 0,15 GOTA 0,03 CPR 0,35 GOTAS 0,01 COMP 2,29 COMP 2,61 COMP 1,44 COMP 2,98 COMP 1,63 COMP 0,67 COMP 0,67 COMP 0,67 DRAG 1,80 GOTAS 0,03 FA 2,40 FA 2,32 FA 2,38 FA 2,79

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1629 1630 1631 1632 1633 1634 1635 1636 1637 1638 1639 1640 1641 1642 1643 1644 1645 1646 1647 1648 1649 1650 1651 1652 1653 1654 1655 1656 1657 1658 1659 1660 1661 1662 1663 1664 1665 1666

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95009337 BENZATRON 1,200,000UIcx,100FA ARISTON 95009345 BENZATRON 1,200,000UIpo inj,cx,50 FAvd,+ 50 amps, dil, plas ARISTON 95013482 BENZATRON 600,000 UI po inj, cx, 50 FA vd,+ 50 amps, dil, plast, x 5 ARISTON 95009353 BENZATRON 600,000UIcx,100FA ARISTON 95051686 BENZECILIN Po sol, inj, 1,000,000 UI cx, 25 frs, TEUTO BRAS, 95119779 BENZENIL (Restrito Hosp,) 100 mg, cx, 1 FA BIOCHIMICO 95119787 BENZENIL (Restrito Hosp,) 500 mg, cx, 1 FA BIOCHIMICO 95991360 BENZETACIL 1,200,000 10 frs, EUROFARMA 95991379 BENZETACIL 600,000 10 frs, EUROFARMA 95076760 BENZETACIL Fracao de venda (1,200,000) EUROFARMA 95076751 BENZETACIL Fracao de venda (600,000) EUROFARMA 95136231 BENZETACIL (Restrito Hosp,) 150,000 U/ml (600,000 U) susp, inj, cx, 50 FA vd, inc, x 4 mlEUROFARMA 95136240 BENZETACIL (Restrito Hosp,) 300,000 U/ml (1,200,000 U) susp, inj, cx, 50 FA vd, inc, x 4 EUROFARMA ml 95013512 BENZILPEN 5,000,000 UI po sol, inj, 50 FA CELLOFARM 95372997 BENZILPENICILINA POTASSICA - GENERICO 5,000,000 UI cx, 50 FA EUROFARMA 95830014 BENZOCAN 100 ml TEUTO BRAS, 95013539 BENZOILMETRINIDAZOL + NISTATINA + CLORET Creme vag, bisn, 40 g+ 10 aplic, MEDLEY 95051716 BENZOILMETRONIDAZOL - GENERICO 40 mg/ml sus, or, ct, fr, plast, amb, x 100 ml+ cp, med, PRATI DONADUZZI 95051724 BENZOILMETRONIDAZOL - GENERICO 40 mg/ml sus, or, ct, fr, plast, amb, x 120 ml+ cp, med, PRATI DONADUZZI 95051708 BENZOILMETRONIDAZOL - GENERICO 40 mg/ml susp, oral fr, vd, amb, x 100 ml+ cp, med, SANOFI-AVENTIS 95026746 BENZOILMETRONIDAZOL - GENERICO Susp,40mg/mlx80ml NEO QUIMICA 95119795 BENZOILMETRONIDAZOL - GENERICO (Restrito Hosp,) 40 mg/ml sus, or, cx, 50 fr, plast, amb, x 100 ml + 50 cp, med, PRATI (hosp,) DONADUZZI 95136258 BENZOILMETRONIDAZOL - GENERICO (Restrito Hosp,) Susp, oral 40 mg/ml cx, 50 frs, vd, x 100 ml + cp,med, (hosp,) TEUTO BRAS, 95051740 BENZOILMETRONIDAZOL + NISTATINA + CLORETO DE BENZALCONIO 62,5 mg/g+ -25,000 GENERICO UI/g+ 1,25 mg/g crem, vag, ct, bg, al, x 40 PRATI g+ 10DONADUZZI aplic, vag, 95051732 BENZOILMETRONIDAZOL + NISTATINA + CLORETO DE BENZALCONIO Creme vag, -bisn, GENERICO 40 g+ 10 aplic, MEDLEY 95991387 BENZOLOM Cx, c/50 fr, c/60 ml OSORIO DE MORAES 95923071 BENZOLOM Emuls, fr, 60 ml, OSORIO DE MORAES 95051783 BEPEBEN 1,200,000 UI po inj, SD 50 FA TEUTO BRAS, 95051791 BEPEBEN 1,200,000 UI po susp, inj, 50 FA+ 50 amp, dil, x 4 ml TEUTO BRAS, 95051775 BEPEBEN 600,000 UI po inj, SD 50 FA TEUTO BRAS, 95119809 BEPEBEN (Restrito Hosp,) 600,000 UI po inj, 50 FA + 50 amp, dil, x 4 ml (hosp,) TEUTO BRAS, 95610278 BEPLEXARON (*) Inj, 100 amps, 2 ml, ARISTON 95923080 BEPLUS Cx, 60 drags, CAZI 95250158 BEQUIDRIL Xpe, vd, 120 ml TEUTO BRAS, 95900080 BERIGLOBINA 320 mg - 160 mg/ml inj, ct amp, vd, inc x 2,0 ml, CSL BEHRING 95570152 BERIPLAST-P 0,5 ml po liof, ct 2 fr, vd, inc,+2 fr, dil, x 0,5 ml CSL BEHRING 95570136 BERIPLAST-P 1,0 ml po liof, ct 2 fr, vd, inc,+2 fr, dil, x 1,0 ml, CSL BEHRING 95570144 BERIPLAST-P 3,0 ml po liof, ct 2 fr, vd, inc,+2 fr, dil, x 3,0 ml CSL BEHRING

UNIDADE Pco Unt Base A FA 2,85 FA 3,38 FA 2,57 FA 2,08 FA 1,86 FA 108,58 FA 290,70 F,A, 8,70 F,A, 7,38 AMP 8,71 AMP 7,38 FA 6,39 FA 7,82 FA 4,33 AP 5,18 ML 0,08 GRAMA 0,46 ML 0,08 ML 0,05 ML 0,07 FR 5,02 FR 3,90 FR 5,80 G 0,46 G 0,46 ML 5,78 ML 0,12 FA 1,86 FA 2,28 FA 1,36 FA 1,74 AP 0,45 CPR 0,16 ML 0,05 AP 26,54 FA 282,70 X FA 508,97 X FA 1520,15 X

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1667 1668 1669 1670 1671 1672 1673 1674 1675 1676 1677 1678 1679 1680 1681 1682 1683 1684 1685 1686 1687 1688 1689 1690 1691 1692 1693 1694 1695 1696 1697 1698 1699 1700 1701 1702 1703 1704

CODIGO BENEFICIO 95570179 BERIPLEX P/N 95200533 BEROTEC 95200525 BEROTEC 95200550 BEROTEC 95200568 BEROTEC 95051848 BESEROL 95923101 BESILATO DE 95923110 BESILATO DE 95026800 BESILATO DE 95991395 BESILATO DE 95991409 BESILATO DE 95043160 BESILATO DE 95923128 BESILATO DE 95923144 BESILATO DE 95923152 BESILATO DE 95923160 BESILATO DE 95991417 BESILATO DE 95991425 BESILATO DE 95991433 BESILATO DE 95923179 BESILATO DE 95923136 BESILATO DE 95026819 BESILATO DE 95051856 BESILATO DE 95051899 BESILATO DE 95051864 BESILATO DE 95051902 BESILATO DE 95070877 BESILATO DE 95009388 BESILATO DE 95923098 BESILATO DE 95026797 BESILATO DE 95923187 BESILATO DE 95026827 BESILATO DE 95991441 BESILATO DE 95991450 BESILATO DE 95043179 BESILATO DE 95923209 BESILATO DE 95923233 BESILATO DE 95923241 BESILATO DE

ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO

APRESENTAÇÃO Laboratorio 500 UI po liof, inj, ct FA vd, inc+ dil, x 20 ml,+ disp, d CSL BEHRING Aerosol dosif, 10 ml, BOEHRINGER INGELHEIM Sol, fr, 20 ml, BOEHRINGER INGELHEIM Xpe, Ad, fr, 120 ml, BOEHRINGER INGELHEIM Xpe, ped, fr, 120 ml, BOEHRINGER INGELHEIM 300 mg,+ 125 mg,+ 50 mg,+ 30 mg, cprs, ct, bl, al, plas, inc,SANOFI-AVENTIS x4 10 mg, 2 bl, x 10 cprs, UNIAO QUIMICA 10 mg, 2 bl, x 10 cprs, MEDLEY 10 mg, 20 cprs, BIOSINTETICA 10 mg, 20 cprs, CRISTALIA 10 mg, 20 cprs, RATIOPHARM 10 mg, 200 cprs, (emb, hosp,) CRISTALIA 10 mg, 20cprs, MERCK 10 mg, 3 bl, x 10 cprs, CRISTALIA 10 mg, 3 bl, x 10 cprs, MEPHA-RATIOPHARM 10 mg, 3 bl, x 10 cprs, BRAINFARMA 10 mg, 3 bl, x 10 cprs, UNIAO QUIMICA 10 mg, 3 bl, x 10 cprs, MERCK 10 mg, 3 bl, x 10 cprs, RANBAXY 10 mg, 30 cprs, BIOSINTETICA 10 mg, 3bl,x10 cprs, MEDLEY 10 mg, 60 cprs, BIOSINTETICA 10 mg, bl, 20 cprs, AUROBINDO PHARMA 10 mg, bl, 20 cprs, SANDOZ 10 mg, bl, 30 cprs, AUROBINDO PHARMA 10 mg, bl, 30 cprs, SANDOZ 10 mg, bl, 30 cprs, EUROFARMA 10 mg, cx, 30 cprs, NEO QUIMICA 10mg,10bl,x10cprs, UNIAO QUIMICA 10mg,9bl,x10cprs, EMS 5 mg 30 cprs, TEUTO BRAS, 5 mg, 20 cprs, BIOSINTETICA 5 mg, 20 cprs, CRISTALIA 5 mg, 20 cprs, RATIOPHARM 5 mg, 200 cprs, CRISTALIA 5 mg, 2bl,x10 cprs, MEDLEY 5 mg, 3 bl, x 10 cprs, RANBAXY 5 mg, 3 bl, x 10 cprs, BRAINFARMA

UNIDADE Pco Unt Base A FA 953,38 DOSE 0,07 GOTAS 0,01 ML 0,03 ML 0,03 COMP 0,94 CPR 1,49 CPR 2,09 CPR 1,69 COMP 2,04 COMP 1,25 CP 1,31 CPR 1,33 CPR 1,93 CPR 1,76 CPR 1,43 COMP 1,50 COMP 1,86 COMP 1,43 CPR 1,67 CPR 2,09 CPR 1,51 COMP 2,88 COMP 1,95 COMP 1,03 COMP 0,89 COMP 1,74 COMP 1,79 CPR 1,80 CPR 2,08 CPR 0,55 CPR 0,84 COMP 1,07 COMP 0,67 CP 0,69 CPR 1,11 CPR 0,71 CPR 0,72

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1741 1742 1743

CODIGO BENEFICIO 95923250 BESILATO DE 95013598 BESILATO DE 95923268 BESILATO DE 95923276 BESILATO DE 95923225 BESILATO DE 95026835 BESILATO DE 95013580 BESILATO DE 95051880 BESILATO DE 95051929 BESILATO DE 95051872 BESILATO DE 95051910 BESILATO DE 95070885 BESILATO DE 95070915 BESILATO DE 95070893 BESILATO DE 95070907 BESILATO DE 95009400 BESILATO DE

ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO ANLODIPINO

GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO

95923195 BESILATO DE ANLODIPINO - GENERICO 95130853 BESILATO DE ANLODIPINO - GENERICO 95130837 BESILATO DE ANLODIPINO - GENERICO 95095705 BESILATO DE ANLODIPINO - GENERICO 95130969 BESILATO DE ANLODIPINO - GENERICO 95130918 BESILATO DE ANLODIPINO - GENERICO 95130926 BESILATO DE ANLODIPINO - GENERICO 95130888 BESILATO DE ANLODIPINO - GENERICO 95130861 BESILATO DE ANLODIPINO - GENERICO 95130845 BESILATO DE ANLODIPINO - GENERICO 95095713 BESILATO DE ANLODIPINO - GENERICO 95130934 BESILATO DE ANLODIPINO - GENERICO 95130942 BESILATO DE ANLODIPINO - GENERICO 95095721 BESILATO DE ATRACURIO - GENERICO (Restrito Hosp,) 95095730 BESILATO DE ATRACURIO - GENERICO (Restrito Hosp,) 95991468 BESITRAC 95991476 BESITRAC 95119817 BETA LONG 95450084 BETA LONG 95009418 BETACARD PLUS 95009426 BETACARD PLUS 95125817 BETAFERON

APRESENTAÇÃO 5 mg, 3 bl, x 20 cprs, 5 mg, 3 x 10 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, 3bl,x10 cprs, 5 mg, 60 cprs, 5 mg, 9 bl, x 10 cprs, 5 mg, bl, 20 cprs, 5 mg, bl, 20 cprs, 5 mg, bl, 30 cprs, 5 mg, bl, 30 cprs, 5 mg, bl, 30 cprs, 5 mg, com, ct, bl, al/al x 400 (hosp,) 5 mg, com, ct, bl, al/al, x 20 5 mg, com, ct, bl, al/al, x 30 5 mg, cx, 30 cprs,

Laboratorio MERCK ZYDUS MEPHA-RATIOPHARM CRISTALIA MEDLEY BIOSINTETICA EMS AUROBINDO PHARMA SANDOZ AUROBINDO PHARMA SANDOZ EUROFARMA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA

5 mg,10bl,x10cprs, 10 mg cx, 30 cprs, 10 mg, 30 cprs, 10 mg, bl, 30 cprs, 10,0 mg, 3 bl, x 10 cprs, 5 mg 20 cprs, 5 mg 30 cprs, 5 mg cx, 20 cprs, 5 mg cx, 30 cprs, 5 mg, 30 cprs, 5 mg, bl, 30 cprs, 5,0 mg, 2 bl, x 10 cprs, 5,0 mg, 3 bl, x 10 cprs, 10 mg/ml sol, inj, IV cx, 25 amps, vd, x 2,5 ml (hosp,) 10 mg/ml sol, inj, IV cx, 25 amps, vd, x 5 ml (hosp,) 25 mg, cx, 5 amps, 2,5 ml 50 mg, cx, 5 amps, 5 ml 3 mg, + 3 mg/ml susp, inj, 25 amps, vd, x 1 ml 3 mg+ 3 mg/ml cx, 1 amp, 2 ml, 100/25 mg, cx, 30 cprs, 50/12,5 cx, 30 cprs, 250 mcg/8 MUI/ml - inj, ser, cx, c/15

UNIAO QUIMICA EMS MEPHA-RATIOPHARM ARROW BIOSINTETICA MERCK BIOSINTETICA TEUTO BRAS, EMS MERCK ARROW UNIAO QUIMICA UNIAO QUIMICA NOVAFARMA NOVAFARMA BIOCHIMICO BIOCHIMICO UNIAO QUIMICA UNIAO QUIMICA TORRENT TORRENT BAYER

UNIDADE Pco Unt Base A CPR 1,00 COMP 0,70 CPR 0,89 CPR 1,01 CPR 1,06 CPR 0,78 COMP 0,96 COMP 1,56 COMP 1,04 COMP 0,48 COMP 0,46 COMP 0,87 COMP 0,29 COMP 0,83 COMP 0,89 COMP 0,90 CPR CPR CPR COMP CPR CPR CPR CPR CPR CPR COMP CPR CPR FA FA AMP AMP AMP AP COMP COMP Unidade

0,98 2,31 1,76 2,48 1,67 0,89 0,84 0,55 1,06 1,06 1,35 0,73 0,70 8,43 16,73 14,79 27,53 9,09 9,90 0,76 0,47 267,89

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781

CODIGO BENEFICIO 95125825 BETAFERON 95720073 BETAGAN 95720081 BETAGAN 95991484 BETALOR 95991492 BETALOR 95035575 BETAMETASONA - GENERICO 95991506 BETAMETASONA - GENERICO 95991514 BETAMETASONA - GENERICO 95991522 BETAMETASONA - GENERICO 95035583 BETAMETASONA - GENERICO 95026843 BETAMETASONA - GENERICO 95991530 BETAMETASONA - GENERICO 95991549 BETAMETASONA - GENERICO 95991557 BETAMETASONA - GENERICO 95026851 BETAMETASONA - GENERICO 95043187 BETAMETASONA - GENERICO 95923349 BETAMETASONA - GENERICO 95923357 BETAMETASONA - GENERICO 95009434 BETAMETASONA - GENERICO 95923373 BETAMETASONA - GENERICO 95991565 BETAMETASONA - GENERICO 95991573 BETAMETASONA - GENERICO 95009442 BETAMETASONA - GENERICO 95450114 BETAMETASONA ELIXIR - GENERICO 95450122 BETAPROSPAN 95991581 BETASERC 95009450 BETASERC 95095748 BETASERC 95119825 BETASPAN 95013601 BETATRINTA 95013610 BETAZIDIM 95095756 BETAZOL 95095764 BETAZOL 95840192 BETNOVATE 95840230 BETNOVATE 95840222 BETNOVATE 95840168 BETNOVATE 95840257 BETNOVATE

APRESENTAÇÃO 9,6 MUI cx, 15 FA c/poliof,+ 15 FA dil, Fr, 10 ml, Fr, 5 ml, 5 mg,+ 25 mg, cx, c/30 5 mg,+ 50 mg, cx, c/30 0,1 mg/ml, elx, ct, fr, vd, amb, x 120 ml, 0,5 mg, 2 bl, x 10 cprs, 0,5 mg, 2 bl, x 10 cprs, 0,5 mg, 2 bl, x 10 cprs, 0,5 mg/ml, sol, or, ct, fr, plas, opc, got, x 15 ml, 0,5mg,9bl,x 10 cprs, 2 mg, 1 bl x 10 cprs, 2 mg, 1 bl, x 10 cprs, 2,0 mg, 1 bl, x 10 cprs, 2,0mg,9bl,x 10 cprs, Elixir 0,5 mg/5 ml fr, x 120 ml Elixir 0,5 ml/5 ml fr, 120 ml Elixir 120 ml Elixir cx, 50 frs, x 100 ml Gts, fr, 15 ml Gts, fr, 15 ml Gts, fr, 15 ml Sol, oral 15 ml 0,1 mg/ml ct, fr, vd, amb, 120 ml+ cp, med, x 10 ml 1 ml, 1 amp, 16 mg, cx, 30 cprs, 24 mg, cx, 30 cprs, 24 mg, cx, 60 cprs, Susp, inj, cx, 1 amp, 5 mg/ml+ 2 mg/ml susp, inj, 1 amp, vd, x 1 ml+ ser, 1 g cx, 50 FA Creme bisn, 30 g Pomada bisn, 30 g Creme bisn,15 g, N-creme bisn, 30 g, N-pom, bisn, 30 g, Pom, bisn, 15 g, Q-creme bisn, 30 g,

Laboratorio BAYER ALLERGAN ALLERGAN BIOSINTETICA BIOSINTETICA PRATI DONADUZZI EMS GERMED EUROGENUS - LEGRAND PRATI DONADUZZI EMS GERMED GEN - LEGRAND EMS EMS GERMED EMS PRATI DONADUZZI PRATI DONADUZZI EMS GERMED GEN - LEGRAND PRATI DONADUZZI MEDLEY UNIAO QUIMICA SOLVAY FARMA SOLVAY FARMA ABBOTT PRODS, P/SAUDE DELTA EUROFARMA CELLOFARM DELTA DELTA GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE

UNIDADE Pco Unt Base A FA 277,23 GOTAS 0,15 GOTAS 0,18 COMP 1,44 COMP 1,70 ML 0,10 COMP 0,28 COMP 0,20 COMP 0,16 GOTA 0,01 CPR 0,28 COMP 0,53 COMP 0,55 COMP 0,76 CPR 0,76 ML 0,09 ML 0,09 ML 0,07 ML 0,02 GOTAS 0,01 GOTA 0,01 GOTA 0,01 ML 0,24 ML 0,09 AP 15,92 COMP 0,70 COMP 1,05 COMP 0,90 FA 12,95 AMP 11,15 FA 20,45 G 0,71 G 0,65 G 0,88 G 0,66 G 0,69 G 0,92 G 0,74

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819

CODIGO BENEFICIO 95720090 BETOPTIC 95720103 BETOPTIC 95095772 BETRIX 95450165 BETROSPAN 95570209 BETSONA 95570217 BETSONA 95991646 BEXTRA 95119833 BEXTRA IM/IV (Restrito Hosp,) 95991662 BEZAFIBRATO - GENERICO 95991670 BEZAFIBRATO - GENERICO 95013628 BEZAFIBRATO - GENERICO 95984178 BIALERGE 95984186 BIALERGE 95035591 BIALERGE 95373055 BIAMOTIL 95373063 BIAMOTIL 95373098 BIAMOTIL 95373080 BIAMOTIL 95373071 BIAMOTIL 95051945 BIAMOTIL D 95051937 BIAMOTIL D 95089896 BICARBONATO DE SODIO 95010246 BICARBONATO DE SODIO 95089888 BICARBONATO DE SODIO 95010211 BICARBONATO DE SODIO 95010220 BICARBONATO DE SODIO 95010238 BICARBONATO DE SODIO 95119841 BICARBONATO DE SODIO (Restrito Hosp,) 95119850 BICARBONATO DE SODIO (Restrito Hosp,) 95582177 BICARBONATO DE SODIO 8,4% 95085548 BICARBONATO DE SODIO 8,4% - SISTEMA FECH 95923390 BICAVINE 95131019 BICONCOR (FUMAR, BISOPROLOL + HIDROCL,) 95131027 BICONCOR (FUMAR, BISOPROLOL + HIDROCL,) 95131035 BICONCOR (FUMAR, BISOPROLOL + HIDROCL,) 95923446 BINOSPAN COMPOSTO 95373144 BINOTAL 95373152 BINOTAL

APRESENTAÇÃO 0,5% fr, 5 ml, sol, oft, S fr, 5 ml, sol, oft, 20 mg/g + 0,64 mg/g creme derm, bisn, 30 g Susp, inj, cx, 1 amp, 1 ml, Creme 1 mg/g bisn, 30 g Pom, 1 mg/g bisn, 30 g IM/IV 40 mg, 10 FA 40 mg, 10 FA 200 mg, 2 bl, x 10 drags, 200 mg, 20 cprs, 200 mg, 6 bl, x 10 cprs, rev, Cx, 5 envs, x 4 cprs, Elixir fr, 100 ml, Gotas fr, 20 ml 10 ml sol, otol 5 ml sol, oft, D pom, oft, 3,5 g D sol, oft, 5 ml Pom, oft, 1 bisn, 3,5 g, Pom, oft, 3,5 g Sol, oft, 5 ml 10% 10 ml cx, 100 amps, vd, 10% cx, 100 x 10 ml, 8,4% 10 ml cx, 100 amps, vd, 8,4% amp, 10 ml, 8,4% amp, 20 ml, 8,4% cx, 100 x 10 ml 10% cx, 100 x 10 ml, vd, 8,4% cx, 100 x 10 ml vd, Fr com 250 ml 250 ml cx, c/35 frs, Cx, 20 drags, 10 mg, 30 cprs, 2,5 mg, 30 cprs, 5,0 mg, 30 cprs, Cx, 20 drags, 1000 mg, cart, 2 tiras x 6 cprs, 1000 mg, cpr, 3 str, x 6

Laboratorio ALCON ALCON GALLIA LEGRAND NEO QUIMICA NEO QUIMICA PFIZER PFIZER GERMED EMS EMS ELOFAR ELOFAR ELOFAR ALLERGAN ALLERGAN ALLERGAN ALLERGAN ALLERGAN ALLERGAN ALLERGAN FARMACE HYPOFARMA FARMACE HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA CAZI MERCK MERCK MERCK CAZI BAYER BAYER

UNIDADE Pco Unt Base A GOTAS 0,17 GOTAS 0,23 G 0,49 AP 10,49 G 0,49 G 0,48 F,A, 34,78 FA 34,78 DRAG 0,75 COMP 0,79 COMP 0,60 COMP 0,28 ML 0,06 GOTA 0,02 GOTAS 0,11 GOTAS 0,15 G 7,07 GOTAS 0,23 G 4,01 G 7,07 GOTA 0,23 AMP 0,66 AP 0,72 AMP 0,65 AP 1,20 AP 1,67 AP 0,71 ML 0,72 ML 0,71 FR 0,02 FR 18,94 CPR 0,51 CPR 2,06 CPR 1,57 CPR 2,04 CPR 0,58 CPR 2,86 CPR 2,86

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1820 1821 1822 1823 1824 1825 1826 1827 1828 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1839 1840 1841 1842 1843 1844 1845 1846 1847 1848 1849 1850 1851 1852 1853 1854 1855 1856 1857

CODIGO BENEFICIO 95373136 BINOTAL 95373101 BINOTAL 95048154 BIOCARBO (CARBOPLATINA) 95540164 BIOCARBO (CARBOPLATINA) 95660402 BIOFENAC 95070923 BIOFENAC 95660410 BIOFENAC 95660437 BIOFENAC 95660429 BIOFENAC 95070931 BIOFENAC 95051953 BIOFENAC AEROSOL 95051961 BIOFENAC GOTAS 95013717 BIOFENT 95013687 BIOFENT 95013709 BIOFENT 95013679 BIOFENT 95013695 BIOFENT 95640134 BIOFLAC 95640150 BIOFLAC 95640142 BIOFLAC 95610359 BIOFRUCTOSE 95610332 BIOFRUCTOSE 95610367 BIOFRUCTOSE 95610340 BIOFRUCTOSE 95430091 BIOGLIC 95430105 BIOGLIC 95430113 BIOGLIC 95051970 BIOMAG 95051988 BIOMAG 95119868 BIOMATROP 95540202 BIOMETROX (METOTREXATO) 95540210 BIOMETROX (METOTREXATO) 95540237 BIOPAXEL (PAcl*tAXEL) 95540229 BIOPAXEL (PAcl*tAXEL) 95540253 BIORRUB (DOXORRUBICINA) 95540261 BIORRUB (DOXORRUBICINA) 95013733 BIOSUFENIL 95013750 BIOSUFENIL

APRESENTAÇÃO 500 mg, cart, 2 tiras x 6 cprs, 500 mg, cpr, 3 str, x 6 10 mg/ml sol, inj, FA vd, amb, x 45 ml 150 mg, po liof, inj, cx, 1 FA 50 mg, 20 cprs, rev, 50 mg, bl, 10 cprs, rev, CLR 75 mg, bl, 14 cprs, rev, DI cx, 20 cprs, LP 100 mg, 20 caps, LP 100 mg, bl, 10 caps, Tb, 60 g 20 ml 78,5 mcg/ml cx, 10 amps, 10 ml 78,5 mcg/ml cx, 10 amps, 2 ml 78,5 mcg/ml cx, 5 amps, 10 ml 78,5 mcg/ml cx, 5 amps, 2 ml 78,5 mcg/ml cx, 50 amps, 2 ml 15 mg, cx, 10 cprs, 15 mg/ml cx, 5 amps, 1,5 ml, 7,5 mg cx, 10 cprs, Cx, 100 amps, 10 ml, Cx, 3 amps, 10 ml, Cx, 3 amps, 20 ml, Cx, 50 amps, 20 ml, 1 mg 30 cprs, 2 mg 30 cprs, 4 mg 30 cprs, 10 mg, 30 caps, 15 mg, 30 caps, 4 UI 1 ml po liof, inj, FA + amp, dil, 50 mg, inj, 1 fr, 500 mg, inj, 1 fr, 100 mg/16,7 ml 1 fr, 30 mg/5 ml 1 fr, 10 mg, inj, cx, 1 FA 50 mg, inj, cx, 1 FA 50 mcg/ml cx, 10 amps, 1 ml 50 mcg/ml cx, 10 amps, 5 ml

Laboratorio BAYER BAYER BIOSINTETICA BIOSINTETICA ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO CRISTALIA CRISTALIA CRISTALIA BUNKER BUNKER BUNKER BUNKER BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS ACHE ACHE BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOCHIMICO BIOCHIMICO

UNIDADE Pco Unt Base A CPR 1,60 CPR 1,60 F,A, 1269,74 AP 331,97 CPR 0,71 COMP 0,68 CPR 1,11 CPR 0,83 CPR 1,20 COMP 1,21 G 0,31 GOTA 0,03 AMP 4,97 AMP 1,78 AMP 4,97 AMP 1,78 AMP 1,78 CPR 2,79 AP 5,17 CPR 1,50 AP 3,79 AP 4,76 AP 8,44 AP 7,04 CPR 0,42 CPR 0,73 CPR 1,26 CAPS 1,25 CAPS 1,39 FA 131,54 AP 32,60 AP 220,60 AP 1601,75 X AP 709,02 X AP 69,07 AP 306,32 AMP 12,93 AMP 58,68

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895

CODIGO BENEFICIO 95013725 BIOSUFENIL 95013741 BIOSUFENIL 95009469 BIOTECAN 95009477 BIOTECAN 95923454 BIOTREX 95510010 BIO-VAGIN 95400320 BIOVIR (ICMS 0%) 95052003 BIOZATIN 95051996 BIOZATIN 95083561 BIPENCIL 95083553 BIPENCIL 95083570 BIPENCIL 95026860 BISALAX 95095780 BISALAX 95250166 BISOLVON 95250174 BISOLVON 95250182 BISOLVON 95119876 BISPECT (Restrito Hosp,) 95136975 BISUISAN 95923497 BISUISAN 95400338 BLAUFERON A-INTERFERON ALFA-2A (ICMS 0%) 95400346 BLAUFERON A-INTERFERON ALFA-2A (ICMS 0%) 95400354 BLAUFERON A-INTERFERON ALFA-2A (ICMS 0%) 95400389 BLAUFERON B-INTERFERON ALFA-2B (ICMS 0%) 95400362 BLAUFERON B-INTERFERON ALFA-2B (ICMS 0%) 95400370 BLAUFERON B-INTERFERON ALFA-2B (ICMS 0%) 95119884 BLAZTERE (ICMS 0%) (Restrito Hosp,) 95540270 BLENOXANE 95131078 BLOPRESS 95131051 BLOPRESS 95984194 BOLSAS DPI/DPA 95987177 BOLSAS DPI/DPA 95987185 BOLSAS DPI/DPA 95987193 BOLSAS DPI/DPA 95987207 BOLSAS DPI/DPA 95987215 BOLSAS DPI/DPA 95987223 BOLSAS DPI/DPA 95052020 BONALEN

APRESENTAÇÃO Laboratorio 50 mcg/ml cx, 5 amps, 1 ml BIOCHIMICO 50 mcg/ml cx, 5 amps, 5 ml BIOCHIMICO 20 mg/ml sol, inj, FA vd, 2 ml BIOSINTETICA 20 mg/ml sol, inj, FA vd, 5 ml BIOSINTETICA 250 mg, cx, 20 cprs, CAZI Cr, vag, tb, 40 g,+ 10 aplic, ELOFAR 60 cprs, GLAXOSMITHKLINE 1,200,000 UI po liof, p/susp, inj, cx, 50 FA vd, NOVAFARMA 600,000 UI po liof, p/susp, inj, cx, 50 FA vd, NOVAFARMA 1 g cx, 50 frs, BIOCHIMICO 500 mg, cx, 200 caps, BIOCHIMICO 500 mg, cx, 50 frs, BIOCHIMICO 5 mg, 20 drags, UNIAO QUIMICA 5 mg, bl, plast, x 150 drags, UNIAO QUIMICA Sol, exp, 50 ml, BOEHRINGER INGELHEIM Xpe, exp, ad, 120 ml BOEHRINGER INGELHEIM Xpe, exp, inf, 120 ml, BOEHRINGER INGELHEIM 0,8 mg, 120 ml 50 fr, vd, amb, inf, cp, med, (hosp,) UCI-FARMA Fracao COSMED Po 12 envs, x 5,5 g COSMED 3,000,000 UI c/ dil, 1 ml, BLAUSIEGEL 4,500,000 UI c/ dil, 1 ml, BLAUSIEGEL 9,000,000 UI c/ dil, 1 ml, BLAUSIEGEL 10,000,000 UI c/ dil, 1 ml, BLAUSIEGEL 3,000,000 UI c/ dil, 1 ml, BLAUSIEGEL 5,000,000 UI c/ dil, 1 ml, BLAUSIEGEL 4 mg, 1 FA DR, REDDY'S 15 mg INJET Frasco-Ampola B-MS 16 mg, 3 bl, x 10 cprs, ABBOTT 8 mg, 3 bl, x 10 cprs, ABBOTT Dianeal Pd2 bolsa single-bag 4,25% glicose 5000 Ml - bolsaBAXTER p Dianeal Pd2 sol, Dial, Perit, Single-bag 2,5 l dext, 1,5% B BAXTER Dianeal Pd2 sol, Dial, Perit, Single-bag 2,5 l dext, 2,5% B BAXTER Dianeal Pd2 sol, Dial, Perit, Single-bag 2,5 l dext, 4,25% B BAXTER Dianeal Pd2 sol, Dial, Perit, Single-bag 6 l dext, 1,5% B Pi BAXTER Dianeal Pd2 sol, Dial, Perit, Single-bag 6 l dext, 2,5% B Pi BAXTER Dianeal Pd2 sol, Dial, Perit, Single-bag 6 l dext, 4,25% B P BAXTER 10 mg, ct, 2 bl, al, plas, inc, x 15 UNIAO QUIMICA

UNIDADE Pco Unt Base A AMP 12,93 AMP 58,67 AMP 544,92 AMP 1298,26 CPR 0,97 G 0,71 CPR 10,27 FA 3,52 FA 2,61 UNID 1,14 CAPS 0,27 UNID 1,02 CPR 0,19 COMP 0,17 ML 0,17 ML 0,11 ML 0,09 ML 7,22 UND 1,63 ENV 1,63 FA 72,62 FA 106,52 FA 198,62 FA 213,15 FA 72,62 FA 116,24 FA 381,11 AP 176,21 CPR 3,19 CPR 2,84 UND 50,76 UND 28,04 UND 28,04 UND 28,04 UND 44,49 UND 44,49 UND 44,49 COMP 2,52

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933

CODIGO BENEFICIO 95052011 BONALEN 95540288 BONAR (BLEOMICINA) 95013768 BONEFOS 95540296 BONEFOS 95089900 BONEFOS 95081860 BONVIVA SOL, INJ, 95650059 BOTOX 95089918 BOTULIFT (Restrito Hosp,) 95119892 BRAMITOB (Restrito Hosp,) 95047263 BRAVITAN 95119906 BRECILA (Restrito Hosp,) 95119914 BRECILA (Restrito Hosp,) 95119922 BRECILA (Restrito Hosp,) 95120360 BREVIBLOC 95991760 BREVIBLOC 95660453 BREXIN 95660488 BREXIN 95200576 BRICANYL 95200584 BRICANYL 95119930 BRIDION (Restrito Hosp,) 95114220 BRILINTA 95114238 BRILINTA 95114246 BRILINTA 95200630 BRISMUCOL 95052038 BROMALEX 95052046 BROMALEX 95330933 BROMALGINA 95330941 BROMALGINA 95035613 BROMAZEPAM - GENERICO 95035621 BROMAZEPAM - GENERICO 95923527 BROMAZEPAM - GENERICO 95923535 BROMAZEPAM - GENERICO 95270140 BROMAZEPAM - GENERICO 95991778 BROMAZEPAM - GENERICO 95013792 BROMAZEPAM - GENERICO 95923560 BROMAZEPAM - GENERICO 95013806 BROMAZEPAM - GENERICO 95009485 BROMAZEPAM - GENERICO

APRESENTAÇÃO 70 mg, ct, bl, al, plas, amb, x 4 cprs, rev, 15 UI 5 ml po liof. inj. vd. + amp. dil. 1500mg,1amp,-25 ml 400 mg, 30 caps, 60 mg, 5 amps, 3 mg, sol, inj, ct, 1 ser, preench, vd, inc, x 3 ml 100 U,I, 100 U po liof, inj, ct, 1 fr, vd, inc, Cx, c/56 flaconetes 2 mg, 20 cprs, 2 mg/ml sol, inj, IM fr, vd, x 10 ml 2 mg/ml sol, inj, IM fr, vd, x 25 ml 2 mg/ml sol, inj, IM fr, vd, x 5 ml 10 mg/ml cx, 20 frs, x 10 ml, 250 mg/ml, cx, 10 amps, x 10 ml, Cx, 10 cprs, Cx, 5 cprs, Exp, 100 ml, Xpe, 100 ml, 100 mg/ml sol, inj, 10 FA x 2 ml 90 mg, bl, 20 cprs, rev, 90 mg, bl, 30 cprs, rev, 90 mg, bl, 60 cprs, rev, Xpe, 50 mg/5 ml 120 ml 3 mg, bl, 30 cprs, 6 mg, bl, 30 cprs, 5 x 2 cc Gts, 10 cc 2,5 mg/ml fr, 20 ml 2,5 mg/ml gts, fr, 20 ml 3 mg, 2 bl, x 10 3 mg, 2 bl, x 10 3 mg, 2 bl, x 10 cprs, 3 mg, 2 bl, x 10 cprs, 3 mg, 20 bl, x 10 cprs, 3 mg, 20 cprs, 3 mg, 200 cprs, 3 mg, 3 bl, x 10 cprs,

Laboratorio UNIAO QUIMICA BIOSINTETICA SCHERING SCHERING BAYER ROCHE ALLERGAN BERGAMO CHIESI DROXTER ACCORD ACCORD ACCORD CRISTALIA CRISTALIA GROSS GROSS ASTRAZENECA ASTRAZENECA SCHERING-PLOUGH ASTRAZENECA ASTRAZENECA ASTRAZENECA B-MS SANDOZ SANDOZ CLIMAX CLIMAX EMS GERMED EMS GERMED ABBOTT UNIAO QUIMICA UNIAO QUIMICA EUROFARMA ARROW EMS

UNIDADE Pco Unt Base A COMP 7,49 AP 175,89 AMP 340,29 CPR 8,83 AMP 59,24 UNID 254,66 AP 1233,64 X FR 1139,66 X UNID 88,12 COMP 0,58 FA 91,57 FA 226,25 FA 55,14 FA 35,89 AMP 215,78 CPR 4,11 CPR 4,14 ML 0,14 ML 0,11 FA 269,73 COMP 3,57 COMP 3,57 COMP 3,57 ML 0,18 COMP 0,45 COMP 0,72 AP 3,57 GOTAS 0,07 GOTA 0,02 GOTA 0,02 CPR 0,34 CPR 0,33 CPR 0,35 COMP 0,34 COMP 0,24 CPR 0,25 COMP 0,29 COMP 0,34

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971

CODIGO BENEFICIO 95009493 BROMAZEPAM - GENERICO 95270167 BROMAZEPAM - GENERICO 95991786 BROMAZEPAM - GENERICO 95923586 BROMAZEPAM - GENERICO 95009507 BROMAZEPAM - GENERICO 95052119 BROMAZEPAM - GENERICO 95052135 BROMAZEPAM - GENERICO 95991794 BROMAZEPAM - GENERICO 95991808 BROMAZEPAM - GENERICO 95045457 BROMAZEPAM - GENERICO 95045430 BROMAZEPAM - GENERICO 95045481 BROMAZEPAM - GENERICO 95095802 BROMAZEPAM - GENERICO 95007750 BROMAZEPAM - GENERICO 95026878 BROMAZEPAM - GENERICO 95270159 BROMAZEPAM - GENERICO 95991824 BROMAZEPAM - GENERICO 95013784 BROMAZEPAM - GENERICO 95013814 BROMAZEPAM - GENERICO 95009515 BROMAZEPAM - GENERICO 95009523 BROMAZEPAM - GENERICO 95270175 BROMAZEPAM - GENERICO 95923632 BROMAZEPAM - GENERICO 95009531 BROMAZEPAM - GENERICO 95052127 BROMAZEPAM - GENERICO 95052143 BROMAZEPAM - GENERICO 95007776 BROMAZEPAM - GENERICO 95984208 BROMAZEPAM - GENERICO 95045465 BROMAZEPAM - GENERICO 95923640 BROMAZEPAM - GENERICO 95923659 BROMAZEPAM - GENERICO 95045449 BROMAZEPAM - GENERICO 95095810 BROMAZEPAM - GENERICO 95270132 BROMAZEPAM - GENERICO 95045473 BROMAZEPAM - GENERICO 95095829 BROMAZEPAM - GENERICO 95991840 BROMAZEPAM - GENERICO 95026886 BROMAZEPAM - GENERICO

APRESENTAÇÃO 3 mg, 3 bl, x 10 cprs, 3 mg, 3 bl, x 10 cprs, 3 mg, 3 bl, x 10 cprs, 3 mg, 30 cprs, 3 mg, bl, 20 cprs, 3 mg, bl, 20 cprs, 3 mg, bl, 30 cprs, 3 mg, bl, al, plast, 20 cprs, 3 mg, bl, al, plast, 30 cprs, 3 mg, cx, 100 cprs, (hosp,) 3 mg, cx, 20 cprs, 3 mg, cx, 30 cprs, 3 mg, cx, 30 cprs, 3,0 mg, cx, 20 cprs, 3,0 mg, cx, 30 cprs, 6 mg, 2 bl, x 10 cprs, 6 mg, 2 bl, x 10 cprs, 6 mg, 20 bl, x 10 cprs, 6 mg, 200 cprs, 6 mg, 3 bl, x 10 cprs, 6 mg, 3 bl, x 10 cprs, 6 mg, 3 bl, x 10 cprs, 6 mg, 30 cprs, 6 mg, bl, 20 cprs, 6 mg, bl, 20 cprs, 6 mg, bl, 30 cprs, 6 mg, bl, al, plast, 20 cprs, 6 mg, bl, al, plast, 30 cprs, 6 mg, cx, 100 cprs, (hosp,) 6 mg, cx, 20 cprs 6 mg, cx, 20 cprs 6 mg, cx, 20 cprs, 6 mg, cx, 20 cprs, 6 mg, cx, 20 cprs, 6 mg, cx, 30 cprs, 6 mg, cx, 30 cprs, 6,0 mg, cx, 20 cprs, 6,0 mg, cx, 30 cprs,

Laboratorio GERMED MEDLEY UNIAO QUIMICA EUROFARMA MERCK SANDOZ SANDOZ BIOSINTETICA BIOSINTETICA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, COSMED ARROW ARROW ABBOTT UNIAO QUIMICA UNIAO QUIMICA ARROW EMS GERMED MEDLEY EUROFARMA MERCK SANDOZ SANDOZ BIOSINTETICA BIOSINTETICA TEUTO BRAS, EMS GERMED TEUTO BRAS, COSMED EUROFARMA TEUTO BRAS, COSMED ARROW ARROW

UNIDADE Pco Unt Base A COMP 0,30 CPR 0,38 COMP 0,35 CPR 0,32 COMP 0,30 COMP 0,33 COMP 0,34 COMP 0,30 COMP 0,31 COMP 0,28 COMP 0,33 COMP 0,34 COMP 0,39 COMP 0,30 CPR 0,30 CPR 0,60 COMP 0,50 COMP 0,37 COMP 0,43 COMP 0,55 COMP 0,47 CPR 0,65 CPR 0,49 COMP 0,46 COMP 0,54 COMP 0,54 COMP 0,46 COMP 0,47 COMP 0,45 CPR 0,55 CPR 0,51 COMP 0,53 COMP 0,66 CPR 0,39 COMP 0,54 COMP 0,66 COMP 0,44 CPR 0,45

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

CODIGO BENEFICIO 95020179 BROMEPAN COMPOSTO (N-BUTIL ESC+DIP,SOD,) 95052151 BROMETO DE IPRATROPIO - GENERICO 95009540 BROMETO DE IPRATROPIO - GENERICO 95009558 BROMETO DE IPRATROPIO - GENERICO 95013822 BROMETO DE IPRATROPIO - GENERICO 95991859 BROMETO DE IPRATROPIO - GENERICO 95991867 BROMETO DE IPRATROPIO - GENERICO 95074430 BROMETO DE ROCURONIO - GENERICO 95923675 BROMETO DE IPATROPIO - GENERICO 95081895 BROMETO DE IPRATROPIO - GENERICO 95081879 BROMETO DE IPRATROPIO - GENERICO 95081887 BROMETO DE IPRATROPIO - GENERICO 95923683 BROMETO DE N-BUTIL ESC, + DIP, - GENERIC 95923691 BROMETO DE N-BUTIL ESC, + DIP, - GENERIC 95991875 BROMETO DE N-BUTIL ESC, + DIP, SODICA 95991883 BROMETO DE N-BUTIL ESC, + DIP, SODICA 95991905 BROMETO DE N-BUTIL ESCOPOLAMINA - GENE 95923721 BROMETO DE N-BUTIL ESCOPOLAMINA - GENE 95991913 BROMETO DE N-BUTIL ESCOPOLAMINA - GENE 95089926 BROMETO DE PANCURONIO - GENERICO (Restrito Hosp,) 95009566 BROMIDRATO FENOTEROL - GENERICO 95009574 BROMIDRATO FENOTEROL - GENERICO 95009582 BROMIDRATO FENOTEROL - GENERICO 95009590 BROMIDRATO FENOTEROL - GENERICO 95009604 BROMIDRATO FENOTEROL - GENERICO 95009612 BROMIDRATO FENOTEROL - GENERICO 95991921 BROMIDRATO FENOTEROL - GENERICO 95009620 BROMIDRATO FENOTEROL - GENERICO 95009647 BROMIDRATO FENOTEROL - GENERICO 95009655 BROMIDRATO FENOTEROL - GENERICO 95081909 BROMIDRATO FENOTEROL - GENERICO 95200657 BROMIFEN 95923764 BROMIL - LINHA CONSUMO 95923772 BROMIL - LINHA CONSUMO 95320083 BROMOGEX 95320091 BROMOGEX 95991930 BROMOPAN

2009 95991948 BROMOPAN

APRESENTAÇÃO Amp, 5 ml, 0,25 mg/ml sol, inal, cx, 100 fr, vd, got, x 20 ml (hosp,) 0,25 mg/ml sol, nasal 20 ml Gts, 0,25 mg/ml fr, vd, 20 ml Sol, inal, 0,25 mg, gts, fr, 20 ml Sol, inal, 20 ml Sol, nasal 20 ml c/200 fr, 10 mg/ml sol, inj, IV 12 FA vd, x 5 ml Sol, nasal 20 ml 0,25 mg/ml fr, 20 ml Sol, p/inal, fr, 20 ml Sol, p/inal, fr, 20 ml 6,67 mg/ml+ 333,40 sol, oral 1 fr, vd, got, x 20 ml Sol, 20 ml Sol, 10 ml c/200 frs, Sol, 20 ml c/200 frs, 10 ml 200 frs, 20 ml 20 ml 200 frs, 2 mg/ml sol, inj, IV cx, 50 amps, vd, amb, x 2 ml (hosp,) 0,25 mg/ml xpe, inf, fr, 120 ml 0,25 mg/ml xpe, inf, fr, 120 ml 0,25 mg/ml xpe, inf, fr, 120 ml 0,5 mg/ml xpe, ad, fr, 120 ml 0,5 mg/ml xpe, ad, fr, 120 ml 0,50 mg/ml xpe, ad, fr, 120 ml 5 mg, fr, 20 ml 5 mg/g sol, oral gts, 20 ml 5 mg/ml fr, 20 ml 5 mg/ml fr, 20 ml 5 mg/ml sol, oral fr, vd, 20 ml+ cgt, Gts, 5 mg/ml vd, 20 ml Xpe, ad, fr, 150 ml Xpe, inf, fr, 150 ml 5 mg/ml inj, cx, 5 amps, x 2 ml, 5 mg/ml inj, cx, 50 amps, x 2 ml, 10 mg, 20 caps,

Laboratorio HALEX ISTAR TEUTO BRAS, TEUTO BRAS, NEO QUIMICA BIOSINTETICA UNIAO QUIMICA PRATI DONADUZZI EUROFARMA PRATI DONADUZZI GEN - LEGRAND EMS GERMED MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI NOVAFARMA EMS GERMED GEN - LEGRAND GERMED GEN - LEGRAND EMS EMS PRATI DONADUZZI GERMED GEN - LEGRAND TEUTO BRAS, NEO QUIMICA EMS EMS WASSER FARMA WASSER FARMA UCI-FARMA

Gts, ped, fr, 20 ml

UCI-FARMA

UNIDADE Pco Unt Base A AP 1,76 GOTA 0,36 GOTA 0,01 GOTA 0,02 GOTA 0,02 GOTA 0,02 GOTA 0,01 FA 23,14 GOTAS 0,02 GOTA 0,02 GOTA 0,02 GOTA 0,02 GOTAS 0,01 GOTAS 0,01 GOTA 0,01 GOTA 0,00 GOTA 0,01 GOTAS 0,01 GOTA 0,01 AMP 3,26 ML 0,02 ML 0,02 ML 0,02 ML 0,02 ML 0,02 ML 0,02 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTA 0,01 AP 9,55 ML 0,07 ML 0,07 AP 3,20 AP 2,61 CAPS 0,71 GOTA

0,03

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2047 2048

CODIGO BENEFICIO 95991956 BROMOPAN 95270183 BROMOPIRIN 95009663 BROMOPRIDA - GENERICO 95009671 BROMOPRIDA - GENERICO 95020217 BROMOPRIDA - GENERICO 95009698 BROMOPRIDA - GENERICO 95923780 BROMOPRIDA - GENERICO 95095837 BROMOPRIDA - GENERICO 95095845 BROMOPRIDA - GENERICO 95095853 BROMOPRIDA - GENERICO 95043195 BROMOPRIDA - GENERICO 95043209 BROMOPRIDA - GENERICO 95095861 BROMOPRIDA - GENERICO 95009701 BROMOPRIDA - GENERICO 95009710 BROMOPRIDA - GENERICO 95052160 BROMOPRIDA - GENERICO 95020195 BROMOPRIDA - GENERICO 95984216 BROMOPRIDA - GENERICO 95095870 BROMOPRIDA - GENERICO 95026894 BROMOPRIDA - GENERICO 95020209 BROMOPRIDA - GENERICO 95991972 BROMOPRIDA - GENERICO 95035648 BROMOPRIDA - GENERICO 95026908 BROMOPRIDA - GENERICO 95085556 BROMOPRIDA - GENERICO 95119949 BROMOPRIDA - GENERICO (Restrito Hosp,) 95138030 BROMOPRIDA - GENERICO (Restrito Hosp.) 95200673 BROMOTEC 95009736 BROMOVENT 95119957 BROMOVENT (Restrito Hosp,) 95013830 BROMUC 95013849 BROMUC 95923802 BRONCATAR 95095888 BRONCHO-VAXOM 95095896 BRONCHO-VAXOM 95095900 BRONCHO-VAXOM 95250298 BRONCOFENIL 95923810 BRONCOFISIN

APRESENTAÇÃO Sol, fr, 120 ml Cx, 20 caps, 1 mg/ml sol, oral fr, 120 ml 1 mg/ml sol, oral fr, 120 ml 1 mg/ml sol, oral vd, 120 ml+ cp-med, 1,0 mg/ml sol, oral fr, vd, 120 ml+ cp, med, 10 mg cap gel dura ct 2 bl, al, plast, inc, x 10 10 mg, 2 bl, 10 caps, 10 mg, 2 bl, x 10 caps, 10 mg, 2 bl, x 10 caps, 10 mg, com, ct, bl, al, plas, inc, x 20 10 mg, com, ct, bl, al, plas, inc, x 800 (emb, hosp,) 4 mg/ml got, x 20 ml 4 mg/ml sol, oral fr, 20 ml 4 mg/ml sol, oral fr, 20 ml 4 mg/ml sol, oral fr, 20 ml 4 mg/ml sol, oral fr, 20 ml, 4 mg/ml sol, oral fr, 20 ml, 4 mg/ml sol, oral fr, plast, opc, got, x 20 ml 4 mg/ml sol, oral got, x 20 ml 4 mg/ml sol, oral gts, 20 ml 4 mg/ml sol, oral gts, 20 ml 4 mg/ml, sol, or, ct, fr, plas, opc, got, x 20 ml, 4,0 mg/ml sol, oral fr, vd, got, x 20 ml 5 mg/ml sol, inj, IM/IV cx, 50 amps, vd, amb, x 2 ml (hosp,) 10 mg, com, ct, bl, al, plas, inc, x 200 (hosp,) 5 mg/ml sol. inj. 50 amps. vd. amb. x 2 ml (hosp.) Sol, gts, 5 mg/ml 20 ml 0,25 mg/ml cart, 1 fr, 20 ml 0,25 mg/ml sol, inal, ct, 10 fr, plast, got, x 20 ml Cx, 100 amps, 3 ml Cx, 5 amps, 3 ml Xpe, fr, 150 ml 10 saches 3,5 mg, po gran, 30 sachets 7 mg, po liof, bl, 30 caps, gel, dura Xpe, fr, 100 ml, Xpe, ad, 150 ml,

Laboratorio UCI-FARMA SIGMA PHARMA EMS GERMED MEDLEY BIOSINTETICA MEDLEY GEN - LEGRAND EMS GERMED PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA GERMED GEN - LEGRAND MEPHA-RATIOPHARM TEUTO BRAS, EMS EUROFARMA UNIAO QUIMICA MEDLEY MERCK PRATI DONADUZZI BIOSINTETICA NOVAFARMA PRATI DONADUZZI UNIAO QUIMICA TEUTO BRAS, BERGAMO BERGAMO ARISTON ARISTON CAZI NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA ZURITA LUPER

UNIDADE Pco Unt Base A ML 0,11 CPR 0,73 ML 0,09 ML 0,09 ML 0,10 ML 0,10 CPR 0,61 CAPS 0,56 CAPS 0,61 CAPS 0,54 CP 0,63 CP 0,30 GOTAS 0,03 GOTA 0,02 GOTA 0,02 GOTA 0,02 GOTAS 0,03 GOTAS 0,02 GOTAS 0,02 GOTAS 0,03 GOTAS 0,02 GOTA 0,02 GOTA 0,03 GOTAS 0,02 AMP 1,86 COMP 0,32 FA 1,86 GOTAS 0,02 GOTA 0,03 GOTAS 0,00 AMP 2,00 AMP 2,10 ML 0,08 SACHE 3,04 SACHE 2,93 CAPS 4,50 ML 0,20 ML 0,07

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2049 2050 2051 2052 2053 2054 2055 2056 2057 2058 2059 2060 2061 2062 2063 2064 2065 2066 2067 2068 2069 2070 2071 2072 2073 2074 2075 2076 2077 2078 2079 2080 2081 2082 2083 2084 2085 2086

CODIGO BENEFICIO 95923829 BRONCOFISIN 95009744 BRONCOFLEX 95009752 BRONCOFLEX 95923837 BRONCOFLUX 95250328 BRONCOFLUX 95013857 BRONCONAL 95200703 BRONDILAT 95991999 BRONDILAT 95013865 BRONFILIL 95013873 BRONFILIL 95992006 BRONQUIDEX 95095918 BROS 95923853 B-TABLOCK 95923861 B-TABLOCK 95013903 BUCLINA 95210083 BUDECORT AQUA 95210091 BUDECORT AQUA 95013911 BUDIAIR 95013920 BUDIAIR 95131094 BUFEDIL 95052186 BUFEDIL 95052178 BUFEDIL 95131108 BUFEDIL 95992014 BUONA 95013954 BUP 95136266 BUPICAN 95136274 BUPICAN 95100105 BURINAX 95052194 BUSCOFEM 95081917 BUSCOPAN 95020292 BUSCOPAN 95013962 BUSCOPAN 95020306 BUSCOPAN 95020233 BUSCOPAN 95992030 BUSCOPAN 95081933 BUSCOPAN COMPOSTO 95081925 BUSCOPAN COMPOSTO 95081941 BUSCOPAN COMPOSTO

APRESENTAÇÃO Xpe, ped, 150 ml, 25 mg/5 ml xpe, inf, fr, 120 ml 50 mg/5 ml xpe, ad, fr, 120 ml Ad, xpe, 120 ml Ped, xpe, 3 mg/ml, vd, 120 ml, Sol, oral 0,4 mg/ml 120 ml Ped, 5 mg/ml xpe, fr, 120 ml, Xpe, fr, 120 ml, Xpe, ad, 120 ml Xpe, inf, 120 ml Xpe, fr, 150 ml 100 mg, cx, 20 caps, Fr, 10 ml Fr, 5 ml 20 cprs, 32 mcg, 120 doses 64 mcg, 120 doses 200 mcg/dose+ bocal 200 doses 200 mcg/dose+ bocal+ esp, 200 doses 150 mg, fr, 30 cprs, rev, 150 mg, fr, 40 cprs, rev, 300 mg, 20 cprs, rev, 300 mg, fr, 30 cprs, rev, 150 mg, 30 caps, 150 mg, 30 cprs, 5 mg/ml sol, inj, cx, 1 amp, vd, inc, x 4 ml 5 mg/ml sol, inj, cx, FA vd, inc, x 20 ml Cx, 20 cprs, 400 mg, bl, 10 caps, gel mole 10 mg, bl, 20 drags, 10 mg/ml, sol, oral 20 ml, 20 mg/ml sol, inj, 5 amps, x 1 ml Comp, cprs, rev, 2 x 10 Comp, sol, 20 ml, Comp,amp,5 ml3amps, 2 bl, x 10 cprs, rev, Sol, 20 ml Sol, inj, 3 amps, x 5 ml

Laboratorio LUPER LEGRAND LEGRAND FARMASA FARMASA CIFARMA ACHE ACHE CIFARMA CIFARMA CHIESI TRB-PHARMA LATINOFARMA LATINOFARMA SANOFI-AVENTIS ASTRAZENECA ASTRAZENECA CHIESI CHIESI ABBOTT ABBOTT ABBOTT ABBOTT EUROFARMA EUROFARMA CLARIS CLARIS SOLVAY FARMA BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM

UNIDADE Pco Unt Base A ML 0,06 ML 0,10 ML 0,14 ML 0,20 ML 0,12 ML 0,05 ML 0,10 ML 0,14 ML 0,17 ML 0,12 ML 0,03 CAPS 12,53 GOTAS 0,14 GOTAS 0,16 COMP 0,28 DOSE 0,16 DOSE 0,28 DOSE 0,43 DOSE 0,43 CPR 1,39 COMP 1,36 COMP 2,72 CPR 2,67 CAPS 1,85 COMP 2,01 AMP 5,54 FA 16,82 CPR 0,40 CAPS 1,19 DRAG 0,41 GOTAS 0,02 AMP 1,29 CPR 0,44 GOTAS 0,02 AMP 3,12 COMP 0,44 GOTA 0,02 AMP 3,12

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2087 2088 2089 2090 2091 2092 2093 2094 2095 2096 2097 2098 2099 2100 2101 2102 2103 2104 2105 2106 2107 2108 2109 2110 2111 2112 2113 2114 2115 2116 2117 2118 2119 2120 2121 2122 2123 2124

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95052208 BUSCOPAN PLUS 20 cprs, rev, BOEHRINGER INGELHEIM 95020314 BUSCOVERAN COMPOSTO Cx, 20 drags, BUNKER 95021078 BUSCOVERAN COMPOSTO Gts, fr, 20 ml, BUNKER 95013970 BUSONID 100 mcg/dose susp, aquosa nasal fr, plast, x 6 ml (120 doses BIOSINTETICA 95210148 BUSONID 100 mcg/susp, aquosa nasal 200 doses BIOSINTETICA 95923888 BUSONID 200 mcg Aer, Bucal x 100 ds (5 ml) BIOSINTETICA 95044930 BUSONID 32 mcg 6 ml susp, aquosa nasal fr, plast, BIOSINTETICA 95923896 BUSONID 50 mcg Aer, Bucal x 100 ds (5 ml) BIOSINTETICA 95210156 BUSONID 50 mcg aquoso nasal 200 doses BIOSINTETICA 95923900 BUSONID 50 mcg susp, aquosa nasal x 120 ds, BIOSINTETICA 95044922 BUSONID 64 mcg 6 ml susp, aquosa nasal fr, plast, BIOSINTETICA 95210172 BUSONID Caps, 200 mcg, x 60 (refil) BIOSINTETICA 95210164 BUSONID Caps, 200 mcg, x 60 c/inalador BIOSINTETICA 95210199 BUSONID Caps, 400 mcg, x 60 (refil) BIOSINTETICA 95210180 BUSONID Caps, 400 mcg, x 60 c/inalador BIOSINTETICA 95119965 BUSONID AQUOSO NASAL 32 mcg, susp, aquosa nasal fr, x 6 ml (120 doses) BIOSINTETICA 95119973 BUSONID AQUOSO NASAL 50 mcg, susp, aquosa nasal fr, x 6 ml (120 doses) BIOSINTETICA 95119981 BUSONID AQUOSO NASAL 64 mcg, susp, aquosa nasal fr, x 6 ml (120 doses) BIOSINTETICA 95095926 BUSONID CAPSULAS 200 mcg, caps, gel 1 bl, x 15 BIOSINTETICA 95095934 BUSONID CAPSULAS 400 mcg, caps, gel, 1 bl, x 15 c/inalador BIOSINTETICA 95095942 BUSONID CAPSULAS 400 mcg, caps, gel, 1 bl, x 15 refil BIOSINTETICA 95270256 BUSPAR 10 mg, cx, 2 bl x 10 cprs B-MS 95270264 BUSPAR 5 mg, cx, 2 bl, x 10 cprs B-MS 95640177 BUTAZOLIDINA 20 drags, NOVARTIS 95640185 BUTAZONA 200 mg, calcica 10 bl, 10 drags, BOEHRINGER INGELHEIM 95035664 BUTILBROMETO DE ESCOPOLAMINA - GENERIC 10 mg/ml, sol, or, ct, fr, plas, opc, got, x 20 ml, PRATI DONADUZZI 95026924 BUTILBROMETO DE ESCOPOLAMINA - GENERIC 20 mg/ml inj, 50 amps, x 1 ml UNIAO QUIMICA 95045538 BUTILBROMETO DE ESCOPOLAMINA - GENERIC Sol, inj, 20 mg/ml cx, 3 amps, x 5 ml TEUTO BRAS, 95070940 BUTILBROMETO DE ESCOPOLAMINA - GENERICO 20 mg/ml sol, inj, cx, 100 amps, vd, amb, x 1 ml (hosp,) HIPOLABOR 95052232 BUTILBROMETO DE ESCOPOLAMINA - GENERICO Sol, inj, 20 mg/ml cx, 3 amps, x 5 ml TEUTO BRAS, 95992049 BUTILBROMETO DE ESCOPOLAMINA - GENERICO 10 mg/ml gts, fr, 20 ml EMS 95992057 BUTILBROMETO DE ESCOPOLAMINA - GENERICO Sol, fr, 20 ml GERMED 95992065 BUTILBROMETO DE ESCOPOLAMINA - GENERICO Sol, fr, 20 ml GEN - LEGRAND 95119990 BUTILBROMETO DE ESCOPOLAMINA - GENERICO (Restrito Hosp,) 10 mg/ml sol, or, cx, 200 fr, plas, x 10 ml (hosp,) PRATI DONADUZZI 95121250 BUTILBROMETO DE ESCOPOLAMINA - GENERICO (Restrito Hosp,) 10 mg/ml sol, or, cx, 200 fr, plas, x 20 ml (hosp,) PRATI DONADUZZI 95992073 BUTILBROMETO DE ESCOPOLAMINA + DIP, SOD 6,67 mg/ml+ 333,40 sol, oral 1 fr, vd, got, x 20 ml MEDLEY 95035699 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODI 6,67 mg/ml,+ 333,4 mg/ml, sol, or, ct, fr, plas, opc, x 20 PRATI DONADUZZI 95035672 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODI Fr, 20 ml GERMED

UNIDADE Pco Unt Base A COMP 0,65 CPR 0,76 GOTAS 0,03 DOSE 0,28 DOSE 0,28 DOSE 0,44 DOSE 12,49 DOSE 0,28 DOSE 0,17 DOSE 0,15 DOSE 24,17 CAPS 0,39 CAPS 0,48 CAPS 0,67 CAPS 0,84 DOSE 0,09 DOSE 0,14 DOSE 0,19 CAPS 0,39 CAPS 0,75 CAPS 0,67 CPR 1,01 CPR 0,66 CPR 0,36 CPR 0,36 GOTA 0,01 AMP 0,69 AMP 2,37 AMP 0,63 AMP 2,37 GOTA 0,01 GOTA 0,01 GOTA 0,01 ML 1,70 ML 2,16 GOTA 0,01 GOTA 0,01 GOTA 0,01

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2125 2126 2127 2128 2129 2130 2131 2132 2133 2134 2135 2136 2137 2138 2139 2140 2141 2142 2143 2144 2145 2146 2147 2148 2149 2150 2151 2152 2153 2154 2155 2156 2157 2158 2159 2160 2161 2162

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95035680 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODI Fr, 20 ml GEN - LEGRAND 95013989 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODI Sol, fr, 20 ml EMS 95070958 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODICA - GENERICO 4 mg/ml+ 500 mg/ml sol, inj, cx, 100 amps, vd, amb, x 5 ml (hosp,) HIPOLABOR 95052240 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODICA - GENERICO Sol, oral gts, fr, 20 ml GEN - LEGRAND 95121269 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODICA - GENERICO 6,67 mg/ml, (Rest Hosp,) + 333,4 mg/ml, sol, or, cx, 200 fr, plas, opc, x 10PRATI ml, (hosp,) DONADUZZI 95121277 BUTILBROMETO DE ESCOPOLAMINA + DIP, SODICA - GENERICO 6,67 mg/ml, (Rest Hosp,) + 333,4 mg/ml, sol, or, cx, 200 fr, plas, opc, x 20PRATI ml, (hosp,) DONADUZZI 95121285 BUTILBROMETO DE ESCOPOLAMINA + DIPIRONA SODICA - 20 GENERICO mg, + 2,5 g - 5 mg, cx, 100 amps, vd, FARMACE 95095950 BUTILBROMETO DE ESCOPOLAMINA + DIPIRONA SODICA - 20 GENERICO ml CT fr, FARMACE 95200711 BUTOVENT PULVINAL 0,2 mg/dose po inal, ct, inal, plast, 100 doses CHIESI 95923918 B-VIT Cx, 50 drags, CAZI 95923926 B-VIT Sol, oral fr, 30 ml CAZI 95923934 C CALCIO Tubo 10 cprs, eferv, EMS 95064567 C PLATIN-CISPLATINA Sol, inj, 1 mg/ml FA vd, x 100 ml BLAUSIEGEL 95121293 C PLATIN-CISPLATINA (Restrito Hosp,) Sol, inj, 1 mg/ml FA vd, x 50 ml BLAUSIEGEL 95610383 C,G,T, Vd, 30 drags, LIBBS 95330968 CAAS Ad, 500 mg, 20 bl, x 10 cprs, EMS 95992090 CADUET 10 mg,+ 10 mg, 30 cprs, PFIZER 95992103 CADUET 10 mg,+ 20 mg, 10 cprs, PFIZER 95992111 CADUET 10 mg,+ 20 mg, 30 cprs, PFIZER 95992081 CADUET 10 mg,+10mg,10cprs, PFIZER 95992146 CADUET 5 mg,+ 10 mg, 30 cprs, PFIZER 95992154 CADUET 5 mg,+ 20 mg, 30 cprs, PFIZER 95992120 CADUET 5 mg,+10 mg,10cprs, PFIZER 95992138 CADUET 5 mg,+20mg,10cprs, PFIZER 95992162 CAELYX 2 mg/ml inj, FA vd, x 10 ml SCHERING PLOUGH 95007954 CAFEINA CAPS C/ 250 MG 5 MG/ML 95126309 CAFEINA ANIDRA 95035702 CAFILISADOR 95035710 CAFILISADOR 95992170 CALATO 95992189 CALATO 95992197 CALATO 95923942 CALCIGENOL 95014004 CALCIJEX 95992200 CALCIMED B-12 95923950 CALCINOL COMPLEXO 95095969 CALCIO D3 95009760 CALCIO ZURITA

Cx, 16 cprs, Cx, 25 x 4 cprs, - 500 mg, 125 mg, cx, 60 cprs, rev, 250mg,cx,15env,po 500mg,cx,15env,po 10 mg/ml+ 0,100 mg/ml sus or, fr, plast, trans, x 300 ml Injetavel 1 ml, (cx, c/ 3 unid,) Susp, vd,150 ml Susp, fr, 240 ml Fr, 60 caps, Fr, 30 cprs, mast,

FARMASA FARMASA ATIVUS ATIVUS ATIVUS SANOFI-AVENTIS ABBOTT MEDQUIMICA EMS BUNKER ZURITA

UNIDADE Pco Unt Base A GOTA 0,01 GOTA 0,01 AMP 1,52 GOTA 0,01 ML 1,27 ML 1,83 AMP 1,53 GOTAS 0,01 DOSE 0,40 CPR 0,25 GOTAS 0,01 CPR 1,14 FA 187,39 FA 93,70 CPR 0,46 CPR 0,16 COMP 4,32 COMP 6,00 COMP 7,11 COMP 3,64 COMP 3,77 COMP 6,56 COMP 3,77 COMP 5,53 F,A, 1569,41 CAPS 0,32 AMP 2,61 CP 0,78 CP 0,79 COMP 0,70 ENV 1,53 ENV 2,72 ML 0,02 UNID 16,73 ML 0,05 ML 0,07 CAPS 0,59 CPR 0,87

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2163 2164 2165 2166 2167 2168 2169 2170 2171 2172 2173 2174 2175 2176 2177 2178 2179 2180 2181 2182 2183 2184 2185 2186 2187 2188 2189 2190 2191 2192 2193 2194 2195 2196 2197 2198 2199 2200

CODIGO BENEFICIO 95992219 CALCIUM D3 95923969 CALCIUM D3 95600191 CALCIUM XAROPE 95660526 CALCORT 95660518 CALCORT 95095977 CALCYLON 95992227 CALDE 95052259 CALMAN 95009779 CALMITON 95270329 CALMOCITENO 95270337 CALMOCITENO 95095985 CALNATE 95610430 CALSYNAR 95610421 CALSYNAR 95610413 CALSYNAR 95009787 CALTRATE 600 + D 95610448 CALTRATE 600 + D 95009795 CALTRATE 600 + M 95610456 CALTRATE 600 + M 95140034 CALTREN 95140050 CALTREN 95140042 CALTREN 95140069 CALTREN 95923977 CALZEM 95420363 CAMBEM 95420371 CAMBEM 95074457 CAMPATH 95540334 CAMPTOSAR 95540326 CAMPTOSAR 95390146 CANCIDAS 95390154 CANCIDAS 95840265 CANDERME 95840273 CANDERME (*) 95840281 CANDERME (*) 95840290 CANDERME (*) 95095993 CANDESARTANA CILEXETILA - GEN╔RICO 95096000 CANDESARTANA CILEXETILA - GEN╔RICO 95096019 CANDICORT

APRESENTAÇÃO 600 mg, 30 ce 600 mg, 60 cprs, rev, Fr, 200 ml, 30 mg, cx, 10 6 mg, cx, 20 Susp, 240 ml Cx, 60 cprs, 20 cprs, rev, Cx, 30 cprs, rev, 10 mg, cx, 20 cprs, 5 mg, cx, 20 cprs, 900 mg/g po oral ct, 60 envs, pap, al/plas, x 30 g 100 UI inj, 5 ser, x 0,5 ml, 100 UI inj, 5 ser, x 1 ml, 100 UI intranasal monodose Fr, 30 cprs, Fr, 60 cprs, Fr, 30 cprs, Fr, 60 cprs, 10 mg, 20 cprs, 10 mg, 30 cprs, 20 mg, 20 cprs, 20 mg, 30 cprs, 60 mg, cx, 25 cprs, 2 comprimidos Susp, fr, 20 ml, 30 mg/ml sol, inj, 3 FA vd, x 1 ml 100 mg, sol, inj, cx, 1 FA 5 ml, 40 mg sol, inj, cx, 1 FA 2 ml, 50 mg, cx, FA 70 mg, cx, FA Susp, fr, 80 ml 250 mg, cx, 20 cprs, 400 mg, cx, 20 cprs, Gel vag, bisn, 50 g 16 mg, bl, 30 cprs, 8 mg, bl, 30 cprs, Creme 10 g

Laboratorio NOVARTIS NOVARTIS NOVARTIS SANOFI-AVENTIS SANOFI-AVENTIS LUPER MARJAN ATIVUS BUNKER MEDLEY MEDLEY EUROFARMA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS WYETH CONSUMER WYETH CONSUMER WYETH CONSUMER WYETH CONSUMER LIBBS LIBBS LIBBS LIBBS CAZI UCI-FARMA UCI-FARMA BAYER PFIZER PFIZER MERCK SHARP & DOHME MERCK SHARP & DOHME LEGRAND LEGRAND LEGRAND LEGRAND SANDOZ SANDOZ ACHE

UNIDADE Pco Unt Base A COMP 0,77 CPR 0,73 GOTAS 0,00 CPR 9,80 CPR 2,05 ML 0,07 COMP 0,80 COMP 0,87 COMP 0,99 CPR 0,31 CPR 0,24 ENV 15,79 AP 18,20 AP 30,73 DOSE 81,95 CPR 0,70 CPR 0,70 CPR 0,74 CPR 0,74 CPR 0,88 CPR 1,10 CPR 1,68 CPR 2,08 CPR 0,58 CPR 3,97 ML 0,31 FA 1381,49 X AP 1150,13 X AP 465,51 X AP 2187,84 X AP 2818,40 X ML 0,08 CPR 0,54 CPR 0,74 G 0,20 COMP 1,84 COMP 1,70 GRAMA 0,28

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2217 2218 2219 2220 2221 2222 2223 2224 2225 2226 2227 2228 2229 2230 2231 2232 2233 2234 2235 2236 2237 2238

CODIGO BENEFICIO 95840311 CANDICORT 95840303 CANDICORT 95840320 CANDIDERM 95840346 CANDISTATIN 95052267 CANDITRAT 95009809 CANDITRAT 95121307 CANDITRAT (Restrito Hosp,) 95390170 CANDIZOL 95992235 CANDIZOL 95390189 CANDORAL 95390200 CANESTEN 95009817 CANESTEN 95390197 CANESTEN 95923985 CAPILAREMA 95096027 CAPILAREMA 95992243 CAPOBAL 95992251 CAPOBAL 95131167 CAPOTEN 95131124 CAPOTEN 95096035 CAPOTEN 95131132 CAPOTEN 95096043 CAPOTEN 95923993 CAPOTRAT 95992260 CAPOTRAT 95924000 CAPOTRAT 95992278 CAPOTRAT 95924019 CAPOTRAT 95992286 CAPOTRAT 95014047 CAPOTRINEO 95014039 CAPOTRINEO 95014012 CAPOTRINEO 95014020 CAPOTRINEO 95131213 CAPRIL 95131256 CAPRIL 95052275 CAPRIL 95131221 CAPRIL 95131302 CAPTIL 95131264 CAPTIL

APRESENTAÇÃO Creme 30 g, Pom, 30 g, 2% creme bisn, 30 g Creme vag, tb, 60 g, 100,000 UI/ml susp, oral 50 fr, vd, amb, x 50 ml Susp, oral 100,000 UI/ml fr, 50 ml 100,000 UI/ml susp, oral 50 fr, vd, amb, x 50 ml (hosp,) 150 mg bl, 1 cap, gel, 150 mg bl, 2 caps, gel, Cx, 10 cprs, 1% cr, derm, bisn, 20 g 1% sol, top, fr, plast, opc, gts, 30 ml 1% sol, vd, neb, 30 ml, 75 mg cx, 30 cprs, 75 mg, cx, 60 cprs, 25 mg, cx, 30 cprs, 50 mg, cx, 30 cprs, 12,5 mg, cx, c/ 1 bl, x 15 25 mg, cx, c/ 1 bl x 16 25 mg, cx, c/ 2 bl, x 15 cprs, 50 mg, cx, c/ 1 bl x 16 50 mg, cx, c/ 2 bl, x 15 cprs, 12,5 mg, bl, 30 cprs, 12,5 mg, com x 300 (EH) 25 mg, bl, 30 cprs, 25 mg, com x 500 (EH) 50 mg, bl, 30 cprs, 50 mg, com x 500 (EH) 12,5 mg, cx, 30 cprs, 25 mg, cx, 16 cprs, 25 mg, cx, 30 cprs, 50 mg, cx, 30 cprs, 12,5 mg, 30 cprs, 25 mg, 15 cprs, 25 mg, 20 bl, x 15 cprs, (hosp,) 50 mg, 30 cprs, 12,5 mg, cx, 15 cprs, 25 mg, cx, 30 cprs,

Laboratorio ACHE ACHE ACHE TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, ACHE ACHE ACHE BAYER BAYER BAYER BALDACCI BALDACCI BALDACCI BALDACCI B-MS B-MS B-MS B-MS B-MS UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, HEBRON HEBRON

UNIDADE Pco Unt Base A G 0,56 G 0,56 G 0,41 G 0,26 ML 0,27 ML 15,22 ML 0,28 CPR 27,43 CAPS 26,35 CPR 2,61 G 0,52 GOTA 15,29 GOTAS 0,04 CPR 0,88 COMP 0,78 COMP 0,53 CPR 1,06 CPR 0,77 CPR 1,32 COMP 1,40 CPR 2,62 COMP 2,78 CPR 0,32 COMP 0,19 CPR 0,57 COMP 0,17 CPR 0,89 COMP 0,28 COMP 0,37 COMP 0,56 COMP 0,49 COMP 1,07 CPR 0,26 CPR 0,46 COMP 0,35 CPR 0,64 CPR 0,45 CPR 0,53

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2239 2240 2241 2242 2243 2244 2245 2246 2247 2248 2249 2250 2251 2252 2253 2254 2255 2256 2257 2258 2259 2260 2261 2262 2263 2264 2265 2266 2267 2268 2269 2270 2271 2272 2273 2274 2275 2276

CODIGO BENEFICIO 95131280 CAPTIL 95052283 CAPTOMAX 95070974 CAPTOMAX 95070966 CAPTOMAX 95070982 CAPTOMAX 95131396 CAPTON 95131361 CAPTON 95131353 CAPTON 95131450 CAPTOPIRIL 95131442 CAPTOPIRIL 95131469 CAPTOPIRIL 95984291 CAPTOPRIL 95009833 CAPTOPRIL 95026932 CAPTOPRIL 95992294 CAPTOPRIL 95992308 CAPTOPRIL 95026940 CAPTOPRIL 95052313 CAPTOPRIL 95052321 CAPTOPRIL 95924060 CAPTOPRIL 95009841 CAPTOPRIL 95924043 CAPTOPRIL 95009825 CAPTOPRIL 95924027 CAPTOPRIL 95924078 CAPTOPRIL 95009850 CAPTOPRIL 95026959 CAPTOPRIL 95924086 CAPTOPRIL 95984305 CAPTOPRIL 95009868 CAPTOPRIL 95009876 CAPTOPRIL 95009884 CAPTOPRIL 95992316 CAPTOPRIL 95014063 CAPTOPRIL 95009892 CAPTOPRIL 95026967 CAPTOPRIL 95052291 CAPTOPRIL 95924094 CAPTOPRIL -

APRESENTAÇÃO 50 mg, cx, 15 cprs, 12 mg, cx, 30 cprs, 25 mg, cx, 15 cprs, 25 mg, cx, 30 cprs, 50 mg, cx, 30 cprs, 12,5 mg, cx, 15 cprs, 25 mg, cx, 16 cprs, 50 mg, cx, 28 cprs, 12,5 mg, cx, 15 cprs, 25 mg, cx, 16 cprs, 50 mg, cx, 16 cprs, 12,5 mg, 2 bl, x 15 cprs, 12,5 mg, 30 cprs, 12,5 mg, 9 bl, x 10 cprs, 12,5 mg, bl, 15 cprs, 12,5 mg, bl, 30 cprs, 12,5 mg, c/30 12,5 mg, com, ct, bl, al, plas, inc, x 30 12,5 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 12,5 mg, ct, c/30 cprs, 12,5 mg, cx, 30 cprs, 12,5 mg,3bl,x10cprs, 12,5mg,2 bl,x15 cprs, 12,5mg,2 bl,x15cprs, 25 mg 3 bl, x 10 cprs, 25 mg, 2 bl, x 14 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 2 bl, x 8 cprs, 25 mg, 3 bl, x 10 cprs, 25 mg, 30 cprs, 25 mg, 30 cprs, 25 mg, 4 bl, x 15 cprs, 25 mg, 6 bl, x 10 cprs, 25 mg, 9 bl, x 10 cprs, 25 mg, bl, 30 cprs, 25 mg, c/14

Laboratorio HEBRON MILIAN MILIAN MILIAN MILIAN ROYTON ROYTON ROYTON BUNKER BUNKER BUNKER EUROGENUS - LEGRAND ARROW EMS LUPER LUPER SANDOZ PRATI DONADUZZI PRATI DONADUZZI EUROFARMA NEO QUIMICA CRISTALIA RANBAXY GERMED CRISTALIA RANBAXY EMS GERMED GEN - LEGRAND RANBAXY RANBAXY ARROW TEUTO BRAS, EMS RANBAXY EMS UNIAO QUIMICA HEXAL

UNIDADE Pco Unt Base A CPR 1,10 COMP 0,26 COMP 0,41 COMP 0,36 COMP 0,50 CPR 0,25 CPR 0,38 CPR 0,38 CPR 0,41 CPR 0,51 CPR 0,85 COMP 0,20 COMP 0,31 CPR 0,33 COMP 0,44 COMP 0,36 CPR 0,33 COMP 0,34 COMP 0,25 CPR 0,32 COMP 0,31 CPR 0,45 COMP 0,25 CPR 0,21 CPR 0,71 COMP 0,43 CPR 0,59 CPR 0,52 COMP 0,49 COMP 0,43 COMP 0,40 COMP 0,51 COMP 0,29 COMP 0,43 COMP 0,32 CPR 0,43 COMP 0,54 CPR 0,45

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2277 2278 2279 2280 2281 2282 2283 2284 2285 2286 2287 2288 2289 2290 2291 2292 2293 2294 2295 2296 2297 2298 2299 2300 2301 2302 2303 2304 2305 2306 2307 2308 2309 2310 2311 2312 2313 2314

CODIGO BENEFICIO 95026975 CAPTOPRIL 95924108 CAPTOPRIL 95026983 CAPTOPRIL 95924116 CAPTOPRIL 95052330 CAPTOPRIL 95052348 CAPTOPRIL 95009906 CAPTOPRIL 95992324 CAPTOPRIL 95992332 CAPTOPRIL 95924124 CAPTOPRIL 95924132 CAPTOPRIL

GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO

95009914 CAPTOPRIL - GENERICO 95009922 CAPTOPRIL - GENERICO 95992340 CAPTOPRIL - GENERICO 95009930 CAPTOPRIL - GENERICO 95009949 CAPTOPRIL - GENERICO 95009957 CAPTOPRIL - GENERICO 95924140 CAPTOPRIL - GENERICO 95992359 CAPTOPRIL - GENERICO 95014055 CAPTOPRIL - GENERICO 95026991 CAPTOPRIL - GENERICO 95052305 CAPTOPRIL - GENERICO 95027009 CAPTOPRIL - GENERICO 95924159 CAPTOPRIL - GENERICO 95027017 CAPTOPRIL - GENERICO 95924167 CAPTOPRIL - GENERICO 95052356 CAPTOPRIL - GENERICO 95052364 CAPTOPRIL - GENERICO 95009965 CAPTOPRIL - GENERICO 95992367 CAPTOPRIL - GENERICO 95992375 CAPTOPRIL - GENERICO 95924175 CAPTOPRIL - GENERICO 95027025 CAPTOPRIL + HCT - GENERICO 95924183 CAPTOPRIL + HIDROCLOROTIAZIDA 95924191 CAPTOPRIL + HIDROCLOROTIAZIDA 95924205 CAPTOPRIL + HIDROCLOROTIAZIDA 95924213 CAPTOPRIL + HIDROCLOROTIAZIDA 95131817 CAPTOPRIL - GENERICO

GENE GENE GENE GENE

APRESENTAÇÃO 25 mg, c/30 25 mg, c/30 25 mg, c/60 25 mg, c/60 25 mg, com, ct, bl, al, plas, inc, x 30 25 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 25 mg, cx, 30 cprs, 25,0 mg, bl, 16 cprs, 25,0 mg, bl, 28 cprs, 25,0 mg, ct, c/30 cprs, 50 mg 3 bl, x 10 cprs,

Laboratorio SANDOZ HEXAL SANDOZ HEXAL PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA LUPER LUPER EUROFARMA CRISTALIA

50 mg, 2 bl, x 14 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 2 bl, x 8 cprs, 50 mg, 3 bl, x 10 cprs, 50 mg, 30 cprs, 50 mg, 30 cprs, 50 mg, 30 cprs, 50 mg, 4 bl, x 15 cprs, 50 mg, 9 bl, x 10 cprs, 50 mg, bl, 30 cprs, 50 mg, c/30 50 mg, c/30 50 mg, c/60 50 mg, c/60 50 mg, com, ct, bl, al, plas, inc, x 30 50 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 50 mg, cx, 30 cprs, 50,0 mg, bl, 16 cprs, 50,0 mg, bl, 28 cprs, 50,0 mg, ct, c/30 cprs, 50/25 mg, 30 cprs, 50 mg,+ 25 mg, 2 bl, x 15 cprs, 50 mg,+ 25 mg, 4 bl, x 15 cprs, 50 mg,+ 25 mg, bl, x 16 cprs, 50/25 mg, 30 cp, 12,5 mg cx, 2 bl, x 15 cprs,

RANBAXY GERMED GEN - LEGRAND RANBAXY RANBAXY ARROW BIOSINTETICA TEUTO BRAS, EMS EMS UNIAO QUIMICA SANDOZ HEXAL SANDOZ HEXAL PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA LUPER LUPER EUROFARMA SANDOZ MEDLEY MEDLEY MEDLEY NOVARTIS EMS

UNIDADE Pco Unt Base A CPR 0,55 CPR 0,37 CPR 0,42 CPR 0,37 COMP 0,59 COMP 0,32 COMP 0,51 COMP 0,52 COMP 0,58 CPR 0,52 CPR 1,26 COMP COMP COMP COMP COMP COMP CPR COMP COMP CPR COMP CPR CPR CPR CPR COMP COMP CPR COMP COMP CPR CPR CPR CPR CPR CPR CPR

0,74 0,67 0,76 0,84 0,68 0,92 1,21 0,57 0,77 0,77 1,08 1,05 0,94 0,70 0,64 0,58 0,68 0,94 1,13 1,08 1,01 0,74 1,20 0,79 1,16 0,96 0,36

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2315 2316 2317 2318 2319 2320 2321 2322 2323 2324 2325 2326 2327 2328 2329 2330 2331 2332 2333 2334 2335 2336 2337 2338 2339 2340 2341 2342 2343 2344 2345 2346 2347 2348 2349 2350 2351 2352

CODIGO BENEFICIO 95131736 CAPTOPRIL - GENERICO 95131639 CAPTOPRIL - GENERICO 95131647 CAPTOPRIL - GENERICO 95131655 CAPTOPRIL - GENERICO 95096051 CAPTOPRIL - GENERICO 95131477 CAPTOPRIL - GENERICO 95096060 CAPTOPRIL - GENERICO 95096078 CAPTOPRIL - GENERICO 95131558 CAPTOPRIL - GENERICO 95131728 CAPTOPRIL - GENERICO 95131663 CAPTOPRIL - GENERICO 95131671 CAPTOPRIL - GENERICO 95131680 CAPTOPRIL - GENERICO 95131485 CAPTOPRIL - GENERICO 95096086 CAPTOPRIL - GENERICO 95096094 CAPTOPRIL - GENERICO 95131574 CAPTOPRIL - GENERICO 95131698 CAPTOPRIL - GENERICO 95131701 CAPTOPRIL - GENERICO 95131710 CAPTOPRIL - GENERICO 95096108 CAPTOPRIL - GENERICO 95096116 CAPTOPRIL - GENERICO 95096124 CAPTOPRIL - GENERICO (Restrito Hosp,) 95924221 CAPTOPRIL + HIDRO - GENERICO 95924230 CAPTOPRIL + HIDRO - GENERICO 95924248 CAPTOPRIL + HIDRO - GENERICO 95027033 CAPTOPRIL + HIDRO - GENERICO 95014071 CAPTOPRON 95014101 CAPTOPRON 95014080 CAPTOPRON 95014110 CAPTOPRON 95014098 CAPTOPRON 95014128 CAPTOPRON 95131922 CAPTOTEC 95131914 CAPTOTEC 95035737 CAPTOTEC 95052380 CAPTOTEC 95131906 CAPTOTEC

APRESENTAÇÃO 12,5 mg cx, 90 cprs, 12,5 mg, 1 bl, al, plast, x 16 cprs, 12,5 mg, 1 bl, al, plast, x 30 cprs, 12,5 mg, 2 bl, al, plast, x 30 cprs, 12,5 mg, 2 bl, x 15 cprs, 12,5 mg, 30 cprs, 12,5 mg, bl, 30 cprs, 12,5 mg, bl, 30 cprs, 12,5 mg, cx, 30 cprs, 25 mg cx, 90 cprs, 25 mg, 1 bl, al, plast, x 16 cprs, 25 mg, 1 bl, al, plast, x 30 cprs, 25 mg, 2 bl, al, plast, x 30 cprs, 25 mg, 30 cprs, 25 mg, bl, 30 cprs, 25 mg, bl, 30 cprs, 50 mg cx, 30 cprs, 50 mg, 1 bl, al, plast, x 16 cprs, 50 mg, 1 bl, al, plast, x 30 cprs, 50 mg, 2 bl, al, plast, x 30 cprs, 50 mg, bl, 30 cprs, 50 mg, bl, 30 cprs, 25 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) 50/25 mg, 1 bl, x 15 cprs, 50/25 mg, 2 bl, x 15 cprs, 50/25 mg, 2 bl, x 15 cprs, 50/25 mg, 9 bl, x 10 cprs, 12,5 mg, 16 cprs, 12,5 mg, 32 cprs, 25 mg, 16 cprs, 25 mg, 32 cprs, 50 mg, 16 cprs, 50 mg, 32 cprs, + HCT 50/25 30 cprs, 12,5 mg, cx, 30 cprs, 25 mg, bl, 30 cprs, 25 mg, bl, 60 cprs, 25 mg, cx, 28 cprs,

Laboratorio MEDLEY MEDLEY MEDLEY MEDLEY GERMED TEUTO BRAS, AUROBINDO PHARMA MARIOL BIOSINTETICA MEDLEY MEDLEY MEDLEY MEDLEY BIOSINTETICA AUROBINDO PHARMA MARIOL EMS MEDLEY MEDLEY MEDLEY AUROBINDO PHARMA MARIOL PRATI DONADUZZI EMS EMS GERMED EMS CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA HEXAL HEXAL HEXAL HEXAL HEXAL

UNIDADE Pco Unt Base A CPR 0,34 CPR 0,41 CPR 0,38 CPR 0,29 COMP 0,29 CPR 0,18 COMP 0,54 COMP 0,32 CPR 0,42 CPR 0,44 CPR 0,50 CPR 0,59 CPR 0,87 CPR 0,51 COMP 0,28 COMP 0,50 CPR 1,07 CPR 1,04 CPR 1,13 CPR 0,82 COMP 1,66 COMP 0,95 COMP 0,37 CPR 0,85 CPR 1,24 CPR 0,80 CPR 0,88 COMP 0,26 COMP 0,26 COMP 0,32 COMP 0,39 COMP 0,55 COMP 0,53 CPR 0,93 CPR 0,33 CP 0,47 COMP 0,37 CPR 0,51

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2353 2354 2355 2356 2357 2358 2359 2360 2361 2362 2363 2364 2365 2366 2367 2368 2369 2370 2371 2372 2373 2374 2375 2376 2377 2378 2379 2380 2381 2382 2383 2384 2385 2386 2387 2388 2389 2390

CODIGO BENEFICIO 95992383 CAPTOTEC 95052372 CAPTOTEC 95131892 CAPTOTEC 95009973 CAPYLA 95043217 CARBAMAZEPINA - GENERICO 95924280 CARBAMAZEPINA - GENERICO 95340122 CARBAMAZEPINA - GENERICO 95009981 CARBAMAZEPINA - GENERICO 95014144 CARBAMAZEPINA - GENERICO 95014136 CARBAMAZEPINA - GENERICO 95340068 CARBAMAZEPINA - GENERICO 95045511 CARBAMAZEPINA - GENERICO 95009990 CARBAMAZEPINA - GENERICO 95045490 CARBAMAZEPINA - GENERICO 95096132 CARBAMAZEPINA - GENERICO 95890114 CARBAMAZEPINA - GENERICO 95027050 CARBAMAZEPINA - GENERICO 95043225 CARBAMAZEPINA - GENERICO 95035745 CARBAMAZEPINA - GENERICO 95035753 CARBAMAZEPINA - GENERICO 95340114 CARBAMAZEPINA - GENERICO 95340084 CARBAMAZEPINA - GENERICO 95924310 CARBAMAZEPINA - GENERICO 95890122 CARBAMAZEPINA - GENERICO 95045520 CARBAMAZEPINA - GENERICO 95083618 CARBAMAZEPINA - GENERICO 95045503 CARBAMAZEPINA - GENERICO 95027068 CARBAMAZEPINA - GENERICO 95035761 CARBAMAZEPINA - GENERICO 95027084 CARBAMAZEPINA - GENERICO 95121315 CARBAMAZEPINA - GENERICO (Restrito Hosp,) 95121323 CARBAMAZEPINA - GENERICO (Restrito Hosp,) 95992405 CARBIDOL 95350063 CARBIDOPA/LEVODOPA - GENERICO 95924337 CARBITAL 95924345 CARBITAL 95081976 CARBOCISTEINA - GENERICO 95034536 CARBOCISTEINA - GENERICO

APRESENTAÇÃO 25 mg, cx, 56 cprs, 50 mg, bl, 30 cprs, 50 mg, cx, 28 cprs, 1 mg, 2 bl, x 15 20 mg/ml susp, oral fr, 100 ml 200 mg, 2 bl, x 10 200 mg, 2 bl, x 10 cprs, 200 mg, 20 cp, 200 mg, 20 cprs, 200 mg, 30 cprs, 200 mg, 30 cprs, 200 mg, bl, 50 cprs, (hosp,) 200 mg, cx, 20 cprs, 200 mg, cx, 20 cprs, 200 mg, cx, 20 cprs, 200 mg, cx, 30 cprs, 200 mg, x 20 200 mg, x 200 200 mg, x 30 200 mg, x 60 400 mg cx, 20 cprs, 400 mg, 2 bl, x 10 cprs, 400 mg, 2 bl, x 20 400 mg, 20 cp, 400 mg, bl, 50 cprs, (hosp,) 400 mg, bl, 500 cprs, (hosp,) 400 mg, cx, 20 cprs, 400 mg, x 20 400 mg, x 30 Susp, fr, 100 ml 200 mg, bl, 200 cprs, 200 mg, bl, 500 cprs, (hosp,) 25 ml/250 mg, cx, 30 cprs, 25/250 mg, cx, 30 cprs, 100 mg, 20 cprs, Sol, oral 40 mg/ml fr, 20 ml 100 mg, xpe, inf, x 100 ml 20 mg/ml fr 100 ml

Laboratorio HEXAL HEXAL HEXAL SIGMA PHARMA UNIAO QUIMICA GERMED EUROFARMA NOVARTIS UNIAO QUIMICA UNIAO QUIMICA BIOSINTETICA TEUTO BRAS, NEO QUIMICA TEUTO BRAS, EMS NEO QUIMICA MEDLEY MEDLEY MEDLEY MEDLEY EMS ABBOTT GERMED NOVARTIS TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, MEDLEY MEDLEY MEDLEY UNIAO QUIMICA TEUTO BRAS, TEUTO BRAS, BIOSINTETICA TEUTO BRAS, TEUTO BRAS, MEDQUIMICA MEDLEY

UNIDADE Pco Unt Base A COMP 0,42 COMP 0,79 CPR 0,79 COMP 0,86 ML 0,08 CPR 0,34 CPR 0,26 COMP 0,32 COMP 0,37 COMP 0,36 CPR 0,31 COMP 0,26 COMP 0,36 COMP 0,30 COMP 0,27 COMP 0,33 CPR 0,31 CP 0,31 CP 0,33 CP 0,33 CPR 0,63 CPR 0,45 CPR 0,27 COMP 0,65 COMP 0,53 COMP 0,53 COMP 0,61 CPR 0,62 CP 0,62 ML 0,08 COMP 0,32 COMP 0,26 COMP 1,26 CPR 0,77 CPR 0,24 ML 0,20 ML 0,08 FR 7,90

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2391 2392 2393 2394 2395 2396 2397 2398 2399 2400 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2418 2419 2420 2421 2422 2423 2424 2425 2426 2427 2428

CODIGO BENEFICIO 95250360 CARBOCISTEINA - GENERICO 95027092 CARBOCISTEINA - GENERICO 95014160 CARBOCISTEINA - GENERICO 95890149 CARBOCISTEINA - GENERICO 95890157 CARBOCISTEINA - GENERICO 95081950 CARBOCISTEINA - GENERICO 95992413 CARBOCISTEINA - GENERICO 95014179 CARBOCISTEINA - GENERICO 95890165 CARBOCISTEINA - GENERICO 95052437 CARBOCISTEINA - GENERICO 95081968 CARBOCISTEINA - GENERICO 95250379 CARBOCISTEINA - GENERICO 95250409 CARBOCISTEINA - GENERICO 95890181 CARBOCISTEINA - GENERICO 95890190 CARBOCISTEINA - GENERICO 95992421 CARBOCISTEINA - GENERICO 95992430 CARBOCISTEINA - GENERICO 95027106 CARBOCISTEINA - GENERICO 95014187 CARBOCISTEINA - GENERICO 95890203 CARBOCISTEINA - GENERICO 95014152 CARBOCISTEINA - GENERICO 95890211 CARBOCISTEINA - GENERICO 95992448 CARBOCISTEINA - GENERICO 95890220 CARBOCISTEINA - GENERICO 95052445 CARBOCISTEINA - GENERICO 95924370 CARBOCISTEINA - GENERICO 95992456 CARBOCISTEINA - GENERICO 95992464 CARBOCISTEINA - GENERICO 95992472 CARBOCISTEINA - GENERICO 95992480 CARBOCISTEINA - GENERICO 95924388 CARBOCISTEINA - GENERICO 95121331 CARBOCISTEINA - GENERICO (Restrito Hosp,) 95121340 CARBOCISTEINA - GENERICO (Restrito Hosp,) 95121358 CARBOCISTEINA - GENERICO (Restrito Hosp,) 95250484 CARBOFAN 95250476 CARBOFAN 95121366 CARBOLIM (Restrito Hosp,) 95280073 CARBOLITIUM

APRESENTAÇÃO Laboratorio 20 mg/ml fr, plast, 100 ml, MERCK 20 mg/ml xpe, 100 ml+ cp, med, UNIAO QUIMICA 20 mg/ml xpe, cx, 50 fr, plast, x 100 ml+ 50 cp, med, PRATI DONADUZZI 20 mg/ml xpe, cx, plast, x 100 ml+ cp, med, PRATI DONADUZZI 20 mg/ml xpe, cx, plast, x 80 ml+ cp, med, (hosp,) PRATI DONADUZZI 20 mg/ml xpe, fr, 100 ml MEPHA-RATIOPHARM 20 mg/ml xpe, fr, vd, 100 ml+ cp, med, BIOSINTETICA 20 mg/ml xpe, inf, fr, 100 ml GERMED 20 mg/ml xpe, inf, fr, 100 ml GEN - LEGRAND 20 mg/mlxpe,fr,100ml MEPHA-RATIOPHARM 250 mg, xpe, ad, x 100 ml MEDQUIMICA 50 mg/ml fr, plast, 100 ml, MERCK 50 mg/ml sol, oral 20 ml MEDLEY 50 mg/ml sol, oral fr, x 20 ml GERMED 50 mg/ml sol, oral fr, x 20 ml GEN - LEGRAND 50 mg/ml sol, oral fr, x 20 ml EMS 50 mg/ml xpe, 100 ml MEDLEY 50 mg/ml xpe, 100 ml+ cp, med, UNIAO QUIMICA 50 mg/ml xpe, ad, fr, 100 ml GERMED 50 mg/ml xpe, ad, fr, 100 ml GEN - LEGRAND 50 mg/ml xpe, cx, 50 fr, plast, x 100 ml+ 50 cp, med, PRATI DONADUZZI 50 mg/ml xpe, cx, 50 fr, plast, x 80 ml+ cp, med, PRATI DONADUZZI 50 mg/ml xpe, fr, vd, 100 ml+ cp, med, BIOSINTETICA 50 mg/ml xpe, plast, x 100 ml+ cp, med, PRATI DONADUZZI 50 mg/mlxpe,fr,100ml MEPHA-RATIOPHARM Xpe, ad, 50 mg/ml cx, 1 fr, TEUTO BRAS, Xpe, ad, 50 mg/ml fr, 100 ml+ cp, med, x 10 ml NEO QUIMICA Xpe, ad, fr, 100 ml EMS Xpe, inf, 20 mg/ml fr, 100 ml+ cp, med, x 10 ml NEO QUIMICA Xpe, inf, fr, 100 ml EMS Xpe, ped, 20 mg/ml cx, 1 fr, TEUTO BRAS, 20 mg/ml, xpe, cx, 50 fr, plas, opc, x 100 ml, + 50 cp, med, PRATI DONADUZZI 50 mg/ml, xpe, cx, 50 fr, plas, opc, x 100 ml, + 50 cp, med, PRATI DONADUZZI 50 mg/ml, xpe, cx, 50 fr, plas, opc, x 80 ml, + cp, med, (hosp,) PRATI DONADUZZI Ped, fr, 100 ml, BUNKER Xpe fr, 100 ml, BUNKER 300 mg, cx, 200 cprs, ARROW CR 450 mg, 3 bl, x 10 cprs, EUROFARMA

UNIDADE Pco Unt Base A ML 0,08 GOTA 0,03 ML 1,21 ML 0,18 ML 1,72 ML 0,08 ML 0,08 ML 0,05 ML 6,45 ML 0,35 ML 0,11 ML 0,12 GOTAS 0,02 GOTA 4,89 GOTA 6,16 GOTA 0,02 ML 0,12 GOTA 0,02 ML 0,94 ML 9,83 ML 1,55 ML 0,03 ML 0,11 ML 0,13 ML 0,13 ML 0,09 ML 0,13 ML 0,12 ML 0,09 ML 0,08 ML 0,06 ML 0,03 ML 0,03 ML 0,03 ML 0,13 ML 0,21 COMP 0,27 CPR 1,08

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2429 2430 2431 2432 2433 2434 2435 2436 2437 2438 2439 2440 2441 2442 2443 2444 2445 2446 2447 2448 2449 2450 2451 2452 2453 2454 2455 2456 2457 2458 2459 2460 2461 2462 2463 2464 2465 2466

CODIGO BENEFICIO 95280065 CARBOLITIUM 95035788 CARBONATO DE LITIO - GENERICO 95035800 CARBONATO DE LITIO - GENERICO 95035796 CARBONATO DE LITIO - GENERICO 95049428 CARBOPLATINA - GENERICO 95049436 CARBOPLATINA - GENERICO 95049410 CARBOPLATINA - GENERICO 95014195 CARBOPLATINA - GENERICO 95014209 CARBOPLATINA - GENERICO 95131949 CARDALIN 95014217 CARDBLOC 95014225 CARDBLOC 95052461 CARDCOR 95992537 CARDCOR 95924396 CARDICORON 95924400 CARDICORON 95120432 CARDILOL 95120394 CARDILOL 95120416 CARDILOL 95120424 CARDILOL 95924418 CARDIO AAS 95924426 CARDIO AAS 95131973 CARDIODOPA 95131981 CARDIODOPA 95992545 CARDIOLITE 95992553 CARDIOLITE 95540369 CARDIOXANE 95081992 CARDIX 95081984 CARDIX 95140085 CARDIZEM 95140077 CARDIZEM 95035818 CARDIZEM 95035826 CARDIZEM 95140107 CARDIZEM 95140093 CARDIZEM 95035834 CARDURAN XL 95890246 CARMAZIN 95924434 CARMAZIN

APRESENTAÇÃO Vd, 50 cprs 300 mg, cx, 200 cprs, 300 mg, cx, 50 cprs, 300 mg, cx, 500 cprs, 10 mg/ml sol, inj, IV FA vd, x 15 ml 10 mg/ml sol, inj, IV FA vd, x 45 ml 10 mg/ml sol, inj, IV FA vd, x 5 ml 150 mg, po liof, p/sol, inj, IV FA vd, x 20 ml 450 mg, po liof, p/sol, inj, IV FA vd, x 100 ml Retard cx, 30 cprs, 40 mg, cx, 30 cprs, 80 mg, cx, 30 cprs, 0,25 mg, 100 cprs, 0,25 mg, 20 cprs, 100 mg, 20 cprs, 200 mg, 20 cprs, 12,5 mg, x 15 cprs, 25 mg, x 30 cprs, 3,125 mg, x 15 cprs, 6,25 mg, x 15 cprs, 325mg,3 bl,x10cprs, 85 mg, 3 bl, x 10 cprs, 250 mg, cx, 30 cprs, 500 mg, cx, 30 cprs, Po liof, cx, 2 frs, Po liof, cx, 5 frs, 500 mg, po liof, inj, 40 mg, 40 cprs, 80 mg, 20 cprs, 30 mg, 50 cprs, 60 mg, 1 x 50 cprs, CD180mg,bl,16caps,gel,dura CD240mg,bl,16caps,gel,dura SR 120 mg, 20 caps, SR 90 mg, 20 caps, 4 mg, bl, x 30 200 mg, cx, 20 cprs, 400 mg, cx, 20 cprs,

Laboratorio EUROFARMA ARROW ARROW ARROW ACCORD ACCORD ACCORD GLENMARK GLENMARK SOLVAY FARMA HEXAL HEXAL TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, LIBBS LIBBS LIBBS LIBBS SIGMA PHARMA SIGMA PHARMA ROYTON ROYTON REM REM ZODIAC MULTILAB MULTILAB BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM PFIZER TEUTO BRAS, TEUTO BRAS,

UNIDADE Pco Unt Base A CPR 0,47 CP 0,24 CP 0,27 CP 0,26 F,A, 269,00 F,A, 696,89 F,A, 132,65 FA 141,60 FA 285,83 CPR 0,45 COMP 0,09 COMP 0,26 COMP 0,04 COMP 0,26 CPR 0,51 CPR 0,94 CPR 0,79 CPR 1,05 CPR 0,62 CPR 0,69 CPR 0,41 CPR 0,27 CPR 0,75 CPR 1,47 FR 1060,72 FR 1061,65 AP 853,11 COMP 0,11 COMP 0,21 CPR 0,32 CPR 0,61 CP 2,29 CP 2,72 CPR 1,55 CPR 1,19 CP 6,27 COMP 0,19 CPR 0,78

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 2480 2481 2482 2483 2484 2485 2486 2487 2488 2489 2490 2491 2492 2493 2494 2495 2496 2497 2498 2499 2500 2501 2502 2503 2504

CODIGO BENEFICIO 95840362 CARTRAX 95992588 CARVEDILAT 95984313 CARVEDILAT 95992596 CARVEDILAT 95992600 CARVEDILAT 95096140 CARVEDILOL - GENERICO 95992618 CARVEDILOL - GENERICO 95992626 CARVEDILOL - GENERICO 95096159 CARVEDILOL - GENERICO 95992634 CARVEDILOL - GENERICO 95096167 CARVEDILOL - GENERICO 95992642 CARVEDILOL - GENERICO 95096175 CARVEDILOL - GENERICO 95096183 CARVEDILOL - GENERICO 95096191 CARVEDILOL - GENERICO 95096205 CARVEDILOL - GENERICO 95992650 CARVEDILOL - GENERICO 95560106 CASODEX 95924442 CASPACIL 95096213 CASTANHA DA INDIA MILIAN 95096221 CASTANHA DA INDIA MILIAN 95035842 CATAFLAM 95096230 CATAFLAM 95924450 CATAFLAM (*) 95660607 CATAFLAM (*) 95660666 CATAFLAM (*) 95660631 CATAFLAM (*) 95924469 CATAFLAM (*) 95660615 CATAFLAM (*) 95660640 CATAFLAM (*) 95014284 CATAFLEX 95014276 CATAFLEX 95014250 CATAFLEX 95014268 CATAFLEX 95052500 CATAFLEXYM 95052518 CATAFLEXYM 95052496 CATAFLEXYM 95052470 CATAFLEXYM

APRESENTAÇÃO Creme bisn, 35 g, 12,5 mg, 3 bl, x 10 25 mg, 3 bl, x 10 3,125 mg, 3 bl, x 10 6,25 mg, 3 bl, x 10 12,5 mg, bl, 15 cprs, 12,5 mg, bl, 15 cprs, 25 mg, bl, 15 cprs, 25 mg, bl, 30 cprs, 25 mg, bl, 30 cprs, 3,125 mg, bl, 15 cprs, 3,125 mg, bl, 15 cprs, 3,125 mg, bl, al/al 15 cprs, 3,125 mg, bl, al/al 30 cprs, 3,125 mg, bl, al/al 60 cprs, 6,25 mg, bl, 15 cprs, 6,25 mg, bl, 15 cprs, 50 mg, 28 cprs, 2,5% shampoo fr, 100 ml 170 mg, - 2 bl, x 15 cprs, rev, 170 mg, - 4 bl, x 15 cprs, rev, Emulgel 100 g Emulgel 150 g 50 mg, 10 dg, 50 mg, 20 drags, 75 mg, 3 amps, 75 mg, 5 suposits, D 20 cprs, Gts, fr, 20 ml Susp, 120 ml 15 mg, 10 ml 15 mg, 20 ml 50 mg, 10 cprs, 50 mg, 20 cprs, 10 mg/g gel bisn, 40 g 15 mg/ml susp, oral fr, plast, got, 10 ml 15 mg/ml susp, oral fr, plast, got, 20 ml 50 mg, bl, 10 cprs, rev,

Laboratorio PFIZER SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA NEO QUIMICA BIOSINTETICA BIOSINTETICA NEO QUIMICA BIOSINTETICA NEO QUIMICA BIOSINTETICA MEDLEY MEDLEY MEDLEY NEO QUIMICA BIOSINTETICA ASTRAZENECA CAZI MULTILAB MULTILAB NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA

UNIDADE Pco Unt Base A G 1,31 COMP 0,91 COMP 1,08 COMP 0,68 COMP 0,79 COMP 1,24 COMP 1,14 COMP 1,49 COMP 1,42 COMP 1,34 COMP 0,96 COMP 0,88 COMP 1,17 COMP 0,88 COMP 0,60 COMP 1,08 COMP 0,99 CPR 19,82 ML 0,40 COMP 0,52 COMP 0,50 G 0,20 GRAMA 0,17 CPR 1,04 CPR 1,04 AP 2,24 UND 1,57 CPR 1,02 GOTAS 0,03 ML 0,17 GOTA 0,03 GOTA 0,02 COMP 0,45 COMP 0,43 G 0,35 GOTA 0,35 GOTA 0,35 COMP 0,48

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2505 2506 2507 2508 2509 2510 2511 2512 2513 2514 2515 2516 2517 2518 2519 2520 2521 2522 2523 2524 2525 2526 2527 2528 2529 2530 2531 2532 2533 2534 2535 2536 2537 2538 2539 2540 2541 2542

CODIGO BENEFICIO 95052488 CATAFLEXYM 95530053 CAVERJECT 95530061 CAVERJECT 95982159 CAVILON 95982167 CAVILON 95924477 CAZIDERM 95924485 CAZIDERM 95924493 CAZIDERM 95924507 CAZIGERAN 95924515 CAZIGERAN 95096248 CEBRALAT 95052534 CEBRALAT 95052526 CEBRALAT 95924540 CEBRILIN 95290168 CEBRILIN 95924558 CEBRONFILINA 95924566 CEBRONFILINA 95014314 CECLOR 95014322 CECLOR 95992723 CECLOR 95373330 CECLOR 95046275 CECLOR 95890254 CECNOIN 95890262 CECNOIN 95890270 CECNOIN 95096256 CECOFENE 95373349 CEDROXIL 95924612 CEFABEN 95924620 CEFABEN 95331026 CEFABRINA 95331034 CEFABRINA 95331042 CEFABRINA 95890297 CEFACLOR - GENERICO 95373403 CEFACLOR - GENERICO 95014357 CEFACLOR - GENERICO 95014381 CEFACLOR - GENERICO 95890289 CEFACLOR - GENERICO 95014373 CEFACLOR - GENERICO

APRESENTAÇÃO 50 mg,bl,20cprs,rev, 10 mcg, 20 mcg, ENVELOPE SPRAY 2 mg, fr, 100 ml 2 mg, fr, 30 ml 2 mg, pom, bisn, 20 g Cx, 20 drags, Cx, 60 drags, 100 mg, 15 cprs, 100 mg, or, 60 cprs, 50 mg, or, 60 cprs, 10 mg,x30 cprs, 20 mg, x 20 cprs, Xpe,ad,cx, 1fr,120ml Xpe,inf,cx, 1 fr,120ml 250 mg/5 ml susp, fr, 100 ml 375 mg/5 ml susp, fr, 100 ml AF 500 mg, 1 bl, x 10 drags, AF 750 mg, cx, 14 drags, BD 750 mg, 2 bl, x 7 cprs, rev, 10 mg, bl, 30 cprs, 20 mg, bl, 30 cprs, Gel, 0,5 mg/g bisn, 30 g 100 mg, 12 cprs, 500 mg, cx, 8 cprs, 100 mg/ml po susp, oral fr, vd, 15 ml 500 mg, cx, 8 cprs, 500 mg cx, 25 bl, x 4cprs, 750 mg cx,25 bl, x 4 cprs, Gts, 200 mg/ml cx, 1 fr, plast, x 10 ml 250 mg, bl, 10 caps, 250 mg/5 ml susp, oral fr, 80 ml, 250 mg/5 ml susp, oral, fr, 100 ml 250 mg/5 ml, susp, oral, fr, 80 ml 250mg,1bl,x10 caps, 375 mg/5 ml susp, oral 80 ml

Laboratorio CIFARMA PFIZER PFIZER

CAZI CAZI CAZI CAZI CAZI LIBBS LIBBS LIBBS LIBBS LIBBS NEO QUIMICA NEO QUIMICA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA RANBAXY RANBAXY RANBAXY MULTILAB LEGRAND CAZI CAZI NEO QUIMICA NEO QUIMICA NEO QUIMICA GERMED EMS GERMED GEN - LEGRAND GEN - LEGRAND GEN - LEGRAND

UNIDADE Pco Unt Base A COMP 0,46 UND 50,65 UND 71,36 ENV 17,12 FR 84,23 ML 0,16 ML 0,16 G 0,29 CPR 0,54 CPR 0,53 COMP 1,09 COMP 0,66 COMP 0,33 CPR 1,40 CPR 2,35 ML 0,20 ML 0,15 ML 0,48 ML 0,65 DRAG 3,53 CPR 5,30 COMP 6,30 COMP 1,75 COMP 3,24 GRAMA 1,06 COMP 1,45 CPR 3,63 ML 0,94 CPR 2,75 CPR 0,24 CPR 0,62 GOTAS 0,02 CAPS 1,97 ML 0,50 ML 0,36 ML 0,31 CAPS 1,66 ML 0,44

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2543 2544 2545 2546 2547 2548 2549 2550 2551 2552 2553 2554 2555 2556 2557 2558 2559 2560 2561 2562 2563 2564 2565 2566 2567 2568 2569 2570 2571 2572 2573 2574 2575 2576 2577 2578 2579 2580

CODIGO BENEFICIO 95992740 CEFACLOR - GENERICO 95014365 CEFACLOR - GENERICO 95992758 CEFACLOR - GENERICO 95373420 CEFACLOR - GENERICO 95014349 CEFACLOR - GENERICO 95924728 CEFACLOR - GENERICO 95890319 CEFACLOR - GENERICO 95992766 CEFACLOR - GENERICO 95052550 CEFACLOREN 95014390 CEFADRIN 95987240 CEFADROX 95987258 CEFADROX 95373543 CEFADROXIL - GENERICO 95373551 CEFADROXIL - GENERICO 95373527 CEFADROXIL - GENERICO 95373535 CEFADROXIL - GENERICO 95373560 CEFADROXIL - GENERICO 95924817 CEFADROXILA - GENERICO 95027114 CEFADROXILA - GENERICO 95052585 CEFADROXILA - GENERICO 95027122 CEFADROXILA - GENERICO 95924825 CEFADROXILA - GENERICO 95027130 CEFADROXILA - GENERICO 95052577 CEFADROXILA - GENERICO 95924833 CEFADROXILA - GENERICO 95014403 CEFADROXILA - GENERICO 95035850 CEFADROXILA - GENERICO 95027149 CEFADROXILA - GENERICO 95052593 CEFADROXILA - GENERICO 95052569 CEFADROXILA - GENERICO 95992782 CEFADROXILA - GENERICO 95992790 CEFADROXILA - GENERICO 95027157 CEFADROXILA - GENERICO 95096264 CEFADROXILA - GENERICO 95096272 CEFADROXILA - GENERICO 95890327 CEfa*gRAN 95890335 CEfa*gRAN 95890343 CEFALEXINA - GENERICO

APRESENTAÇÃO 375 mg/5 ml susp, oral fr, 80 ml, 375 mg/5 ml susp, oral, fr, 100 ml 50 mg/ml susp, or, fr, vd, 80 ml+ dos, 500 mg cx, 10 caps, 500 mg, bl, 10 caps, 500 mg, caps, ct, bl, al, plast, inc, x 10 500mg,1bl,x10 caps, 75 mg/ml susp, or, fr, vd, 80 ml+ dos, 500 mg, cx, 1 bl, x 10 caps, 500 mg, 12 cprs, 250 mg, po susp, vd, 80 ml 500 mg, cx, 8 caps, 250 mg/5 ml susp, fr, 100 ml 500 mg, 2 envs, x 4 caps, 500 mg, cx, 8 caps, 500 mg/5 ml susp, fr, 100 ml Susp, 250 mg/5 ml ct c/fr 100 ml 100 mg/ml po p/susp, 1 fr, vd, 100 ml+ dos, 100 mg/ml po p/susp, fr, vd, x 100 ml+ ser, dos, 100 mg/ml po p/susp, oral fr, vd, 100 ml+ col, dos, 250 mg/5 ml po p/susp, oral fr, 100 ml 50 mg/ml po p/susp, 1 fr, vd, 100 ml+ dos, 50 mg/ml po p/susp, fr, vd, x 100 ml+ ser, dos, 50 mg/ml po p/susp, oral fr, vd, 100 ml+ col, dos, 500 mg, 1 bl, x 8 caps, gel, dura 500 mg, 10 bl, x 6 caps, 500 mg, 8 caps, 500 mg, 8 cs, 500 mg, bl, 8 caps, gel dura 500 mg, bl, al, 8 caps, gel dura 500 mg, fr, plast, 20 caps, 500 mg, fr, plast, 8 caps, 500 mg/5 ml po p/susp, oral fr, 100 ml 50 mg/ml po p/susp, fr, plast, x 100 ml + ser, dosad, 500 mg, bl, 8 caps, gel, dura 250 mg, susp, fr, po 100 ml 500 mg, bl, 8 cprs, 1 g 8 cprs, rev,

Laboratorio EMS GERMED MEDLEY EMS GERMED MEDLEY GEN - LEGRAND MEDLEY NEO QUIMICA CIFARMA MEDQUIMICA MEDQUIMICA EMS EUROFARMA EMS EMS EUROFARMA MEDLEY BIOSINTETICA SANDOZ NOVARTIS MEDLEY BIOSINTETICA SANDOZ MEDLEY EMS MEPHA-RATIOPHARM NOVARTIS SANDOZ AUROBINDO PHARMA APOTEX APOTEX NOVARTIS AUROBINDO PHARMA TEUTO BRAS, LEGRAND LEGRAND EMS

UNIDADE Pco Unt Base A ML 0,67 ML 0,52 ML 0,41 CPR 5,06 CAPS 3,92 CPR 4,15 CAPS 3,92 ML 0,55 CAPS 5,18 COMP 1,35 ML 0,26 CAPS 2,39 ML 0,35 CPR 2,52 CPR 3,16 ML 0,70 ML 0,27 ML 0,73 GOTA 0,03 ML 0,70 GOTA 0,01 ML 0,35 GOTA 0,03 ML 0,37 CPR 3,92 CAPS 2,65 CP 2,81 UND 2,73 CAPS 3,06 CAPS 2,65 CAPS 2,66 CAPS 3,49 GOTA 0,02 ML 0,26 CAPS 4,00 GOTA 0,01 COMP 2,44 COMP 4,68

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2581 2582 2583 2584 2585 2586 2587 2588 2589 2590 2591 2592 2593 2594 2595 2596 2597 2598 2599 2600 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2614 2615 2616 2617 2618

CODIGO BENEFICIO 95890360 CEFALEXINA - GENERICO 95992804 CEFALEXINA - GENERICO 95052607 CEFALEXINA - GENERICO 95052615 CEFALEXINA - GENERICO 95052623 CEFALEXINA - GENERICO 95052640 CEFALEXINA - GENERICO 95992812 CEFALEXINA - GENERICO 95096280 CEFALEXINA - GENERICO 95373683 CEFALEXINA - GENERICO 95081321 CEFALEXINA - GENERICO 95096299 CEFALEXINA - GENERICO 95096302 CEFALEXINA - GENERICO 95924892 CEFALEXINA - GENERICO 95014411 CEFALEXINA - GENERICO 95890378 CEFALEXINA - GENERICO 95071008 CEFALEXINA - GENERICO 95081313 CEFALEXINA - GENERICO 95035869 CEFALEXINA - GENERICO 95890386 CEFALEXINA - GENERICO 95096310 CEFALEXINA - GENERICO 95096329 CEFALEXINA - GENERICO 95043233 CEFALEXINA - GENERICO 95043241 CEFALEXINA - GENERICO 95373748 CEFALEXINA - GENERICO 95043250 CEFALEXINA - GENERICO 95043268 CEFALEXINA - GENERICO 95096337 CEFALEXINA - GENERICO 95070990 CEFALEXINA - GENERICO 95373730 CEFALEXINA - GENERICO 95890394 CEFALEXINA - GENERICO 95890408 CEFALEXINA - GENERICO 95089535 CEFALEXINA - GENERICO 95089543 CEFALEXINA - GENERICO 95096345 CEFALEXINA - GENERICO 95052631 CEFALEXINA - GENERICO 95027165 CEFALEXINA - GENERICO 95992847 CEFALEXINA - GENERICO 95035931 CEFALEXINA - GENERICO

APRESENTAÇÃO 1 g 8 cprs, rev, 100 mg/ml 1 fr, vd, 100 ml+ dos, 250 mg/5 ml po susp, 100 ml 250 mg/5 ml po susp, 50 frs, 60 ml 250 mg/5 ml susp, oral fr, 100 ml+ col, dos, 250 mg/5 ml susp, oral fr, 60 ml+ col, dos, 50 mg/ml 1 fr, vd, 100 ml+ dos, 50 mg/ml po susp, or, fr, vd, x 60 ml + cp, med, 500 mg cx, 10 cprs, 500 mg, 1 bl, x 10 cprs, 500 mg, 1 bl, x 10 cprs, rev, 500 mg, 1 bl, x 8 cprs, rev, 500 mg, 1 bl, x 8 cprs, rev, 500 mg, 10 bl, x 6 cprs, rev, 500 mg, 10 caps, gel, dura 500 mg, 10 cprs, 500 mg, 2 bl, x 10 cprs, 500 mg, 40 caps, gel, 500 mg, 8 caps, gel, dura 500 mg, bl, 10 caps, gel, dura 500 mg, bl, 10 cprs, 500 mg, bl, 10 cprs, rev, 500 mg, bl, 10 cprs, rev, 500 mg, bl, 20 cprs, 500 mg, bl, 200 cprs, rev, (hosp,) 500 mg, bl, 40 cprs, rev, 500 mg, bl, 8 caps, gel, dura 500 mg, bl, 8 cprs, 500 mg, bl, 8 cprs, 500 mg, bl, 8 cprs, 500 mg, bl, 8 cprs, 500 mg, cap, x 10 500 mg, cap, x 8 500 mg, ct, bl, al, plas, inc, x 8 caps, gel, dura 500 mg, cx, 200 drags, 500 mg, cx, 8 caps, 500 mg, cx, 8 cprs, 500 mg, cx, 8 drags,

Laboratorio GEN - LEGRAND MEDLEY TEUTO BRAS, TEUTO BRAS, ABL ABL MEDLEY UNIAO QUIMICA EMS MEPHA-RATIOPHARM AUROBINDO PHARMA AUROBINDO PHARMA BRAINFARMA EMS MEDLEY TEUTO BRAS, MEPHA-RATIOPHARM MEDLEY MEDLEY AUROBINDO PHARMA RANBAXY EUROFARMA SANDOZ RANBAXY SANDOZ SANDOZ AUROBINDO PHARMA EUROFARMA RANBAXY GERMED GEN - LEGRAND UNIAO QUIMICA UNIAO QUIMICA BRAINFARMA ABL SANDOZ EMS ABL

UNIDADE Pco Unt Base A COMP 3,91 ML 0,63 ML 0,20 ML 0,30 ML 0,35 ML 0,32 ML 0,24 ML 0,33 CPR 1,58 COMP 1,65 COMP 1,98 COMP 1,16 CPR 1,56 COMP 1,41 CAPS 1,58 COMP 1,16 COMP 1,53 CP 15,19 CAPS 1,56 CAPS 1,59 COMP 1,44 CP 1,54 CP 1,99 CPR 1,44 CP 1,28 CP 1,49 CAPS 1,59 COMP 1,57 CPR 1,44 COMP 1,38 COMP 1,54 CAPS 1,50 CAPS 1,46 CAPS 1,59 DRAG 1,92 CPR 1,58 COMP 1,67 CP 2,42

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2619 2620 2621 2622 2623 2624 2625 2626 2627 2628 2629 2630 2631 2632 2633 2634 2635 2636 2637 2638 2639 2640 2641 2642 2643 2644 2645 2646 2647 2648 2649 2650 2651 2652 2653 2654 2655 2656

CODIGO BENEFICIO 95890424 CEFALEXINA - GENERICO 95924906 CEFALEXINA - GENERICO 95924914 CEFALEXINA - GENERICO 95924841 CEFALEXINA - GENERICO 95373713 CEFALEXINA - GENERICO 95089551 CEFALEXINA - GENERICO 95373691 CEFALEXINA - GENERICO 95121374 CEFALEXINA - GENERICO (Restrito Hosp,) 95121382 CEFALEXINA - GENERICO (Restrito Hosp,) 95121390 CEFALEXINA - GENERICO (Restrito Hosp,) 95121404 CEFALEXINA - GENERICO (Restrito Hosp,) 95089934 CEFALEXINA - GENERICO (Restrito Hosp,) 95992855 CEFALINA 95096353 CEFALINA 95331050 CEFALIUM 95331069 CEFALIV 95373764 CEFALOTIL 95044639 CEFALOTINA - GENERICO 95064648 CEFALOTINA - GENERICO 95064630 CEFALOTINA - GENERICO 95014420 CEFALOTINA SODICA - GENERICO 95992880 CEFALOTINA SODICA - GENERICO 95027173 CEFALOTINA SODICA - GENERICO 95992898 CEFALOTINA SODICA - GENERICO 95014438 CEFALOTINA SODICA - GENERICO 95373802 CEFALOTINA SODICA - GENERICO 95121420 CEFALOTINA SODICA - GENERICO (Restrito Hosp,) 95373853 CEFAMOX 95373829 CEFAMOX 95373810 CEFAMOX 95373837 CEFAMOX 95373861 CEFANAL 95052666 CEFANID 95890432 CEFARISTON 95890440 CEFARISTON 95083626 CEFAZIMA 95083634 CEFAZIMA 95014462 CEFAZOLINA SODICA - GENERICO

APRESENTAÇÃO 500 mg, cx, 80 cprs, 500 mg, cx,40 cprs, 500 mg, cx,8 cprs, 500mg,1bl,x8cprs, Fr, 250 mg/5 ml, c/100 ml, Sus, or, 250 mg/5 ml 100 ml Susp, 50 mg/ml fr, 100 ml 250 mg/5 ml po p/prep, ext, ct, 50 fr, vd, amb, x 60 ml 500 mg, bl, 100 caps, gel dura (hosp,) 500 mg, bl, 200 caps, gel, dura (hosp,) 500 mg, cx, 200 drags, 500 mg, cx, 50 bl, x 10 cprs, rev, Cx, 20 cprs, Cx, c/25 x 4 cprs, Blist, 12 cprs, Blist, 12 cprs, 1 g cx, 50 FA+ dil, 1 g po inj, 100 FA Po sol, inj, 1 g cx, 50 FA Posol,inj,1gcx,1FA 1 g po p/sol, inj, 1 FA vd,+ 1 dil, amp, vd, x 5 ml 1 g po p/sol, inj, 50 FA vd,+ amp, dil, x 10 ml 1 g po p/sol, inj, cx, 50 FA vd, x 10 ml 1 g po p/sol, inj, FA vd,+ amp, dil, x 10 ml 1 g pop/sol, inj,50 FA vd,+50 dil, amp, vd, x 5 ml (h Inj, 1000 mg, cx, 1 FA 1 g po p/sol, inj, 50 FA vd, + 50 amps, dil, x 10 ml 1 g, cprs, cx, c/10 250 mg/5 ml po susp, frs, c/100 ml+ col, med, 500 mg, cx, 12 envs, x 4 caps, 500 mg/5 ml po prep, extemp, fr, 100 ml 500 mg, cx, 8 cprs, Po susp, oral 250 mg/5 ml vd, 100 ml 1000 mg, po inj, cx, 100 FA 1000 mg, po inj, cx, 50 FA vd,+ 50 amps, dil, plast, 5 ml 1 g cx, 1 fr,+ 1 amp, 1 g cx, 50 frs, 1 g po p/sol, inj, 50 FA vd, (hosp,)

Laboratorio TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, MEPHA-RATIOPHARM EUROFARMA UNIAO QUIMICA EMS BERGAMO AUROBINDO PHARMA AUROBINDO PHARMA ABL BERGAMO MEDQUIMICA MEDQUIMICA ACHE ACHE UNIAO QUIMICA ABL TEUTO BRAS, TEUTO BRAS, AUROBINDO PHARMA AUROBINDO PHARMA NOVAFARMA AUROBINDO PHARMA AUROBINDO PHARMA TEUTO BRAS, AUROBINDO PHARMA B-MS B-MS B-MS B-MS BUNKER DUCTO ARISTON ARISTON BIOCHIMICO BIOCHIMICO AUROBINDO PHARMA

UNIDADE Pco Unt Base A COMP 0,94 CPR 1,13 CPR 1,18 CPR 1,58 ML 0,24 ML 0,23 CPR 0,26 ML 15,58 CAPS 1,31 CAPS 1,31 DRAG 2,10 COMP 1,45 CPR 0,45 COMP 0,45 CPR 1,07 CPR 0,81 AP 5,14 FA 2,83 FA 4,73 FA 5,09 FA 3,38 F,A, 3,18 FA 3,18 F,A, 4,44 FA 3,37 AP 5,09 AMP 3,37 CPR 10,19 ML 0,73 CPR 6,42 ML 1,19 CPR 3,43 ML 0,27 FA 4,70 FA 4,68 UNID 10,73 UNID 8,73 FA 6,29

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2657 2658 2659 2660 2661 2662 2663 2664 2665 2666 2667 2668 2669 2670 2671 2672 2673 2674 2675 2676 2677 2678 2679 2680 2681 2682 2683 2684 2685 2686 2687 2688 2689 2690 2691 2692 2693 2694

CODIGO BENEFICIO 95027181 CEFAZOLINA SODICA - GENERICO 95373900 CEFAZOLINA SODICA - GENERICO 95014454 CEFAZOLINA SODICA - GENERICO 95121439 CEFAZOLINA SODICA - GENERICO (Restrito Hosp,) 95121447 CEFAZOLINA SODICA - GENERICO (Restrito Hosp,) 95052690 CEFELIC 95096361 CEFELIC 95052674 CEFELIC 95052682 CEFELIC 95992979 CEFEPIM 95992987 CEFEPIM 95373918 CEFLEN 95373950 CEFNAX 95373969 CEFORAN 95014519 CEFOTAXIMA SODICA - GENERICO 95014535 CEFOTAXIMA SODICA - GENERICO 95014489 CEFOTAXIMA SODICA - GENERICO 95014497 CEFOTAXIMA SODICA - GENERICO 95992995 CEFOTAXIMA SODICA - GENERICO 95014527 CEFOTAXIMA SODICA - GENERICO 95014500 CEFOTAXIMA SODICA - GENERICO 95014543 CEFOTAXIMA SODICA - GENERICO 95027190 CEFOX 95083642 CEFOXITINA SODICA - GENERICO 95027203 CEFOXITINA SODICA - GENERICO 95374043 CEFOXITINA SODICA - GENERICO 95027211 CEFTAFOR 95014578 CEFTAZIDIMA - GENERICO 95014560 CEFTAZIDIMA - GENERICO 95014551 CEFTAZIDIMA - GENERICO 95993029 CEFTAZIDIMA - GENERICO 95064729 CEFTAZIDON 95064745 CEFTON 95993037 CEFTRAT 95374132 CEFTRIAX 95374116 CEFTRIAX 95374124 CEFTRIAX 95374191 CEFTRIAXONA - GENERICO

APRESENTAÇÃO Laboratorio 1 g po p/sol, inj, cx, 50 FA NOVAFARMA 1 g, FA AUROBINDO PHARMA 1000 mg, po p/sol, inj, 25 FA vd,+ 25 dil, x 10 ml AUROBINDO PHARMA 1 g po inj, 50 FA ABL 1 g po sol, inj, 50 FA vd, x 13 ml (hosp,) UNIAO QUIMICA 100 mg, cx, 14 cprs, ARROW 50 mg, cx, 10 cprs, ARROW 50 mg, cx, 20 cprs, ARROW 50 mg, cx, 30 cprs, ARROW 1 g po inj, ct, FA vd, amb,+ amp, vd, inc, x 3 ml UNIAO QUIMICA 2 g po inj, ct, FA vd, amb, UNIAO QUIMICA 1 g cx, 50 FA CELLOFARM 400 mg, cx, 5 caps, TEUTO BRAS, 1 g IM/IVx cx, FA+ dil, 4 ml UNIAO QUIMICA 1 g po p/sol, inj, 25 FA vd,+ 25 amps, dil, vd, x 5 ml AUROBINDO PHARMA 1 g po p/sol, inj, 25 FA vd,+ 25 dil, x 10 ml AUROBINDO PHARMA 1 g po p/sol, inj, 50 FA vd, AUROBINDO PHARMA 1 g po p/sol, inj, FA vd,+ amp, dil, vd, x 5 ml AUROBINDO PHARMA 1 g po p/sol, inj, FA vd,+ dil, x 10 ml AUROBINDO PHARMA 500 mg, po p/sol, inj, 25 FA vd,+ dil, x 5 ml AUROBINDO PHARMA 500 mg, po p/sol, inj, 50 FA vd, AUROBINDO PHARMA 500 mg, po, p/sol, inj, FA vd,+ dil, x 5 ml AUROBINDO PHARMA 1 g po inj, FA vd,+ amp, dil, x 10 ml NOVAFARMA 1 g po inj, cx, 20 FA vd, x 17 ml+ dil, amp, plast, x 10 ml (hosp,) NOVAFARMA 1 g po inj, FA vd,+ amp, dil, x 10 ml NOVAFARMA 1 g, IV cart, FA+ dil EUROFARMA 1 g po inj, cx, 50 FA vd, NOVAFARMA 1 g po p/sol, inj, 25 FA vd,+ 25 dil, amp, vd, x 10 ml AUROBINDO PHARMA 1 g po p/sol, inj, 50 FA vd, AUROBINDO PHARMA 1 g po p/sol, inj, FA vd,+ dil, x 10 ml AUROBINDO PHARMA 1 g, inj, 10 ml, display c/50 EUROFARMA 1000 mg, po inj, cx, 20 FA vd, ARISTON 1000 mg, po inj, cx, 20 FA vd, (hosp,) ARISTON Po inj, ct, 50 FA vd, inc, (1G) UNIAO QUIMICA IM 1 g, 1 amp, SIGMA PHARMA IM 250 mg, 1 amp, SIGMA PHARMA IM 500 mg, 1 amp, SIGMA PHARMA 1 g IM cart, FA+ dil, EUROFARMA

UNIDADE Pco Unt Base A FA 6,69 AP 5,07 FA 4,99 FA 6,81 FA 6,61 COMP 4,37 COMP 2,11 COMP 1,99 COMP 1,80 F,A, 53,88 F,A, 98,14 AP 5,09 CPR 12,76 AP 33,09 FA 23,27 FA 19,07 FA 23,27 FA 24,95 F,A, 19,46 FA 10,61 FA 16,09 FA 10,70 FA 24,23 FA 14,54 FA 15,39 AP 21,11 FA 24,72 FA 18,66 FA 18,37 FA 16,35 F,A, 17,81 FA 31,41 FA 24,10 F,A, 7,85 AP 17,36 AP 9,05 AP 11,65 AP 18,95

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2695 2696 2697 2698 2699 2700 2701 2702 2703 2704 2705 2706 2707 2708 2709 2710 2711 2712 2713 2714 2715 2716 2717 2718 2719 2720 2721 2722 2723 2724 2725 2726 2727 2728 2729 2730 2731 2732

CODIGO BENEFICIO 95993045 CEFTRIAXONA - GENERICO 95374183 CEFTRIAXONA - GENERICO 95121471 CEFTRIAXONA DISSODICA - GENERICO (Restrito Hosp,) 95374221 CEFTRIAXONA SODICA - GENERICO 95014594 CEFTRIAXONA SODICA - GENERICO 95014608 CEFTRIAXONA SODICA - GENERICO 95014586 CEFTRIAXONA SODICA - GENERICO 95993061 CEFTRIAXONA SODICA - GENERICO 95993088 CEFTRIAXONA SODICA - GENERICO 95374213 CEFTRIAXONA SODICA - GENERICO 95014616 CEFTRIAXONA SODICA - GENERICO 95014624 CEFTRIAXONA SODICA - GENERICO 95014632 CEFTRIAXONA SODICA - GENERICO 95064834 CEFTRIONA 95064842 CEFTRIONA 95993100 CEFUROXIMA - GENERICO 95014640 CEFUROXIMA - GENERICO 95014659 CEFUROXIMA - GENERICO 95374310 CEFZIL 95374302 CEFZIL 95052712 CELAPRAM 95660674 CELEBRA 95052720 CELEBRA 95071016 CELEBRA 95136290 CELEMIN HEPA 8% (Restrito Hosp,) 95136282 CELEMIN HEPA 8% (Restrito Hosp,) 95136312 CELENIN NEPHRO 7% (Restrito Hosp,) 95136304 CELENIN NEPHRO 7% (Restrito Hosp,) 95136339 CELEPID (Restrito Hosp,) 95136320 CELEPID (Restrito Hosp,) 95924981 CELERG 95924990 CELERG 95925007 CELERGIN 95925015 CELERGIN 95780149 CELESTAMINE 95780130 CELESTAMINE 95450190 CELESTONE 95450238 CELESTONE

APRESENTAÇÃO 1 g, IV display c/50 500 IM cart, FA+ dil, 1 g IV po inj, ct, 25 FA 1 g IM cx, 1 FA+ amp, dil, 1 g po inj, IV 5 FA vd,+ 5 amps, dil, x 10 ml 1 g po p/sol, inj, 25 FA vd,+ dil, 10 ml 1 g po p/sol, inj, FA vd,+ dil, x 10 ml 1 g po sol, inj, 50 FA vd, 500 g po sol, inj, 50 FA vd, 500 mg, IM cx, 1 FA+ amp, dil, 500 mg, po p/sol, inj, 25 FA vd,+ 25 amps, dil, x 5 ml 500 mg, po p/sol, inj, 5 FA vd,+ 5 amps, dil, x 5 ml 500 mg, po p/sol, inj, FA vd,+ dil, x 5 ml 1 g po inj, cx, 50 FA vd, 500 mg, po inj, cx, 50 FA vd, 750 mg, po p/sol, inj, 25 FA vd, 750 mg, po p/sol, inj, 25 FA vd,+ 25 amps, dil, vd, x 6 ml 750 mg, po p/sol, inj, FA vd,+ amp, dil, vd, x 6 ml 500 mg, 2 bl, x 5 cprs, Po p/susp, 250 mg/5 ml fr, 100 ml 20 mg, bl, 30 cprs, rev, 100 mg, 20 caps, 200 mg, 10 caps, 200 mg, 4 caps, 80 mg/ml sol, inj, fr, vd, inc, x 1000 ml 80 mg/ml sol, inj, fr, vd, inc, x 500 ml 70 mg/ml sol, inj, ct, fr, vd, inc, x 1000 ml 70 mg/ml sol, inj, ct, fr, vd, inc, x 500 ml 0,1 g/ml emul, inj, ct, fr, vd, inc, x 500 ml 0,2 g/ml emul, inj, ct, fr, vd, inc, x 500 ml 2 bl, x 10 cprs, Xpe, fr, 120 ml Cx, 20 cprs, Xpe, fr, 120 ml Est, 20 cprs, Xpe, fr, 120 cc 0,5 mg, est, 20 cprs, 2 mg, 1 bl, 10 cprs,

Laboratorio EUROFARMA EUROFARMA ABL EMS AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA EMS AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA NOVAFARMA NOVAFARMA AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA B-MS B-MS MERCK PFIZER PFIZER PFIZER CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS LEGRAND LEGRAND EMS EMS MANTECORP MANTECORP MANTECORP MANTECORP

UNIDADE Pco Unt Base A F,A, 24,23 AP 12,60 FA 24,72 AP 18,14 FA 22,43 FA 22,76 FA 21,66 F,A, 22,50 F,A, 14,92 AP 12,06 FA 12,65 FA 12,29 FA 12,06 FA 37,47 FA 8,16 F,A, 16,92 FA 17,96 FA 16,32 CPR 9,00 ML 0,90 COMP 2,03 CPR 2,06 CAPS 3,39 COMP 3,35 FR 90,89 FR 75,47 FR 71,42 FR 58,58 FR 151,76 FR 207,89 CPR 0,56 ML 0,13 CPR 0,56 ML 0,13 CPR 0,81 ML 0,24 CPR 0,46 CPR 1,26

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2733 2734 2735 2736 2737 2738 2739 2740 2741 2742 2743 2744 2745 2746 2747 2748 2749 2750 2751 2752 2753 2754 2755 2756 2757 2758 2759 2760 2761 2762 2763 2764 2765 2766 2767 2768 2769 2770

CODIGO BENEFICIO 95450203 CELESTONE 95450220 CELESTONE 95450211 CELESTONE 95450246 CELESTONE SOLUSPAN 95925023 CELESTRAT 95780157 CELESTRAT 95900136 CELLCEPT 95035958 CELLEXINA 95014772 CELLEXINA 95374450 CELLEXINA 95374477 CELLOZINA 95993150 CELLTRIAXON 95740015 CELLUFRESH 95925031 CELOCORT 95670114 CELOFTAL 95993177 CELOVAN 95121498 CELOVAN (Restrito Hosp,) 95052739 CELSENTRI 95096370 CELSENTRI 95052747 CELSENTRI 95096388 CELSENTRI 95014799 CEMAX 95993185 CEMAX 95014802 CEMAX 95014810 CEMAX 95993193 CEMAX 95074481 CEMAX SIST, FECH, 95074490 CEMAX SIST, FECH, 95074503 CEMAX SIST, FECH, 95074511 CEMAX SIST, FECH, 95074520 CEMAX SIST, FECH, 95074538 CEMAX SIST, FECH, 95610723 CENALFAN 95925040 CENEVIT 95925058 CENEVIT 95096396 CENEVIT 95890505 CENTROTABS 95610774 CENTRUM SELECT

APRESENTAÇÃO Elixir fr, 120 cc Gts, sol, oral 1 fr, 15 ml Inj, 1 amp, 1 ml, Sol, 1 amp, 1 ml, 2 mg/0,25 mg, 15 cprs, 2 mg/5 ml xpe 120 ml 500 mg, 5 bl, x 10 cprs, 500 mg, 8 caps, dura 500 mg, cx, 1 bl, x 10 caps, 500 mg, cx, 200 caps, (20 x 10) 1 g, cx, 25 FA IV 1 g, cx, 100 FA+ dil, 10 ml 30 flac, x 0,4 ml Creme bisn, 30 g SERINGA A 2% - CX C/ 1 UNID x 1,5 ML 500 mg cx, 1 FA+ dil 10 ml, 500 mg, po liof, inj, 50 FA vd, x 10 ml 150 mg, fr, plast, 60 cprs, rev, 150 mg, fr, plast, 60 cprs, rev, 300 mg, fr, plast, 60 cprs, rev, 300 mg, fr, plast, 60 cprs, rev, 1 g 50 FA 1 g cx, FA+ dil, 3 ml 1 g50 FA+dil, 3 ml 2 g 50 FA 2 g cx, FA 1 g cx, 1 FA+ bolsa 1 gcx,10FA+bolsa 1gcx,50FA+bolsa 2 g cx, 1 FA+ bolsa 2 g cx, 10 FA+ bolsa 2 g cx, 50 FA+ bolsa Plus fr, 32 cprs, rev, 1 g tb, 10 cprs, eferv, 2 g tb, 10 cprs, eferv, 200 mg/ml sol, oral fr, 30 ml Cx, 30 cprs, Fr, 100 cprs,

Laboratorio MANTECORP MANTECORP MANTECORP MANTECORP UNIAO QUIMICA UNIAO QUIMICA ROCHE CELLOFARM CELLOFARM CELLOFARM CELLOFARM CELLOFARM ALLERGAN LEGRAND OFTALMOPHARMA CELLOFARM ASPEN PHARMA PFIZER GLAXOSMITHKLINE PFIZER GLAXOSMITHKLINE BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO SIGMA PHARMA LEGRAND LEGRAND LEGRAND NEO QUIMICA WYETH CONSUMER

UNIDADE Pco Unt Base A ML 0,17 GOTAS 0,03 AP 4,58 AP 12,52 CPR 0,58 ML 0,13 CPR 13,55 CP 0,92 CAPS 1,03 CPR 0,95 AP 9,71 F,A, 19,30 UND 1,00 G 0,54 UND 16,17 F,A, 21,56 FA 21,56 COMP 32,87 COMP 34,02 COMP 32,87 COMP 34,02 FA 54,20 F,A, 55,31 FA 55,30 FA 106,80 F,A, 109,34 FA 53,01 FA 53,01 FA 53,01 FA 92,65 FA 92,65 FA 92,65 CPR 1,40 CPR 0,92 CPR 1,32 ML 0,22 COMP 1,17 CPR 1,00

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2771 2772 2773 2774 2775 2776 2777 2778 2779 2780 2781 2782 2783 2784 2785 2786 2787 2788 2789 2790 2791 2792 2793 2794 2795 2796 2797 2798 2799 2800 2801 2802 2803 2804 2805 2806 2807 2808

CODIGO BENEFICIO 95760075 CEPACAINA 95660704 CEPROFEN 95052771 CERTICAN 95052780 CERTICAN 95052798 CERTICAN 95083650 CERTICAN D 95083669 CERTICAN D 95750037 CERUMIN 95420398 CESTOX 95993207 CETAFRIN 95993215 CETAFRIN 95374582 CETAZ 95064915 CETAZIMA 95064923 CETAZIMA 95925066 CETIHEXAL 95925074 CETIHEXAL 95035966 CETILPLEX 95035974 CETILPLEX 95071032 CETIRIZINA 2HCL - GENERICO 95071040 CETIRTEC 95993223 CETIVIT 95610804 CETIVIT 95987304 CETOCONAZOL - GENERICO (*) 95925104 CETOCONAZOL + BETAMETASONA + SULFATO 95925112 CETOCONAZOL + BETAMETASONA + SULFATO 95925120 CETOCONAZOL + BETAMETASONA + SULFATO 95035990 CETOCONAZOL - GENERICO 95052801 CETOCONAZOL - GENERICO 95035982 CETOCONAZOL - GENERICO 95071059 CETOCONAZOL - GENERICO 95840460 CETOCONAZOL - GENERICO 95027246 CETOCONAZOL - GENERICO 95096400 CETOCONAZOL - GENERICO 95840435 CETOCONAZOL - GENERICO 95890513 CETOCONAZOL - GENERICO 95036008 CETOCONAZOL - GENERICO 95840478 CETOCONAZOL - GENERICO 95840540 CETOCONAZOL - GENERICO

APRESENTAÇÃO Sol, 100 ml, 50 mg cx, 2 bl, x 12 caps, 0,50 mg, 60 cp, 0,75 mg, 60 cp, 1 mg, 60 cp, 0,10 mg, 60 cp, 0,25 mg, 60 cp, Fr, 8 ml, Emb, 3 str, x 4 cprs 200 mg, sol, gts, 20 ml 750 mg, 50 bl, x 4 cprs, 1 g, IM/IV 1 FA+ dil, 10 ml 1 g po inj, cx, 50 FA vd, 500 mg, po inj, cx, 50 FA vd, 10 mg, cx, 12 10 mg, cx, 6 Gran, 100 mg, cx, 16 envs, x 5 g Gran, 200 mg, cx, 16 envs, x 5 g 1 mg/ml sol, oral fr, vd, amb, x 120 ml+ cp, med, 1 mg/ml sol, oral fr, vd, amb, x120 ml+ cp, med, 500 mg, cx, 05 env, c/4 Gts, fr, 20 ml, 200 mg, cx, 10 cprs, Creme bisn, 30 g Pomada bisn, 30 g Pomada bisn, 30 g 20 mg/g crem, ct, bg, al, x 30 g 20 mg/g crem, ct, bl, al, x 15 g 20 mg/g crem, cx, 100 bg, al, x 30 g (emb, hosp,) 20 mg/g crem, derm, cx, 100 bg al, x 30 g (hosp,) 20 mg/g creme bisn, 30 g 20 mg/g creme derm, bisn, 30 g 20 mg/g creme derm, bisn, 30 g 20 mg/g creme derm,bisn, 30 g 20 mg/g SH 100 ml 20 mg/g shamp, ct, fr, plas, opc, x 100 ml, 20 mg/g shampoo fr, 100 ml, 200 mg cx,1 bl, x 10 cprs,

Laboratorio SANOFI-AVENTIS NEO QUIMICA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS ALCON MERCK LUPER LUPER UNIAO QUIMICA NOVAFARMA NOVAFARMA HEXAL HEXAL NEO QUIMICA NEO QUIMICA TEUTO BRAS, TEUTO BRAS, DUCTO DUCTO NEO QUIMICA EUROFARMA EMS EUROFARMA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI HIPOLABOR CRISTALIA BIOSINTETICA LUPER EMS TEUTO BRAS, PRATI DONADUZZI CRISTALIA APOTEX

UNIDADE Pco Unt Base A ML 0,08 CPR 0,75 CAPS 17,01 CAPS 25,52 CAPS 34,02 COMP 2,92 COMP 7,31 GOTAS 0,05 CPR 3,16 GOTA 0,03 COMP 0,78 FA 22,65 FA 18,55 FA 11,06 CPR 1,69 CPR 1,80 ENV 1,02 ENV 1,15 ML 0,14 ML 0,18 ENV 0,51 GOTAS 0,01 COMP 1,61 G 0,39 G 0,47 G 0,36 G 0,46 G 0,35 G 0,11 G 0,18 G 0,46 G 0,32 G 0,38 G 0,35 ML 24,32 GOTA 0,01 ML 0,27 CPR 1,23

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2820 2821 2822 2823 2824 2825 2826 2827 2828 2829 2830 2831 2832 2833 2834 2835 2836 2837 2838 2839 2840 2841 2842 2843 2844 2845 2846

CODIGO BENEFICIO 95925139 CETOCONAZOL - GENERICO 95925147 CETOCONAZOL - GENERICO 95096418 CETOCONAZOL - GENERICO 95071067 CETOCONAZOL - GENERICO 95840524 CETOCONAZOL - GENERICO 95840532 CETOCONAZOL - GENERICO 95840451 CETOCONAZOL - GENERICO 95840486 CETOCONAZOL - GENERICO 95890548 CETOCONAZOL - GENERICO 95014829 CETOCONAZOL - GENERICO 95014837 CETOCONAZOL - GENERICO 95840443 CETOCONAZOL - GENERICO 95890556 CETOCONAZOL - GENERICO 95890564 CETOCONAZOL - GENERICO 95840427 CETOCONAZOL - GENERICO 95925155 CETOCONAZOL - GENERICO 95052810 CETOCONAZOL - GENERICO (*) 95925180 CETOCONAZOL - GENERICO (*) 95925198 CETOCONAZOL - GENERICO (*) 95052828 CETOCONAZOL - GENERICO (*) 95052836 CETOCONAZOL - GENERICO (*) 95052844 CETOCONAZOL - GENERICO (*) 95840567 CETOCONAZOL - GENERICO (*) 95840559 CETOCONAZOL - GENERICO (*) 95925163 CETOCONAZOL - GENERICO (*) 95925171 CETOCONAZOL - GENERICO (*) 95014853 CETOCONAZOL - GENERICO (*) 95014861 CETOCONAZOL - GENERICO (*) 95014845 CETOCONAZOL - GENERICO (*) 95121501 CETOCONAZOL - GENERICO (Restrito Hosp,) 95121510 CETOCONAZOL - GENERICO (Restrito Hosp,) 95014870 CETOCONAZOL + BETAMETASONA - GENERICO 95014888 CETOCONAZOL + BETAMETASONA - GENERICO 95014896 CETOCONAZOL + BETAMETASONA + SULF 95890572 CETOCONAZOL + BETAMETASONA + SULF 95036016 CETOCONAZOL + BETAMETASONA + SULF 95890580 CETOCONAZOL + BETAMETASONA + SULF 95027254 CETOCONAZOL + DIPROPIONATO DE BETAMETASO

APRESENTAÇÃO 200 mg, 1 str, x 10 cprs, 200 mg, 3 str, x 10 cprs, 200 mg, bl, 10 cprs, 200 mg, bl, al, plas, inc, x 10 cprs, 200 mg, est, bl, 10 cprs, 200 mg, est, bl, 30 cprs, Bisn, 30 g, Creme 20 mg/g bisn, 30 g Creme 30 g Creme bisn, 30 g Creme bisn, 30 g Creme bisn, 30 g, Shampoo cx, 50 fr, 100 ml Shampoo fr, 100 ml Shampoo fr, 100 ml, Shampoo fr, 110 ml, 200 mg, 100 cprs, 200 mg, 3 bl, x 10 cprs, 200 mg, bl, x 10 cprs, 200 mg, com, ct, bl, al, plas, inc, x 10 200 mg, com, ct, bl, al, plas, inc, x 30 200 mg, com, ct, bl, al, plas, inc, x 450 (hosp,) 200 mg, cx, 10 cprs, 200 mg, cx, 30 cprs, 200 mg,10 cprs, 200 mg,30 cprs, 200mg,1bl,x10cprs, 200mg,1bl,x10cprs, 200mg,6 bl,x10 cprs, 20 mg/g shamp, cx, 50 fr, plas, opc, x 100 ml, (hosp,) 200 mg, 100 cprs, (hosp,) Creme bisn, 30 g Pom, bisn, 30 g Creme bisn, 30 g Creme bisn, 30 g Pom, bisn, 30 g Pom, bisn, 30 g 20 mg,+ 0,5 mg/g creme 30 g

Laboratorio MEPHA-RATIOPHARM MEPHA-RATIOPHARM SANOFI-AVENTIS BRAINFARMA RANBAXY RANBAXY MEDLEY NEO QUIMICA PRATI DONADUZZI GERMED GEN - LEGRAND TEUTO BRAS, PRATI DONADUZZI PRATI DONADUZZI EMS MEDLEY TEUTO BRAS, MEDLEY MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI EMS EMS TEUTO BRAS, TEUTO BRAS, GERMED GEN - LEGRAND EMS PRATI DONADUZZI TEUTO BRAS, RANBAXY RANBAXY RANBAXY TEUTO BRAS, RANBAXY TEUTO BRAS, TEUTO BRAS,

UNIDADE Pco Unt Base A CPR 1,64 CPR 1,46 COMP 1,49 COMP 1,72 CPR 1,67 CPR 1,48 G 0,46 G 0,32 GRAMA 0,31 GRAMA 0,26 GRAMA 0,46 G 0,31 ML 0,11 ML 0,16 ML 0,25 ML 0,23 COMP 1,13 CPR 1,74 CPR 1,86 COMP 1,86 COMP 1,06 COMP 0,34 CPR 1,86 CPR 1,72 CPR 1,31 CPR 1,14 COMP 1,60 COMP 1,60 COMP 1,72 FR 11,01 COMP 1,30 GRAMA 0,44 GRAMA 0,36 GRAMA 0,47 GRAMA 0,49 G 0,36 G 0,47 UND 12,61

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2847 2848 2849 2850 2851 2852 2853 2854 2855 2856 2857 2858 2859 2860 2861 2862 2863 2864 2865 2866 2867 2868 2869 2870 2871 2872 2873 2874 2875 2876 2877 2878 2879 2880 2881 2882 2883 2884

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95014934 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg,+ 0,5 mg/g pom, 30 g TEUTO BRAS, 95036059 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g crem, derm, ct, bg, al, x 30 g PRATI DONADUZZI 95036067 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g crem, derm, cx, 100 bg, al, x 30 g (emb,PRATI DONADUZZI 95043276 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g creme derm, bg, al, 30 g FARMASA 95036040 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g pom, derm, ct, bg, al, x 30 g PRATI DONADUZZI 95036075 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g pom, derm, cx, 100 bg, al, x 30 g (emb, h PRATI DONADUZZI 95890602 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g+ 2,5 mg/g creme derm, bisn, 30 g PRATI DONADUZZI 95890610 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,5 mg/g+ 2,5 mg/g pom, derm, bisn, 30 g PRATI DONADUZZI 95043284 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+ 0,64 mg/g creme bisn, 30 g BRAINFARMA 95890599 CETOCONAZOL + DIPROPIONATO DE BETAMETASO 20 mg/g+0,5 mg/gpom,derm , bisn, 30 g FARMASA 95890629 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme 30 g PRATI DONADUZZI 95014918 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme bisn, 30 g EMS 95014942 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme bisn, 30 g GEN - LEGRAND 95890637 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme bisn, 30 g GERMED 95890645 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme bisn, 30 g GERMED 95890653 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme bisn, 30 g GEN - LEGRAND 95036032 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Creme bisn,10 g EMS 95890661 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, 30 g PRATI DONADUZZI 95036024 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, bisn, 10 g EMS 95014926 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, bisn, 30 g EMS 95890670 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, bisn, 30 g GERMED 95890688 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, bisn, 30 g GERMED 95890696 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, bisn, 30 g GEN - LEGRAND 95014950 CETOCONAZOL + DIPROPIONATO DE BETAMETASO Pom, bisn, 30g EUROGENUS - LEGRAND 95052860 CETOCONAZOL + DIPROPIONATO DE BETAMETASONA - GENERICO (20 mg,+ 0,5 mg,)Cremederm,bisn,30g MEPHA-RATIOPHARM 95052879 CETOCONAZOL + DIPROPIONATO DE BETAMETASONA - GENERICO (20 mg,+ 0,5 mg,)Pom,derm,bisn,30g MEPHA-RATIOPHARM 95052852 CETOCONAZOL + DIPROPIONATO DE BETAMETASONA - GENERICO Creme 20+ 0,5 mg/g bisn, 10 g EMS 95925201 CETOCONAZOL + DIPROPRIONATO DE BETAMETAS Creme bisn 30 g, EUROFARMA 95925210 CETOCONAZOL + DIPROPRIONATO DE BETAMETAS Creme bisn, 30 g EMS 95925228 CETOCONAZOL + DIPROPRIONATO DE BETAMETAS Creme derm, 30 g MEDLEY 95925244 CETOCONAZOL + DIPROPRIONATO DE BETAMETAS Pom, bisn, 30g EUROFARMA 95925252 CETOCONAZOL + DIPROPRIONATO DE BETAMETAS Pomada derm, 30 g MEDLEY 95840591 CETOCONAZOL+DIP, BETAMETASONA - GENERICO Creme derm, bisn, 30 g, MEDLEY 95840583 CETOCONAZOL+DIP, BETAMETASONA - GENERICO Pom, derm, bisn, 30 g, MEDLEY 95052887 CETOCONAZOL+DIPROPIONATO DE BETAMETASONA+SULFATO (20 mg,+ NEOMICINA-GENERICO 0,5 mg,+ 2,5 mg,) Creme derm, bisn, 30 g MEPHA-RATIOPHARM 95052895 CETOCONAZOL+DIPROPIONATO DE BETAMETASONA+SULFATO (20 mg,+ NEOMICINA-GENERICO 0,5 mg,+ 2,5 mg,) Pom, derm, bisn, 30 g MEPHA-RATIOPHARM 95052909 CETOCONAZOL+DIPROPIONATO DE BETAMETASONA+SULFATO 20 mg/g+ NEOMICINA-GENERICO 0,5 mg/g+ 2,5 mg/g bisn, creme 30 g BRAINFARMA 95096426 CETOCONAZOL+DIPROPIONATO DE BETAMETASONA+SULFATO Pom, bisn, NEOMICINA-GENERICO 30 g GEN - LEGRAND

UNIDADE Pco Unt Base A GRAMA 0,41 G 0,38 G 0,23 G 0,30 G 0,38 G 0,23 GRAMA 12,89 GRAMA 15,44 G 0,50 GRAMA 14,18 GRAMA 0,36 GRAMA 0,13 GRAMA 0,45 GRAMA 0,30 GRAMA 0,39 GRAMA 0,39 G 0,39 G 0,35 G 0,43 GRAMA 0,12 G 0,30 G 0,30 G 0,45 GRAMA 0,27 G 0,50 G 0,50 G 0,30 G 0,37 G 0,43 G 0,55 G 0,26 G 0,52 G 0,53 G 0,52 G 0,55 G 0,52 G 0,51 GRAMA 11,55

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2885 2886 2887 2888 2889 2890 2891 2892 2893 2894 2895 2896 2897 2898 2899 2900 2901 2902 2903 2904 2905 2906 2907 2908 2909 2910 2911 2912 2913 2914 2915 2916 2917 2918 2919 2920 2921 2922

CODIGO BENEFICIO 95840605 CETOCORT 95840613 CETOCORT 95014969 CETOCORTEN 95014977 CETOCORTEN 95993274 CETODERM (*) 95993282 CETODERM (*) 95096434 CETOFENID 95096442 CETOFENID 95390243 CETOHEXAL 95014985 CETOHEXAL 95390251 CETONAX 95390260 CETONAX 95390278 CETONAX (*) 95052917 CETONEO 95390294 CETONEO 95390308 CETONEO 95390316 CETONEO (*) 95015000 CETONIN 95014993 CETONIN 95015019 CETONIN 95925260 CETOPROFENO - GENERICO 95660720 CETOPROFENO - GENERICO 95890700 CETOPROFENO - GENERICO 95660755 CETOPROFENO - GENERICO 95890718 CETOPROFENO - GENERICO 95015035 CETOPROFENO - GENERICO 95925279 CETOPROFENO - GENERICO 95015027 CETOPROFENO - GENERICO 95925287 CETOPROFENO - GENERICO 95043292 CETOPROFENO - GENERICO 95890726 CETOPROFENO - GENERICO 95660763 CETOPROFENO - GENERICO 95925309 CETOPROFENO - GENERICO 95027262 CETOPROFENO - GENERICO 95993312 CETOPROFENO - GENERICO 95027289 CETOPROFENO - GENERICO (*) 95052925 CETOPROFENO - GENERICO (*) 95052933 CETOPROFENO - GENERICO (*)

APRESENTAÇÃO Creme bisn, 30 g Pom, bisn 30 g Creme 30 g Pomada 30 g 200 mg, cx, 10 cprs, 200 mg, cx, 30 cprs, 20 mg/ml sol oral 20 ml 25 mg/g gel bisn, 30 g 200 mg, 10 cprs, 200 mg, 30 cprs, Creme bisn, 30 g, Shampoo fr, 100 ml,(incluso 5%IPI) Blister 10 cprs, 20 mg/g creme derm, cx, 50 bisn, x 30 g (hosp,) Creme 20 mg/gbisn, 30 g Shampoo fr,100 ml 200 mg cx, 1 bl, x 10 cprs, 200 mg, 10 cprs, 200 mg, 30 cprs, Creme 30 g 100 mg, 2 bl, x 10 cprs, rev, 100 mg, IM 50 mg/ml cx,6 amps, x 2 ml 100mg,2 bl, x 10 cprs, 20 mg/ml sol, oral 20 ml, 25 mg/g gel bisn, 30 g 25mg/ggel,bisn,30 g 50 mg, 2 bl, x 12 caps, gel dura 50 mg, 6 bl, x 10 cprs, 50 mg, bl, 24 caps, 50 mg/ml sol, inj, cx, 6 amps, vd, amb, x 2 ml 50mg/ml48amps,2 ml Gel 25 mg/g bisn, 30 g, Gel bisn, 30 g Inj, 100 mg, 50 amps, x 2 ml IV 100 mg, po liof, cx, 50 FA 100 mg, 2 bl, x 10 cprs, rev, 100 mg, bl, 20 cprs, rev, 20 mg/ml sol, oral, fr, vd, amb, got, x 20 ml

Laboratorio TEUTO BRAS, TEUTO BRAS, CIFARMA CIFARMA UCI-FARMA UCI-FARMA TEUTO BRAS, TEUTO BRAS, HEXAL HEXAL JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA CIFARMA CIFARMA CIFARMA MEDLEY EUROFARMA RANBAXY MEDLEY GERMED GEN - LEGRAND MEDLEY EMS EMS CRISTALIA CRISTALIA MEDLEY EMS EMS CRISTALIA MEDLEY SANOFI-AVENTIS SANOFI-AVENTIS

UNIDADE Pco Unt Base A G 0,76 G 0,75 GRAMA 0,46 GRAMA 0,47 COMP 1,86 COMP 1,55 ML 15,12 GRAMA 15,14 CPR 1,84 COMP 1,73 G 0,75 ML 0,40 CPR 3,24 G 0,38 G 0,54 ML 0,37 CPR 2,66 COMP 1,25 COMP 1,04 GRAMA 0,36 CPR 0,84 AP 1,15 COMP 0,68 GOTAS 0,02 GRAMA 8,47 GRAMA 0,29 CPR 0,39 COMP 0,40 CPR 0,44 AMP 1,56 AMP 1,15 G 0,36 G 0,34 AMP 0,25 F,A, 4,27 CPR 0,95 COMP 0,76 GOTA 0,02

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2923 2924 2925 2926 2927 2928 2929 2930 2931 2932 2933 2934 2935 2936 2937 2938 2939 2940 2941 2942 2943 2944 2945 2946 2947 2948 2949 2950 2951 2952 2953 2954 2955 2956 2957 2958 2959 2960

CODIGO BENEFICIO 95027297 CETOPROFENO - GENERICO (*) 95027300 CETOPROFENO - GENERICO (*) 95036091 CETOPROFENO - GENERICO (*) 95036083 CETOPROFENO - GENERICO (*) 95027319 CETOPROFENO - GENERICO (*) 95036105 CETOPROFENO - GENERICO (*) 95036113 CETOPROFENO - GENERICO (*) 95121528 CETOPROFENO - GENERICO (Restrito Hosp,) 95121536 CETOPROFENO - GENERICO (Restrito Hosp,) 95121544 CETOPROFENO - GENERICO (Restrito Hosp,) 95925317 CETOROLACO DE TROMETAMINA - GENERICO 95890734 CETOROLACO DE TROMETAMINA - GENERICO 95925325 CETOROLACO DE TROMETAMINA - GENERICO 95036121 CETOROLACO DE TROMETAMOL - GENERICO 95082000 CETOROLACO DE TROMETAMOL - GENERICO 95560114 CETOTERON 95036130 CETOTIFENO - GENERICO

APRESENTAÇÃO 20 mg/mlsol,oral20ml 50 mg, 2 bl, x 12 caps, gel dura 50 mg, 6 bl, x 10 cprs, 50 mg, bl, 24 caps, Inj, 100 mg, 50 amps, x 2 ml Inj, 100 mg, 50 amps, x 2 ml Inj, 100 mg, 50 amps, x 2 ml 100 mg, IV po liof, 50 FA 50 mg/ml sol, inj, 48 amps, 2 ml (hosp,) IV 100 mg, po liof, cx, 50 FA 5 mg, fr, 5 ml 5 mg/ml sol, oft, est, fr, plast, 5 ml Sol, oft, fr, 5 ml 0,5% sol, oft, cx, 1 fr, 5 ml Sol, oft, fr, 5 ml 50 mg 20 cprs, 0,2 mg/ml xpe, 120 ml

Laboratorio MEDLEY MEDLEY EMS EMS GERMED EMS GEN - LEGRAND EUROFARMA CRISTALIA CRISTALIA GERMED BIOSINTETICA EMS CRISTALIA NEO QUIMICA EUROFARMA TEUTO BRAS,

95390375 CETOZAN 95390367 CETOZAN 95390391 CETOZAN (*) 95015043 CETOZIN 95925341 CETOZOL 95925368 CETOZOL (*) 95230416 CETRIZIN 95230424 CETRIZIN 95660780 CETROLAC 95993339 CETROTIDE 95064931 CEVITA 95121552 CEVITA (Restrito Hosp,) 95015051 CEWIN 95015060 CEWIN 95083677 CEZOLIN 95074546 CEZOLIN 95052941 CHAMPIX 95993347 CHEMIPLAC 95899243 CHEMIPLAC 95036202 CHEMIPLAC 95027327 CHEMIPLAC

30 g, creme 1 bisn, Shampoo 100 ml 200 mg, 20 cprs, Creme bisn, 30 g 2%shampoofr,100ml 200 mg, cx, 20 cprs, 10 mg, cx, 6 cprs, rev, 10 mg, gts, fr, 7 ml Colirio 5 ml 0,25 mcg, c/1 FA po liof, p/inj,+ solv, 100 mg/ml sol, inj, 100 amps, 5 ml 100 mg/ml sol, inj, 120 amps, 5 ml (hosp,) Cx, 30 cprs, Gts, fr, 20 ml, 1 g po p/sol, inj, FA 1gcx,50FA 1,0 mg, bl, 28 cprs, rev, 6 mg/ml sol, inj, FA vd, 16,7 ml 6 mg/ml sol, inj, FA vd, 25 ml 6 mg/ml sol, inj, FA vd, 5 ml 6 mg/ml sol, inj, FA x 50 ml

ROYTON ROYTON ROYTON MEDIC CAZI CAZI SOLVAY FARMA SOLVAY FARMA UNIAO QUIMICA SERONO TEUTO BRAS, TEUTO BRAS, SANOFI-AVENTIS SANOFI-AVENTIS BIOCHIMICO BIOCHIMICO PFIZER CHEMICALTECH CHEMICALTECH CHEMICALTECH CHEMICALTECH

UNIDADE Pco Unt Base A GOTA 0,02 CPR 0,59 CP 0,59 CP 0,59 AMP 1,12 AMP 1,12 AMP 1,12 FA 4,87 FA 1,32 FA 4,90 GOTAS 0,20 GOTA 0,06 GOTAS 0,22 GOTA 0,22 Gota 0,22 CPR 3,77 ML 0,16 G ML CPR GRAMA ML CPR CPR GOTAS GOTAS F,A, AMP AMP COMP GOTA FA FA COMP F,A, FA FA FA

0,45 0,19 1,09 0,39 0,32 1,75 2,32 0,11 0,32 182,45 0,50 0,44 0,58 0,02 3,95 4,23 5,50 1483,59 2039,72 426,32 4264,55

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 2961 2962 2963 2964 2965 2966 2967 2968 2969 2970 2972 2973 2974 2975 2976 2977 2978 2979 2980 2981 2982 2983 2984 2985 2986 2987 2988 2989 2990 2991 2992 2993 2994 2995 2996 2997 2998 2999

CODIGO BENEFICIO 95132104 CHEMOPENT 95993363 CHORAGON 95993371 CHORAGON 95052950 CHRON-ASA 5 95925376 CIALIS 95925384 CIALIS 95925392 CIBALENA A 95925406 CIBALENA A 95925414 CIBALENA A 95840630 CICATRENE 95660798 CICLADOL 95660801 CICLADOL 95400397 CICLAVIX 95400400 CICLAVIX (*) 95890750 CICLOBENZAPRINA CLOR, - GENERICO 95925422 CICLOLATO 95925430 CICLOMIDRIN 95082018 CICLOPIROX OLAMINA - GENERICO 95082026 CICLOPIROX OLAMINA - GENERICO 95082034 CICLOPIROX OLAMINA - GENERICO 95925449 CICLOPIROX OLAMINA - GENERICO 95710019 CICLOPLEGICO 95899278 CIFLOXTRON 95121560 CIFLOXTRON (Restrito Hosp,) 95374701 CILINON 95015094 CILINON 95374744 CILINON 95015086 CILINON 95374779 CILODEX 95374787 CILODEX 95071083 CILOSTAZOL - GENERICO 95082042 CILOSTAZOL - GENERICO 95071075 CILOSTAZOL - GENERICO 95082050 CILOSTAZOL - GENERICO 95374817 CILOXAN 95374809 CILOXAN 95374795 CILOXAN 95121579 CIMAHER (Restrito Hosp,)

APRESENTAÇÃO 400 mg, cx, 20 cprs, 1500 UI cart, 3 amps, po liof,+ 3 amps, dil, 5000 UI cart, 3 amps, po liof,+ 3 amps, dil, 500 mg, fr, 50 cprs, rev, 20 mg, 2 bl, al, plast, x 2 cprs, rev, 20 mg, bl, al, plast, x 2 cprs, rev, 2 x 10 cp, 48 x 4 cp, Cart, 4 x 4 cp, Creme bisn, 20 g, Cx, 10 cprs, Cx, 5 supos, Creme bisn, 10 g, 200 mg, 25 cprs, 5 mg, bl, 30 cprs, rev, Fr, 5 ml Fr, 5 ml 10 mg/ml sol, top, fr, 15 ml 10 mg/ml sol, top, fr, 15 ml 10 mg/ml sol, top, fr, 15 ml Sol, top, 15 ml Fr, 5 ml, 200mg,inf,IVFA100 ml 2 mg/ml sol, inj, fr, plast, transp, sist, fech, x 100 ml 1000 mg cx, 100 amps, 1000 mg, po inj, cx, 100 FA vd,+ amp, dil, plast, x 5 ml 500 mg cx, 100 FA 500 mg, po inj, cx, 100 FA vd,+ amp, dil, plast, x 5 ml Pom, bisn, 3,5 g Susp, fr, 5 ml 100 mg, bl, 30 cprs, 100 mg, bl, 60 cprs, 50 mg, bl, 30 cprs, 50 mg, bl, 60 cprs, Otologico fr, 5 ml, Pom, bisn, 3,5 g, Sol, oft, fr, 5 ml, 50 mg, sol, inj, IV 4 FA x 10 ml

Laboratorio DIFFUCAP - CHEMOBRAS FERRING FERRING SIGMA PHARMA ELI LILLY ELI LILLY NOVARTIS NOVARTIS NOVARTIS FARMOQUIMICA CHIESI CHIESI LUPER LUPER EUROFARMA LATINOFARMA LATINOFARMA EMS GERMED GEN - LEGRAND PRATI DONADUZZI ALLERGAN ARISTON ARISTON ARISTON ARISTON ARISTON ARISTON ALCON ALCON EUROFARMA EUROFARMA EUROFARMA EUROFARMA ALCON ALCON ALCON EUROFARMA

UNIDADE Pco Unt Base A CPR 1,05 AMP 19,70 AMP 49,94 COMP 1,93 CPR 36,97 CPR 36,98 CPR 0,19 CPR 0,43 CPR 0,22 G 0,51 CPR 3,71 UND 3,74 G 1,50 CPR 2,13 COMP 0,45 GOTAS 0,06 GOTAS 0,10 ML 0,84 ML 0,82 ML 0,82 ML 0,82 GOTAS 0,06 FA 62,27 FA 62,27 AP 2,76 FA 2,63 FA 2,28 FA 2,23 G 6,53 GOTAS 0,21 COMP 1,15 COMP 0,70 COMP 0,58 COMP 0,35 GOTAS 0,17 G 5,33 GOTAS 0,14 FA 1035,76

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3000 3001 3002 3003 3004 3005 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3032 3033 3034 3035 3036 3037

CODIGO BENEFICIO 95027378 CIMEDAX 95027386 CIMETIDINA - GENERICO 95027394 CIMETIDINA - GENERICO 95096450 CIMETIDINA - GENERICO 95071091 CIMETIDINA - GENERICO 95071105 CIMETIDINA - GENERICO 95052976 CIMETIDINA - GENERICO 95052984 CIMETIDINA - GENERICO 95052992 CIMETIDINA - GENERICO 95993444 CIMETIDINA - GENERICO 95071113 CIMETIDINA - GENERICO 95096469 CIMETIDINA - GENERICO 95053000 CIMETIDINA - GENERICO 95053018 CIMETIDINA - GENERICO 95053026 CIMETIDINA - GENERICO 95993452 CIMETIDINA - GENERICO 95015108 CIMETIDINA - GENERICO 95052968 CIMETIDINA - GENERICO 95010416 CIMETINA 95010424 CIMETINAX 95015124 CINADERM 95015132 CINADERM 95015140 CINAFLAN 95660860 CINAFLAN 95064940 CINALEO 95925520 CINARAN 95320121 CINARIX 95320130 CINARIX 95890807 CINARIZINA - GENERICO 95015159 CINARIZINA - GENERICO 95890815 CINARIZINA - GENERICO 95015167 CINARIZINA - GENERICO 95053034 CINATIL 95015183 CINATREX 95015191 CINATREX 95140166 CINCORDIL 95140158 CINCORDIL 95053042 CINETIC

APRESENTAÇÃO 200 mg, cx, 20 cprs, 200 mg 40 cprs, 200 mg, 20 cprs, 200 mg, 40 cprs, 200 mg, bl, 10 cprs, 200 mg, bl, 20 cprs, 200 mg, com, ct, bl, al, plas, inc, x 20 200 mg, com, ct, bl, al, plas, inc, x 40 200 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) 200 mg, cx, 10 cprs, 400 mg, 2 bl, x 8 cprs, 400 mg, 20 cprs, 400 mg, com, ct, bl, al, plas, inc, x 20 400 mg, com, ct, bl, al, plas, inc, x 40 400 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) 400 mg, cx, 2 bl, x 8 cprs, HCL 150 mg/ml sol, inj, 2 ml c/100 HCL 150 mg/ml sol, inj, 2 ml c/120 (hosp,) Cx, 20 cprs, 200 mg, cx, 4 bl, x10 cprs, 3,5 mg, pom, derm, bisn, 10 g 3,5 mg, pom, derm, bisn, 20 g 50 mg, cx, 20 cprs, Gts, fr, 10 ml 15 UI po liof, inj, cx, FA vd, 25 mg, cx, 20 cprs, 25 mg cx, 30cprs, 75 mg cx, 30 cprs, 25 mg, 3 bl, x 10 cprs, 25 mg, 30 caps, 75 mg, 3 bl, x 10 cprs, 75 mg, 30 caps, Gel, bisn, 60 g 500 mg, 100 caps, Pom, oft, 3,5 g 20 mg, bl, 30 cprs, 40 mg, bl, 30 cprs, 4mg/mlsol,oralx10ml

Laboratorio ROYTON SANDOZ SANDOZ MULTILAB TEUTO BRAS, TEUTO BRAS, PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA TEUTO BRAS, MULTILAB PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA TEUTO BRAS, TEUTO BRAS, HEXAL DUCTO CELLOFARM CELLOFARM BRASTERAPICA BRASTERAPICA MEIZLER CAZI ROYTON ROYTON RANBAXY MEPHA-RATIOPHARM RANBAXY MEPHA-RATIOPHARM BRASTERAPICA CIFARMA CIFARMA SIGMA PHARMA SIGMA PHARMA BIOLAB SANUS

UNIDADE Pco Unt Base A CPR 0,45 CPR 0,52 CPR 0,49 COMP 0,50 COMP 0,63 COMP 0,59 COMP 0,63 COMP 0,38 COMP 0,17 COMP 0,53 COMP 1,08 COMP 0,83 COMP 0,94 COMP 0,86 COMP 0,27 COMP 0,86 AMP 0,99 AMP 0,99 CPR 0,40 CPR 0,30 GRAMA 0,38 GRAMA 0,34 COMP 0,30 GOTAS 0,03 FA 175,94 CPR 0,42 CPR 0,22 CPR 0,30 COMP 0,24 CAPS 0,24 COMP 0,33 CAPS 0,33 G 0,18 CAPS 0,52 GRAMA 2,18 CPR 0,26 CPR 0,51 GOTA 0,03

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3038 3039 3040 3041 3042 3043 3044 3045 3046 3047 3048 3049 3050 3051 3052 3053 3054 3055 3056 3057 3058 3059 3060 3061 3062 3063 3064 3065 3066 3067 3068 3069 3070 3071 3072 3073 3074 3075

CODIGO BENEFICIO 95053050 CINETOL 95141685 CINETOL 95044655 CINETOL 95993479 CINTON 95121587 CINTON (Restrito Hosp,) 95290206 CIPRAMIL 95374914 CIPRO 95064958 CIPRO 95374876 CIPRO 95374906 CIPRO 95064966 CIPRO 95374884 CIPRO 95374949 CIPRO HC 95993495 CIPRO XR 95027408 CIPRO XR 95993509 CIPRO XR 95036210 CIPROBACTER 95036229 CIPROBACTER 95036237 CIPROBIOT 95036253 CIPROBIOT 95036245 CIPROBIOT 95925546 CIPROCILIN 95925554 CIPROCILIN 95925562 CIPROCILIN 95925570 CIPROCILIN 95375031 CIPROFAR 95375040 CIPROFAR 95071121 CIPROFIBRATO - GENERICO 95082069 CIPROFIBRATO - GENERICO 95096477 CIPROFIBRATO - GENERICO 95375066 CIPROFLOX 95375082 CIPROFLOX 95993541 CIPROFLOXACINA - GENERICO 95993533 CIPROFLOXACINA - GENERICO 95015205 CIPROFLOXACINO - GENERICO 95015213 CIPROFLOXACINO - GENERICO 95036261 CIPROFLOXACINO - GENERICO 95036270 CIPROFLOXACINO - GENERICO

APRESENTAÇÃO 2 mg, 20 bl, 10 cps, 2 mg. 8 bl. x 10 caps. 5 mg/ml - 50 amps, 1 ml 300 mg, cx, 50 amps, 2 ml, 150 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml 20 mg, est, 14 cprs, 200 mg, inj, fr, 100 ml, 200 mg,flexibag100ml 250 mg, 14 cprs, 400 mg, inj, fr, 200 ml 400 mg,flexibag200ml 500 mg, 6 cprs, Sol, fr, 10 ml, 1000 mg, fr, 7 cprs, 500 mg, bl, 7 cprs, 500 mg, fr, 3 cprs, Inj, 2 mg/ml bolsa poliet, 100 ml Inj, 2 mg/ml bolsa poliet, 200 ml 250 mg, 6 cprs, 500 mg, 14 cprs, 500 mg, 6 cprs, 250 mg, 1 bl, x 6 cprs, 250 mg, 2 bl, x 7 cprs, 500 mg, 1 bl, x 6 cprs, 500 mg, 2 bl, x 7 cprs, 250 mg, 14 cprs, rev, 500 mg, 6 cprs, rev, 100 mg, bl, 30 cprs, 100 mg, bl, 30 cprs, 100 mg, bl, 30 cprs, 250 mg blist, 6 cprs, 500 mg blist, 6 cprs, 2 mg/ml bolsa 200 ml 2mg/mlbolsa 100ml 2 mg/ml bolsa poliet, 100 ml 2 mg/ml bolsa poliet, 200 ml 2 mg/ml sol, inj, 6 bolsas plast, x 100 ml 2 mg/ml sol, inj, 6 bolsas plast, x 200 ml

Laboratorio CRISTALIA CRISTALIA CRISTALIA ARISTON ARISTON LUNDBECK BAYER BAYER BAYER BAYER BAYER BAYER ALCON BAYER BAYER BAYER ISOFARMA ISOFARMA SANDOZ SANDOZ SANDOZ LEGRAND LEGRAND LEGRAND LEGRAND ELOFAR ELOFAR SANOFI-AVENTIS BRAINFARMA COSMED HEBRON HEBRON HALEX ISTAR HALEX ISTAR ISOFARMA ISOFARMA EUROFARMA EUROFARMA

UNIDADE Pco Unt Base A COMP 0,18 CAPS 0,21 AMP 1,32 AMP 0,79 AMP 0,84 CPR 4,71 FA 85,40 UNID 97,97 CPR 6,68 FA 146,93 UNID 168,57 CPR 15,18 GOTAS 0,21 COMP 26,54 CPR 17,33 COMP 17,34 UND 62,51 UND 107,57 CP 3,20 CP 2,30 CP 4,04 CPR 2,42 CPR 2,17 CPR 3,15 CPR 3,13 CPR 1,03 CPR 3,69 COMP 1,61 COMP 1,61 COMP 1,35 CPR 2,47 CPR 4,58 UNID 99,22 UNID 58,23 BOLSA 58,24 BOLSA 100,23 UND 23,64 UND 47,28

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3076 3077 3078 3079 3080 3081 3082 3083 3084 3085 3086 3087 3088 3089 3090 3091 3092 3093 3094 3095 3096 3097 3098 3099 3100 3101 3102 3103 3104 3105 3106 3107 3108 3109 3110 3111 3112 3113

CODIGO BENEFICIO 95096485 CIPROLIP 95925600 CIPRONAL 95053069 CIPRONID 95560122 CIPROSTAT 95375236 CIPROXAN 95375228 CIPROXAN 95925619 CIRLEG 95064974 CISPLATINA - GENERICO 95064982 CISPLATINA - GENERICO 95064990 CISPLATINA - GENERICO 95420401 CISTICID 95096493 CITAFORIN 95096507 CITAGRAN 95053077 CITALOPRAM - GENERICO 95925643 CITALOPRAM - GENERICO 95925651 CITALOPRAM - GENERICO 95925660 CITALOPRAM - GENERICO 95096515 CITALOPRAM - GENERICO 95925678 CITALOPRAM - GENERICO 95082093 CITALOPRAM - GENERICO 95015264 CITALOPRAM - GENERICO 95082077 CITALOPRAM - GENERICO 95096523 CITALOPRAM - GENERICO 95096531 CITALOPRAM - GENERICO 95096540 CITALOPRAM - GENERICO 95890866 CITALOPRAM - GENERICO 95993592 CITALOPRAM - GENERICO 95082085 CITALOPRAM - GENERICO 95096558 CITALOPRAM - GENERICO 95096566 CITALOPRAM - GENERICO 95890874 CITALOPRAM - GENERICO 95993606 CITALOPRAM - GENERICO 95015221 CITALOPRAM - GENERICO 95890882 CITALOPRAM - GENERICO 95993614 CITALOPRAM - GENERICO 95993622 CITALOPRAM - GENERICO 95925686 CITALOPRAM - GENERICO 95925694 CITALOPRAM - GENERICO

APRESENTAÇÃO 100 mg, bl, 30 cprs, 500 mg, cx,6 cprs, 500 mg cx, 2 bl, x 7 cprs, rev, 50 mg 20 cprs, 500 mg, cx, 14 cprs, 500 mg, cx, 6 cprs, 10 mg, cx, 6 cprs, 1 mg/ml sol, inj, IV FA vd, x 10 ml 1 mg/ml sol, inj, IV FA vd, x 25 ml 1 mg/ml sol, inj, IV FA vd, x 50 ml Fr, 50 cprs, 20 mg, 2 bl, x 15 cprs, rev, 20 mg, 2 bl, x 15 cprs, rev, 15 mg, 20 cprs, rev, 20 mg, 1 bl, x 14 cprs, 20 mg, 14 cprs, 20 mg, 2 bl, x 14 cprs, 20 mg, 2 bl, x 14 cprs, rev, 20 mg, 2 bl, x 15 cprs, rev, 20 mg, 28 cprs, 20 mg, 3 x 10 cprs, 20 mg, bl, 14 cprs, rev, 20 mg, bl, 14 cprs, rev, 20 mg, bl, 14 cprs, rev, 20 mg, bl, 14 cprs, rev, 20 mg, bl, 14 cprs, rev, 20 mg, bl, 14 cprs, rev, 20 mg, bl, 28 cprs, rev, 20 mg, bl, 28 cprs, rev, 20 mg, bl, 28 cprs, rev, 20 mg, bl, 28 cprs, rev, 20 mg, bl, 28 cprs, rev, 20 mg, bl, 30 cprs, 20 mg, bl, 7 cprs, rev, 20 mg, c/14 20 mg, c/28 20 mg, ct, 14 cprs, 20 mg, ct, 28 cprs,

Laboratorio UCI-FARMA CAZI DUCTO APSEN ROYTON ROYTON CAZI ACCORD ACCORD ACCORD MERCK LEGRAND GERMED PHARMA MEDLEY RANBAXY NOVA QUIMICA RANBAXY NEO QUIMICA MERCK NOVA QUIMICA ZYDUS FARMASA BIOSINTETICA BRAINFARMA NEO QUIMICA FARMASA BRAINFARMA FARMASA BIOSINTETICA BRAINFARMA FARMASA BRAINFARMA RANBAXY FARMASA ARROW ARROW EUROFARMA EUROFARMA

UNIDADE Pco Unt Base A COMP 1,45 CPR 5,70 COMP 2,35 CPR 3,13 CPR 2,24 CPR 2,35 CPR 2,27 FA 24,26 FA 56,25 FA 116,31 CPR 8,01 COMP 0,97 COMP 0,97 COMP 1,91 CPR 1,56 CPR 2,24 CPR 1,78 COMP 2,67 CPR 2,32 COMP 2,04 COMP 1,83 COMP 2,07 COMP 2,05 COMP 2,19 COMP 2,64 COMP 1,68 COMP 1,57 COMP 2,07 COMP 2,07 COMP 2,19 COMP 1,68 COMP 1,57 COMP 1,94 COMP 1,61 COMP 2,14 COMP 2,11 CPR 2,20 CPR 2,20

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3114 3115 3116 3117 3118 3119 3120 3121 3122 3123 3124 3125 3126 3127 3128 3129 3130 3131 3132 3133 3134 3135 3136 3137 3138 3139 3140 3141 3142 3143 3144 3145 3146 3147 3148 3149 3150 3151

CODIGO BENEFICIO 95053107 CITALOPRAM - GENERICO 95053093 CITALOPRAM - GENERICO 95027424 CITALOPRAM - GENERICO 95925708 CITALOPRAM - GENERICO 95015248 CITALOPRAM - GENERICO 95015256 CITALOPRAM - GENERICO 95015230 CITALOPRAM - GENERICO 95027416 CITALOPRAM - GENERICO 95925627 CITALOPRAM - GENERICO 95053085 CITALOPRAM - GENERICO 95993630 CITALOR 95096574 CITALOR 95180117 CITALOR 95984534 CITALOR 95065008 CITARABINA - GENERICO 95065024 CITARABINA - GENERICO 95065016 CITARABINA - GENERICO 95036300 CITARAX - CITARABINA 95036318 CITARAX - CITARABINA 95044663 CITOCAINA 3% + FELIPRESSINA 95610944 CITONEURIN 95610952 CITONEURIN 95610979 CITONEURIN (*) 95610960 CITONEURIN (*)

APRESENTAÇÃO 20 mg, cx, 14 cprs, 20 mg, cx, 28 cprs, 20 mg, cx, 30 cprs, rev, 20 mg, cx, 30 cprs, rev, 20 mg, x 14 20 mg, x 28 20 mg, x 7 20mg,cx,10cprs,rev, 20mg,cx,10cprs,rev, 30 mg, 20 cprs, rev, 10 mg, 30 cprs, rev, 20 mg, 10 cprs, rev, 40 mg 30 cprs, rev, 80 mg, 30 cprs, rev, 100 mg/ml sol, inj, IV FA vd, x 1 ml 100 mg/ml sol, inj, IV FA vd, x 10 ml 100 mg/ml sol, inj, IV FA vd, x 5 ml 20 mg/ml sol, inj, 10 FA vd, x 5 ml 50 mg/ml sol, inj, 10 FA vd, x 10 ml 50 carp, 50 emb, 20 drags, 5000 emb, 20 drags, 1000 cx, 3 amps, 3 ml, 5000 cx, 3 amps, 3 ml,

95036326 CITOPLATINA 95036342 CITOPLATINA 95036334 CITOPLATINA 95899308 CITOPLAX 95899316 CITOPLAX 95540482 CITOSTAL 95540490 CITOSTAL 95041753 CITRATO DE FENTANILA - GENERICO 95041745 CITRATO DE FENTANILA - GENERICO 95041761 CITRATO DE FENTANILA - GENERICO 95090851 CITRATO DE SILDENAFILA - GENERICO 95027432 CITRATO DE TAMOXIFENO - GENERICO 95027440 CITRATO DE TAMOXIFENO - GENERICO 95071130 CITRATO DE TAMOXIFENO - GENERICO

10 mg/ml sol, inj, cx, 1 FA vd, amb, x 15 ml 10 mg/ml sol, inj, cx, 1 FA vd, amb, x 45 ml 10 mg/ml sol, inj, cx, 1 FA vd, amb, x 5 ml 10mg,sol,inj, fr,10ml 50mg,sol,inj, fr, 50 ml Fr, 5 caps, 10 mg, Fr, 5 caps, 40 mg, 50 mcg/ml sol, inj, cx, 25 amps, vd, x 10 ml 50 mcg/ml sol, inj, cx, 25 amps, vd, x 2 ml 50 mcg/ml sol, inj, cx, 25 amps, vd, x 5 ml 25 mg, bl, 4 cprs, rev, 10 mg, 30 cprs, rev, 20 mg, 30 cprs, rev, 20 mg, bl, 30 cprs, rev,

Laboratorio ARROW ARROW SANDOZ HEXAL AUROBINDO PHARMA AUROBINDO PHARMA AUROBINDO PHARMA SANDOZ HEXAL MEDLEY PFIZER PFIZER PFIZER PFIZER ACCORD ACCORD ACCORD BLAUSIEGEL BLAUSIEGEL CRISTALIA MERCK MERCK MERCK MERCK MEIZLER MEIZLER MEIZLER BERGAMO BERGAMO B-MS B-MS EUROFARMA EUROFARMA EUROFARMA EMS SANDOZ SANDOZ EUROFARMA

UNIDADE Pco Unt Base A COMP 2,24 COMP 2,21 CPR 2,14 CPR 2,29 COMP 1,69 COMP 1,57 COMP 1,73 CPR 2,11 CPR 2,11 COMP 3,75 COMP 1,97 COMP 1,75 CPR 3,94 COMP 3,94 FA 5,24 FA 52,49 FA 26,24 FA 8,86 FA 49,48 Und 0,51 CPR 0,62 CPR 1,82 AP 2,00 AMP 2,93 FA 369,96 FA 1048,89 FA 164,29 FA 33,34 FA 127,37 CPR 4,77 CPR 2,50 AMP 3,04 AMP 1,09 AMP 2,22 CPR 8,42 CPR 1,28 CPR 2,46 COMP 2,95

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3152 3153 3154 3155 3156 3157 3158 3159 3160 3161 3162 3163 3164 3165 3166 3167 3168 3169 3170 3171 3172 3173 3174 3175 3176 3177 3178 3179 3180 3181 3182 3183 3184 3185 3186 3187 3188 3189

CODIGO BENEFICIO APRESENTAÇÃO 95890890 CITRATO ORFENADRINA + DIP, SOD, + CAF, A 35+ 300+ 50 mg/ml gts, fr, 20 ml 95890904 CITRATO ORFENADRINA + DIP, SOD, + CAF, A Gts, fr, 20 ml 95890912 CITRATO ORFENADRINA + DIP, SOD, + CAF, A Gts, fr, 20 ml 95096582 CITRATO ORFENADRINA + DIP, SOD, + CAF, ANIDRA - GENERICO Gts, fr, 20 ml, 95096590 CITRATO ORFENADRINA + DIP, SOD, + CAF, ANIDRA - GENERICO Gts, fr, 20 ml, 95027459 CITROPLEX Inj, 500 mg, cx, 50 amps, x 5 ml 95987339 CITROPLEX C Gts,fr, 20 ml 95993649 CITTA 20 mg, 14 cprs, rev, 95993657 CITTA 20 mg, 28 cprs, rev, 95096604 CITTA 20 mg, bl, 7 cprs, rev, 95036350 CIZAX 10 mg, bl, 10 cprs, 95036369 CIZAX 10 mg, bl, 30 cprs, 95036385 CIZAX 5 mg, bl, 10 cprs, 95036377 CIZAX 5 mg, bl, 30 cprs, 95375325 CLAFORAN 250 mg/ml fr, amp, c/4 ml, dil, 95074570 CLAFORDIL 1000 mg, cx, 20 FA+ dil, x 5 ml 95993665 CLAMIBEN 5 mg, cx, 30 cprs 95740023 CLARIL Fr, 15 ml, 95993673 CLARILERG 10 mg, 12 cprs, 95083693 CLARILIB 500 mg, po liof, inj, FA 95375392 CLARINEO 250 mg cx, 1 bl, x 8 cprs, 95770046 CLARIPEL Acquagel bisn, 30 g, 95770038 CLARIPEL Creme 4% bisn, 30 g, 95096612 CLARITIN 1 mg/ml sol, oral 60 ml 95230432 CLARITIN Cx, 12 cprs, 10 mg, 95230475 CLARITIN D 24 horas 240 mg,+ 10 mg, bl, 6 cprs, rev, 95230459 CLARITIN D cx, 12 drags, 95230467 CLARITIN D xpe, 60 ml, 95230440 CLARITIN Xpe, fr, 100 ml 95375520 CLARITROMICINA - GENERICO 250 mg, 1 bl, x 10 cprs, rev, 95925724 CLARITROMICINA - GENERICO 500 mg 1 bl, x 10 cprs, rev, 95925732 CLARITROMICINA - GENERICO 500 mg 2 bl, x 7 cprs, rev, 95375511 CLARITROMICINA - GENERICO 500 mg, 2 bl, x 7 cprs, rev, 95015272 CLARITROMICINA - GENERICO 500 mg, 5 bl, x 6 cprs, rev, 95993681 CLARITROMICINA - GENERICO 500 mg, 5 FA+ dil, 95375430 CLARITROMICINA - GENERICO 500 mg, cx, 10 cprs, 95027467 CLARITROMICINA - GENERICO 500 mg, IV inj, FA 95925767 CLARITROMICINA - GENERICO Susp, 125 mg/5 ml fr, 60 ml

Laboratorio EMS GERMED EUROGENUS - LEGRAND GEN - LEGRAND GERMED NEO QUIMICA NEO QUIMICA EUROFARMA EUROFARMA EUROFARMA MANTECORP MANTECORP MANTECORP MANTECORP SANOFI-AVENTIS ARISTON TEUTO BRAS, ALCON HEXAL LIBRA NEO QUIMICA STIEFEL STIEFEL MANTECORP MANTECORP SCHERING PLOUGH SCHERING PLOUGH SCHERING PLOUGH MANTECORP MEDLEY MERCK MERCK MEDLEY EMS EUROFARMA EMS ABL EMS

UNIDADE Pco Unt Base A GOTA 5,26 GOTAS 0,01 GOTAS 0,01 GOTAS 0,01 GOTAS 0,01 AMP 2,42 GOTA 0,02 COMP 2,23 COMP 2,23 COMP 2,23 CP 0,68 CP 0,68 CP 0,61 CP 0,61 FA 53,63 FA 29,82 COMP 0,18 GOTAS 0,03 COMP 1,27 FA 201,18 CPR 4,56 G 1,24 G 1,24 ML 0,26 CPR 2,65 CPR 4,94 CPR 2,47 ML 0,45 ML 0,26 CPR 3,71 CPR 6,03 CPR 6,03 CPR 7,05 COMP 6,60 F,A, 69,84 CPR 6,60 FA 85,51 ML 0,48

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3190 3191 3192 3193 3194 3195 3196 3197 3198 3199 3200 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3219 3220 3221 3222 3223 3224 3225 3226 3227

CODIGO BENEFICIO 95925775 CLARITROMICINA - GENERICO 95096620 CLARITROMICINA - GENERICO (Restrito Hosp,) 95015280 CLARITRON 95750355 CLAROFT 95925783 CLARUS 95740031 CLARVISOL 95046135 CLAUDIC 95046160 CLAUDIC 95046143 CLAUDIC 95046151 CLAUDIC 95015302 CLAVICIN 95015299 CLAVICIN 95375775 CLAVULIN 95375767 CLAVULIN 95084738 CLAVULIN 95084746 CLAVULIN 95375740 CLAVULIN 95084754 CLAVULIN 95084762 CLAVULIN 95375805 CLAVULIN BD 95375791 CLAVULIN BD 95375813 CLAVULIN BD 95375821 CLAVULIN BD 95993690 CLAVULIN ES 95993703 CLAVULIN ES 95993711 CLAVULIN IV 95993720 CLAVULIN IV 95375880 CLAVUTAM 95375872 CLAVUTAM 95071148 CLAVUTREX 95053115 CLAXAM 95053123 CLAXAM 95053131 CLAXAM 95850090 CLEANBAC 95210202 CLENIL 95210229 CLENIL A 95210237 CLENIL COMPOSITUM A 95210245 CLENIL COMPOSITUM SPRAY JET

APRESENTAÇÃO Susp, 250 mg/5 ml fr, 60 ml 500 mg, po liof, inj, IV 1 FA 500 mg, inj, cx, 1 FA+ dil, 10 ml Sol, fr, 15 ml, Xpe, 120 ml Fr, 15 ml,+ 1 cpr, 100 mg, 30 cprs, 100 mg, 60 cprs, 50 mg, 30 cprs, 50 mg, 60 cprs, 1000 mg,+ 200 mg, po inj, 50 FA 500 mg,+ 100 mg, po inj, 50 FA 125 mg, fr, 75 ml, 250 mg, fr, 75 ml 500 mg, 21 cprs, 500 mg, 30 cprs, 500 mg, fr, 12 cprs, Susp, 125 mg/100 ml Susp, 250 mg/100 ml 200 mg, po ext, p/susp, oral fr, 70 ml 400 mg, po ext, p/susp, oral fr, 70 ml 875 mg bl, 14 cprs, rev, 875 mg bl, 20 cprs, rev, 600 mg, 100 ml 600 mg, 50 ml Inj, 1 g 10 FA Inj, 500 mg 10 FA 1000 mg,+ 200 mg, po inj, FA 500 mg,+ 100 mg, po inj, FA 250 mg/5 ml+ 62,5 mg/5 ml susp, oral fr, vd, amb, x 75 ml 80 mg/ml+ 11,4 mg/ml po susp, oral fr, vd, x 70 ml+ dos, 875 mg,+ 125 mg, fr, plast, x 14 cprs, rev, 875 mg,+ 125 mg, fr, plast, x 20 cprs, rev, 2 mg pom, 500 g 24 pt 250 mcg, spray Cx, 10 flac, 2 ml Cx, 10 flac, x 2 ml Fr, 15 ml,

Laboratorio EMS ASPEN PHARMA CELLOFARM ALCON JOSPER ALLERGAN BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS CELLOFARM CELLOFARM GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE LIBRA LIBRA CIFARMA HEXAL HEXAL HEXAL PRATI DONADUZZI CHIESI CHIESI CHIESI CHIESI

UNIDADE Pco Unt Base A ML 0,95 FA 78,05 FA 110,07 GOTAS 0,02 ML 0,09 GOTAS 0,05 COMP 1,53 COMP 1,27 COMP 0,78 COMP 0,66 FA 36,44 FA 18,57 ML 0,36 ML 0,63 COMP 3,61 COMP 3,33 CPR 4,94 ML 0,30 ML 0,53 ML 0,59 ML 0,61 CPR 4,48 CPR 3,89 ML 0,55 ML 1,03 F,A, 44,17 F,A, 25,89 FA 13,69 FA 10,55 ML 0,44 ML 0,44 COMP 3,64 COMP 3,53 UND 4,20 DOSE 0,25 UND 3,93 UND 3,93 GOTAS 0,10

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3228 3229 3230 3231 3232 3233 3234 3235 3236 3237 3238 3239 3240 3241 3242 3243 3244 3245 3246 3247 3248 3249 3250 3251 3252 3253 3254 3255 3256 3257 3258 3259 3260 3261 3262 3263 3264 3265

CODIGO BENEFICIO 95210253 CLENIL NASAL AQUOSO 95210261 CLENIL NASAL SPRAY 95210270 CLENIL PULVINAL 95210288 CLENIL PULVINAL 95210296 CLENIL PULVINAL 95993738 CLENIL SPRAY ORAL 95480269 CLEVERON 95160132 CLEXANE 95090703 CLEXANE 95160140 CLEXANE 95925830 CLEXANE 95090711 CLEXANE 95090720 CLEXANE 95160159 CLEXANE 95925848 CLEXANE 95090738 CLEXANE 95090746 CLEXANE 95160167 CLEXANE 95090754 CLEXANE 95160175 CLEXANE 95090762 CLEXANE 95015337 CLIBIUM 95015310 CLIBIUM 95015329 CLIBIUM 95132112 CLIMATIDINE 95840656 CLINAGEL 95993746 CLINDABIOTIC 95375953 CLINDACIN 95121595 CLINDACIN (Restrito Hosp,) 95840664 CLINDACNE 95375970 CLINDAL AZ 95890947 CLINDAL AZ 95376011 CLINDAMICINA - GENERICO 95376020 CLINDAMICINA - GENERICO 95136347 CLINDAMICINA - GENERICO (Restrito Hosp,) 95890955 CLINDAMICINA HCL - GENERICO 95376038 CLINDAMIN C 95899332 CLINDARIX

APRESENTAÇÃO 20 ml, Tubo 15 ml (15,5 g) 100 mcg 100 doses 200 mcg 100 doses 400 mcg 100 doses 50 mcg 15 ml 10 mg, cx, 1 bl, 15 cprs, 100 mg, 2 ser, 100 mg, sol, inj, ct, 2 ser, x 1,0 ml+ sist, seg, 20 mg, 10 ser, 20 mg, 2 ser, pre-enchida 20 mg, sol, inj, ct, 10 ser, x 0,2 ml+ sist, seg, 20 mg, sol, inj, cx, 2 ser, pre x 0,2 ml+ sist, seg, 40 mg, 10 ser, 40 mg, 2 ser, pre-enchida 40 mg, sol, inj, ct, 10 ser, x 0,4 ml+ sist, seg, 40 mg, sol, inj, cx, 2 ser, pre, x 0,4 ml+ sist, seg, 60 mg, 2 ser, 60 mg, sol, inj, ct, 2 ser, x 0,6 ml+ sist, seg, 80 mg, 2 ser, 80 mg, sol, inj, ct, 2 ser, x 0,8 ml+ sist, seg, 120 mg, cx, 30 cprs, 40 mg, cx, 30 cprs, 80 mg, cx, 30 cprs, Cart, 40 cprs, Bisn, 45 g 300 mg,2bl,x10caps, 600 mg amp, cx, 50 x 4 ml 300 mg, amp, cx, 50 x 2 ml Gel bisn, 25 g 500 mg, 3 cprs, 500 mg, 5 cprs, rev, 300 mg, est, bl, 16 cprs, 300 mg, est,bl,10cprs, 300 mg, 320 caps, gel, dura (hosp,) 300 mg, 16 caps, 300 mg, cx, 16 caps, 600 mg, cx, 20 amps, 4 ml

Laboratorio CHIESI CHIESI CHIESI CHIESI CHIESI CHIESI TRB-PHARMA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS GLENMARK GLENMARK GLENMARK CLIMAX STIEFEL UNIAO QUIMICA CELLOFARM ASPEN PHARMA THERASKIN MERCK MERCK RANBAXY RANBAXY TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, ARISTON

UNIDADE Pco Unt Base A DOSE 0,20 DOSE 0,15 DOSE 0,15 DOSE 0,29 DOSE 0,51 DOSE 0,15 CPR 2,64 UND 92,55 Und 95,78 UND 19,13 AP 19,13 Und 19,33 Und 19,33 UND 37,16 AP 37,15 Und 37,54 Und 37,53 UND 56,97 Und 57,55 UND 75,88 Und 76,65 COMP 1,61 COMP 0,98 COMP 1,24 CPR 0,43 G 0,68 CAPS 2,00 AP 9,70 AMP 4,89 G 1,27 CPR 3,25 COMP 3,25 CPR 2,23 COMP 2,41 CAPS 2,00 CAPS 2,30 CPR 3,00 AMP 18,63

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3266 3267 3268 3269 3270 3271 3272 3273 3274 3275 3276 3277 3278 3279 3280 3281 3282 3283 3284 3285 3286 3287 3288 3289 3290 3291 3292 3293 3294 3295 3296 3297 3298 3299 3300 3301 3302 3303

CODIGO BENEFICIO 95899340 CLINDARIX 95925864 CLINDOXYL 95890963 CLINET 95993762 CLINFAR 95096639 CLINFAR 95993770 CLINFAR 95096647 CLINFAR 95053140 CLINFAR 95096655 CLINFAR 95053158 CLINFAR 95053166 CLINFAR 95015345 CLISTIN 95071156 CLISTIN 95925872 CLO 95925880 CLO 95925899 CLO 95790144 CLOBESOL 95790136 CLOBESOL 95790160 CLOB-X 95790179 CLOB-X 95790152 CLOB-X 95790187 CLOB-X 95065067 CLOCEF 95074597 CLOCEF 95074589 CLOCEF 95121609 CLOCEF 95660887 CLOFENAK 95015353 CLOFENID 95840680 CLOMAZEN 95015361 CLOMAZOL 95096663 CLOMENAC 95096671 CLOMENAC 95096680 CLOMENAC 95490132 CLOMID 95925929 CLOMIPRAN 95925937 CLOMIPRAN 95027483 CLONAZEPAM - GENERICO 95045830 CLONAZEPAM - GENERICO

APRESENTAÇÃO 900 mg, cx, 20 amps, 6 ml Gel, bisn, 30 g 30 cprs, rev, 10 mg, 3 bl, x 10 cprs, rev, 10 mg, cart, bl, al, plas, inc, x 10 cprs, rev, 20 mg, 3 bl, x 10 cprs, rev, 20 mg, cart, bl, al, plas, inc, x 10 cprs, rev, 40 mg, bl, 30 cprs, rev, 40 mg, bl, al, plas, inc, x 10 cprs, rev, 80 mg, bl, 10 cprs, rev, 80 mg, bl, 30 cprs, rev, 10 mg, cx, 12 cprs, Xpe, 100 ml 10 mg,2bl,10cprs,rev, 25 mg, 2 bl, 10 cprs, rev, 75 mg, 2 bl, x 10 cprs, rev, Creme 1 bisn, 30 g, Pom, 1 bisn, 30 g, Creme bisn, 30 g, Gel bisn, 30 g, Pom, bisn, 30 g, Sol, top, 50 g, 1 g inj, FA+ amp, dil, 3 ml 1 g po inj, cx, 50 FA vd, amb, (hosp,) 2 g po inj, cx, 50 FA vd, amb, (hosp,) 2 g po sol, inj, ct, FA vd, amb, s/dil, 50 mg, cx 10 cprs, 50 mg, 20 cprs, 1% creme bisn, 20 g Creme 50 g 10 mg, 30 cprs, rev, 10 mg, 60 cprs, rev, 10 mg, 7 cprs, rev, 10 cprs, 10 mg, 20 drags, 25 mg, 20 drags, 0,5 mg, bl, 2 x 10 cprs, 0,5 mg, bl, 20 cprs,

Laboratorio ARISTON STIEFEL ATIVUS MERCK MERCK MERCK MERCK MERCK MERCK MERCK MERCK GLENMARK GLENMARK SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA VALEANT VALEANT GALDERMA GALDERMA GALDERMA GALDERMA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, MEDLEY CIFARMA UNIAO QUIMICA CIFARMA ARROW ARROW ARROW MEDLEY UNIAO QUIMICA UNIAO QUIMICA RANBAXY MEDLEY

UNIDADE Pco Unt Base A AMP 24,14 G 1,01 CPR 1,64 COMP 0,37 COMP 0,38 COMP 0,72 COMP 0,71 COMP 1,45 COMP 1,45 COMP 1,80 COMP 1,98 COMP 1,56 ML 0,15 CPR 0,38 CPR 0,87 CPR 1,11 G 0,65 G 0,59 G 0,66 G 0,73 G 0,68 G 0,42 FA 53,18 FA 53,17 FA 98,73 FA 98,73 CPR 0,62 COMP 0,37 G 0,58 GRAMA 0,25 COMP 1,19 COMP 1,19 COMP 1,19 CPR 3,79 CPR 0,39 CPR 0,82 CPR 0,13 COMP 0,14

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3304 3305 3306 3307 3308 3309 3310 3311 3312 3313 3314 3315 3316 3317 3318 3319 3320 3321 3322 3323 3324 3325 3326 3327 3328 3329 3330 3331 3332 3333 3334 3335 3336 3337 3338 3339 3340 3341

CODIGO BENEFICIO 95027491 CLONAZEPAM - GENERICO 95045813 CLONAZEPAM - GENERICO 95045848 CLONAZEPAM - GENERICO 95053255 CLONAZEPAM - GENERICO 95053263 CLONAZEPAM - GENERICO 95071164 CLONAZEPAM - GENERICO 95071172 CLONAZEPAM - GENERICO 95027505 CLONAZEPAM - GENERICO 95045805 CLONAZEPAM - GENERICO 95045074 CLONAZEPAM - GENERICO 95027513 CLONAZEPAM - GENERICO 95045791 CLONAZEPAM - GENERICO 95045082 CLONAZEPAM - GENERICO 95045821 CLONAZEPAM - GENERICO 95096698 CLONAZEPAM - GENERICO 95096701 CLONAZEPAM - GENERICO 95890971 CLONAZEPAM - GENERICO 95890980 CLONAZEPAM - GENERICO 95890998 CLONAZEPAM - GENERICO 95993789 CLONAZEPAM - GENERICO 95891005 CLONAZEPAM - GENERICO 95132120 CLONIDIN 95121617 CLONIDIN (Restrito Hosp,) 95925945 CLONOTRIL 95925953 CLONOTRIL 95043357 CLOPAM 95043365 CLOPAM 95043373 CLOPAM 95043381 CLOPAM 95043349 CLOPAM 95096710 CLOPIDO-GRAN 95036393 CLOPIDOGREL, BISSULFATO 95045864 CLOPIDOGREL, BISSULFATO 95036407 CLOPIDOGREL, BISSULFATO 95045872 CLOPIDOGREL, BISSULFATO 95045880 CLOPIDOGREL, BISSULFATO 95047204 CLOPIDOGREL, BISSULFATO 95047212 CLOPIDOGREL, BISSULFATO

DE DE DE DE DE DE DE

GEN GEN GEN GEN GEN GEN GEN

APRESENTAÇÃO 0,5 mg, bl, 3 x 10 cprs, 0,5 mg, bl, 30 cprs, 0,5 mg, bl, 60 cprs, 2 mg, 2 bl, x 10 cprs, 2 mg, 3 bl, x 10 cprs, 2 mg, 3 bl, x 10 cprs, 2 mg, 3 bl, x 10 cprs, 2 mg, bl, 2 x 10 cprs, 2 mg, bl, 20 cprs, 2 mg, bl, 20 cprs, rev, 2 mg, bl, 3 x 10 cprs, 2 mg, bl, 30 cprs, 2 mg, bl, 30 cprs, rev, 2 mg, bl, 60 cprs, 2 mg, bl, plast, x 30 cprs, 2,5 mg/ml gts, 20 ml 2,5 mg/ml gts, fr, 20 ml 2,5 mg/ml gts, fr, 20 ml 2,5 mg/ml gts, fr, 20 ml 2,5 mg/ml sol, oral fr, vd, got, x 20 ml Gts fr, 20 ml, 150 mcg/ml cx, 25 est,1 ml 150 mcg/ml 30 est, 1 ml 0,5 mg, cx, 20 cprs, 2 mg,cx, 20 cprs, 0,5 mg, cprs, ct, 2 bl, al, plas, inc, x 10 0,5 mg, cprs, cx, 20 bl, al, plas, inc, x 10 (emb, hosp,) 2 mg, cprs, ct, 2 bl, al, plas, inc, x 10 2 mg, cprs, cx, 20 bl, al, plas inc, x 10 (emb, hosp,) 2,5 mg/ml fr, x 20 ml 75 mg, 4 bl, x 7 cprs, ver, 75 mg, bl, 14 cprs, rev, 75 mg, bl, 14 cprs, rev, 75 mg, bl, 28 cprs, rev, 75 mg, bl, 28 cprs, rev, 75 mg, bl, 56 cprs, rev, 75mg, bl,14cprs,rev, 75mg, bl,28cprs,rev,

Laboratorio RANBAXY MEDLEY MEDLEY GERMED GERMED EMS GEN - LEGRAND RANBAXY MEDLEY EUROFARMA RANBAXY MEDLEY EUROFARMA MEDLEY ZYDUS TEUTO BRAS, UNIAO QUIMICA EMS GERMED MEDLEY GEN - LEGRAND CRISTALIA CRISTALIA TORRENT TORRENT CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA LEGRAND SANOFI-AVENTIS MEDLEY SANOFI-AVENTIS MEDLEY MEDLEY SANDOZ SANDOZ

UNIDADE Pco Unt Base A CPR 0,14 COMP 0,15 COMP 0,15 COMP 0,26 COMP 0,27 COMP 0,27 COMP 0,27 CPR 0,26 COMP 0,26 COMP 0,27 CPR 0,27 COMP 0,27 COMP 0,19 COMP 0,27 COMP 0,23 GOTAS 0,02 GOTA 0,02 GOTA 0,02 GOTA 0,02 GOTA 0,02 GOTAS 0,02 AP 4,81 AMP 4,81 CPR 0,14 CPR 0,25 CP 0,22 CP 0,22 CP 0,39 CP 0,38 FR 8,47 COMP 1,48 CP 3,94 COMP 3,65 CP 3,76 COMP 3,40 COMP 3,94 COMP 3,61 COMP 3,45

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3342 3343 3344 3345 3346 3347 3348 3349 3350 3351 3352 3353 3354 3355 3356 3357 3358 3359 3360 3361 3362 3363 3364 3365 3366 3367 3368 3369 3370 3371 3372 3373 3374 3375 3376 3377 3378 3379

CODIGO BENEFICIO 95071180 CLOPIDOGREL, BISSULFATO DE - GENERICO 95071199 CLOPIDOGREL, BISSULFATO DE - GENERICO 95053298 CLOPIDOGREL, BISSULFATO DE - GENERICO 95053301 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096728 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096736 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096744 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096752 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096760 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096779 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096787 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096795 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096809 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096817 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096825 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096833 CLOPIDOGREL, BISSULFATO DE - GENERICO 95096841 CLOPIDROR 95096850 CLOPIDROR 95053310 CLOPIVIX 95053328 CLOPIVIX 95280081 CLOPIXOL 95925970 CLOPIXOL (*) 95925988 CLOPIXOL (*) 95280111 CLOPIXOL (*) 95096868 CLOPIXOL DEPOT, 95993797 CLOPSINA 95993800 CLOPSINA 95121625 CLOPSINA (Restrito Hosp,) 95121633 CLOPSINA (Restrito Hosp,) 95053336 CLORAFENIL 95987398 CLORAMED 95987401 CLORAMED 95015388 CLORANA 95015370 CLORANA 95376054 CLORANFENICOL 95230521 CLORATADD 95230513 CLORATADD 95230548 CLORATADD

APRESENTAÇÃO 75 mg, 2 bl, x 7 cprs, 75 mg, 4 bl, x 7 cprs, 75mg, bl,14cprs,rev, 75mg, bl,28cprs,rev, 75 mg, 2 bl, x 7 cprs, rev, 75 mg, 2 bl, x 7 cprs, rev, 75 mg, 4 bl, x 7 cprs, rev, 75 mg, 4 bl, x 7 cprs, rev, 75 mg, 4 bl, x 7 cprs, rev, 75 mg, bl, 10 cprs, rev, 75 mg, bl, 10 cprs, rev, 75 mg, bl, 15 cprs, rev, 75 mg, bl, 15 cprs, rev, 75 mg, bl, 30 cprs, rev, 75 mg, bl, 30 cprs, rev, 75 mg, bl, 30 cprs, rev, 75 mg, x 10 cprs, 75 mg, x 30 cprs, 75 mg, 14 cprs, rev, 75 mg, 28 cprs, rev, Sol, inj, acuphase 50 mg, cx, 1 amp, 1 ml 10 mg, 20 cprs, 25 mg, 20 cprs, Sol, inj, depot 200 mg, cx, 1 amp, 1 ml 200 mg, 1 ml 100 mg, cx, 20 cprs, 25 mg, cx, 20 cprs, 100 mg, bl, 200 cprs, (hosp,) 25 mg, bl, 200 cprs, (hosp,) 250 mg, cx, 100 caps, 125 mg, vd, 60 ml 250 mg, cx, 12 caps, 25 mg 30 cprs, 50 mg, 20 cprs, Colirio fr, 10 ml, 10 mg cx, 12 cprs, 5 mg/5 ml xpe, fr, 100 ml, D - cx, 12 cprs,

Laboratorio RANBAXY RANBAXY SANDOZ SANDOZ EMS GERMED EMS GEN - LEGRAND GERMED ARROW EUROFARMA ACHE BIOSINTETICA ACHE ARROW BIOSINTETICA ARROW ARROW DR, REDDY'S DR, REDDY'S LUNDBECK LUNDBECK LUNDBECK LUNDBECK LUNDBECK UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA TEUTO BRAS, MEDQUIMICA MEDQUIMICA SANOFI-AVENTIS SANOFI-AVENTIS ALLERGAN EMS EMS EMS

UNIDADE Pco Unt Base A COMP 3,04 COMP 3,03 COMP 3,61 COMP 3,45 COMP 3,43 COMP 3,43 COMP 3,38 COMP 3,38 COMP 3,38 COMP 3,96 COMP 7,96 COMP 3,01 COMP 3,01 COMP 2,87 COMP 2,70 COMP 2,87 COMP 4,13 COMP 4,13 COMP 3,15 COMP 3,15 AP 24,47 CPR 1,22 CPR 2,66 AP 43,44 COMP 48,80 COMP 0,22 COMP 0,14 COMP 0,19 COMP 0,12 CAPS 0,27 ML 0,19 CAPS 0,67 COMP 0,20 COMP 0,31 GOTAS 0,03 CPR 1,87 ML 0,18 CPR 1,48

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3380 3381 3382 3383 3384 3385 3386 3387 3388 3389 3390 3391 3392 3393 3394 3395 3396 3397 3398 3399 3400 3401 3402 3403 3404 3405 3406 3407 3408 3409 3410 3411 3412 3413 3414 3415 3416 3417

CODIGO BENEFICIO 95230530 CLORATADD 95053352 CLORATADD D 95053344 CLORATADD D 95993835 CLORDOX 95987428 CLORETO DE POTASSIO 95089942 CLORETO DE POTASSIO 95891021 CLORETO DE POTASSIO 95580476 CLORETO DE POTASSIO 95580506 CLORETO DE POTASSIO 95580450 CLORETO DE POTASSIO 95987436 CLORETO DE POTASSIO 95580468 CLORETO DE POTASSIO 95580492 CLORETO DE POTASSIO 95891030 CLORETO DE POTASSIO - GENERICO 95036431 CLORETO DE POTASSIO - GENERICO 95036423 CLORETO DE POTASSIO - GENERICO 95036458 CLORETO DE POTASSIO - GENERICO 95036415 CLORETO DE POTASSIO - GENERICO 95036440 CLORETO DE POTASSIO - GENERICO 95121641 CLORETO DE POTASSIO - GENERICO (Restrito Hosp,) 95121650 CLORETO DE POTASSIO - GENERICO (Restrito Hosp,) 95121668 CLORETO DE POTASSIO (Restrito Hosp,) 95121676 CLORETO DE POTASSIO (Restrito Hosp,) 95121684 CLORETO DE POTASSIO (Restrito Hosp,) 95121692 CLORETO DE POTASSIO (Restrito Hosp,) 95987410 CLORETO DE POTASSIO 19,1% 95987452 CLORETO DE SODIO 95987460 CLORETO DE SODIO 95089977 CLORETO DE SODIO 95136703 CLORETO DE SODIO 95580590 CLORETO DE SODIO 95580603 CLORETO DE SODIO 95580654 CLORETO DE SODIO 95580689 CLORETO DE SODIO 95580700 CLORETO DE SODIO 95987487 CLORETO DE SODIO 95987495 CLORETO DE SODIO 95089969 CLORETO DE SODIO

APRESENTAÇÃO D - xpe, fr, 60 ml 1 mg,+ 12 mg/ml xpe, fr, 60 ml 5 mg/120 mg, bl, 12 cprs, rev, 100 mg, cx, 15 drags, 10% - 10 ml 10% 10 ml amp, plast, 10% amp, 10 ml 10% cx, 100 x10 ml vidro 10% cx, 200 x 10 ml plast, 15% amp, 10 ml, 19,1% - 10 ml 19,1% amp, 10 ml, 19,1% cx, 200 x 10 ml plast, 60 mg/ml sol, oral 50 fr, plast, x 100 ml (hosp,) 60 mg/ml, sol, or, ct, fr, plas, opc, x 100 ml, 60 mg/ml, sol, or, ct, fr, vd, amb, x 100 ml, 60 mg/ml, sol, or, ct, fr, vd, amb, x 150 ml, 60 mg/ml, sol, or, cx, 50 fr, vd, amb, x100 ml, (emb, 60 mg/ml, sol, or, cx, 50 fr, vd, amb, x150ml,(emb,h 10% 10 ml amp, plast, 19,1% 10 ml cx. 200 amp. plast. 10% cx, 200 amps, plast, 10 ml 15% amp, 10 ml 19,1% - 10 ml 19,1% amp, 10 ml 10 ml 0,9% - 10 ml 0,9% - 20 ml 0,9% 10 ml cx. 200 amp. plast. 0,9% 20 ml cx, 100 amp, plast, 0,9% amp, 10 ml, 0,9% amp, 20 ml, 0,9% cx, 100 x 10 ml vidro 0,9% cx, 100 x 5 ml 0,9% cx, 200 x 10 ml plast, 10% - 10 ml 10% - 20 ml 10% 10 ml amp, plast,

Laboratorio EMS EMS EMS TEUTO BRAS, BEKER FARMACE HALEX ISTAR HYPOFARMA HYPOFARMA HALEX ISTAR BEKER HALEX ISTAR HYPOFARMA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI FARMACE FARMACE HALEX ISTAR HALEX ISTAR BEKER HALEX ISTAR EQUIPLEX BEKER BEKER FARMACE FARMACE HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA HYPOFARMA BEKER BEKER FARMACE

UNIDADE Pco Unt Base A ML 0,30 ML 0,33 COMP 1,64 DRAG 1,24 AMP 0,35 AMP 0,48 AMP 0,42 AP 0,69 AP 0,29 AP 0,68 AMP 0,35 AP 0,75 AP 0,29 ML 0,01 ML 0,03 ML 0,03 ML 0,04 ML 0,01 ML 0,01 AMP 0,44 AMP 0,46 AMP 0,42 AMP 0,63 AMP 0,35 AMP 0,69 AMP 0,35 AMP 0,35 AMP 0,58 AMP 0,48 AMP 0,52 AP 0,51 AP 0,77 AP 0,70 AP 0,42 AP 0,31 AMP 0,41 AMP 0,58 AMP 0,48

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3418 3419 3420 3421 3422 3423 3424 3425 3426 3427 3428 3429 3430 3431 3432 3433 3434 3435 3436 3437 3438 3439 3440 3441 3442 3443 3444 3445 3446 3447 3448 3449 3450 3451 3452 3453 3454 3455

CODIGO BENEFICIO 95089993 CLORETO DE SODIO 95580670 CLORETO DE SODIO 95580697 CLORETO DE SODIO 95580611 CLORETO DE SODIO 95987517 CLORETO DE SODIO 95090428 CLORETO DE SODIO 95136711 CLORETO DE SODIO 95580620 CLORETO DE SODIO 95580638 CLORETO DE SODIO 95015396 CLORETO DE SODIO 95580662 CLORETO DE SODIO 95580719 CLORETO DE SODIO 95121706 CLORETO DE SODIO (Restrito Hosp,) 95121714 CLORETO DE SODIO (Restrito Hosp,) 95121722 CLORETO DE SODIO (Restrito Hosp,) 95121730 CLORETO DE SODIO (Restrito Hosp,) 95121749 CLORETO DE SODIO (Restrito Hosp,) 95121757 CLORETO DE SODIO (Restrito Hosp,) 95121765 CLORETO DE SODIO (Restrito Hosp,) 95121773 CLORETO DE SODIO (Restrito Hosp,) 95083715 CLORETO DE SODIO 0,9% 95083707 CLORETO DE SODIO 0,9% 95582258 CLORETO DE SODIO 10% 95987444 CLORETO DE SODIO 17,55% 95582266 CLORETO E SODIO 20% 95581472 CLORETO SODIO 0,9% 95581456 CLORETO SODIO 0,9% 95581464 CLORETO SODIO 0,9% 95581430 CLORETO SODIO 0,9% 95581448 CLORETO SODIO 0,9% 95015400 CLORIDRATO DE BUPIVACAINA HIPERBA 95926038 CLORIDRATO DE FLUOXETINA - GENERIC 95926054 CLORIDRATO DE FLUOXETINA - GENERIC 95926070 CLORIDRATO DE AMBROXOL - GENERICO 95993851 CLORIDRATO DE AMBROXOL - GENERICO 95053425 CLORIDRATO DE AMBROXOL - GENERICO 95053441 CLORIDRATO DE AMBROXOL - GENERICO 95053450 CLORIDRATO DE AMBROXOL - GENERICO

APRESENTAÇÃO 10% 20 ml amp, plast, 10% cx, 100 x 10 ml vidro 10% cx, 200 x 10 ml plast, 17,55 amp, 10 ml, 20% - 10 ml 20% 10 ml 200 amp, plast, 20% 20 ml cx, 100 amp, plast, 20% amp, 10 ml, 20% amp, 20 ml, 20% cx, 100 x 20 ml plast, 20% cx, 100 x10 ml vidro 20% cx, 200 x 10 ml plast, 0,9% - 10 ml 0,9% - 20 ml 0,9% amp, 10 ml 0,9% amp, 20 ml 17,55 amp, 10 ml 20% - 10 ml 20% amp, 10 ml 20% amp, 20 ml 1000 ml IRR - 1 x 1000 ml 500 ml IRR - 1 x 500 ml AMP 10 ML 10 ml AMP 10 ML Bolsa/Frasco em sistema fechado com 100 ml Bolsa/Frasco em sistema fechado com 1000 ml Bolsa/Frasco em sistema fechado com 2000 ml Bolsa/Frasco em sistema fechado com 250 ml Bolsa/Frasco em sistema fechado com 500 ml 0,5% 4 ml - cx, 50 amps, 20 mg, cx, 14 cprs, 20 mg, cx, 28 cprs, 3 mg/ml 120 ml c/50 fr, vd, 3 mg/ml fr, vd, 120 ml+ cp, med, 3 mg/ml xpe, 120 ml 3 mg/ml xpe, 120 ml+ cp, med, 3 mg/ml xpe, 48 frs, x 120 ml+ cp, med, (hosp,)

Laboratorio FARMACE HYPOFARMA HYPOFARMA HALEX ISTAR BEKER FARMACE FARMACE HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA HYPOFARMA BEKER BEKER HALEX ISTAR HALEX ISTAR HALEX ISTAR BEKER HALEX ISTAR HALEX ISTAR FRESENIUS KABI FRESENIUS KABI HALEX ISTAR EQUIPLEX HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR HYPOFARMA EMS EMS PRATI DONADUZZI BIOSINTETICA MEPHA-RATIOPHARM MARIOL MARIOL

UNIDADE Pco Unt Base A AMP 0,57 AP 0,71 AP 0,33 AP 0,59 AMP 0,35 AMP 0,58 AMP 0,58 AP 0,60 AP 0,75 AMP 1,28 AP 0,73 AP 0,32 AMP 0,33 AMP 0,57 AMP 0,47 AMP 0,72 AMP 0,55 AMP 0,35 AMP 0,56 AMP 0,71 UNID 13,52 UNID 12,08 AP 0,51 AMP 0,31 AP 0,60 FR 1,65 FR 3,53 FR 7,55 FR 1,90 FR 2,33 AMP 3,76 CPR 1,65 CPR 1,47 ML 0,02 ML 0,06 ML 0,07 ML 0,35 ML 0,35

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3456 3457 3458 3459 3460 3461 3462 3463 3464 3465 3466 3467 3468 3469 3470 3471 3472 3473 3474 3475 3476 3477 3478 3479 3480 3481 3482 3483 3484 3485 3486 3487 3488 3489 3490 3491 3492 3493

CODIGO BENEFICIO 95071202 CLORIDRATO 95071229 CLORIDRATO 95043390 CLORIDRATO 95015418 CLORIDRATO 95015442 CLORIDRATO 95053387 CLORIDRATO 95993843 CLORIDRATO 95891048 CLORIDRATO 95993878 CLORIDRATO 95926089 CLORIDRATO 95993886 CLORIDRATO 95053433 CLORIDRATO 95053468 CLORIDRATO 95053395 CLORIDRATO 95071210 CLORIDRATO 95015426 CLORIDRATO 95015434 CLORIDRATO 95993860 CLORIDRATO 95926097 CLORIDRATO 95926100 CLORIDRATO 95891056 CLORIDRATO 95027521 CLORIDRATO 95891064 CLORIDRATO 95926119 CLORIDRATO 95027530 CLORIDRATO 95053409 CLORIDRATO 95053417 CLORIDRATO 95045317 CLORIDRATO 95015469 CLORIDRATO 95015450 CLORIDRATO 95993894 CLORIDRATO 95993908 CLORIDRATO 95993916 CLORIDRATO 95993924 CLORIDRATO 95993932 CLORIDRATO 95027548 CLORIDRATO 95993940 CLORIDRATO 95015477 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMBROXOL - GENERICO AMILORIDA + HIDRO AMILORIDA + HIDRO AMILORIDA + HIDRO AMILORIDA + HIDRO AMILORIDA + HCT - GENE AMILORIDA + HCT - GENE AMILORIDA + HCT - GENE AMILORIDA + HCT - GENE

APRESENTAÇÃO Laboratorio 3 mg/ml xpe, cx, 50 frs, plas, amb, x 120 ml+ 50 cp, med, (hosp,) HIPOLABOR 3 mg/ml xpe, cx, 50 frs, vd, amb, x 100 ml+ 50 cp, med, (hosp,) HIPOLABOR 3 mg/ml xpe, fr, 120 ml CRISTALIA 3 mg/ml xpe, fr, vd, 120 ml+ cp, med, FARMASA 3 mg/ml xpe, fr, vd, x 100 ml+ cp, med, ATIVUS 3 mg/ml xpe, ped, 120 ml c/50 TEUTO BRAS, 3 mg/ml100 mlc/50fr, PRATI DONADUZZI 3mg/mlxpe,inf,120 ml PRATI DONADUZZI 6 mg/ml 120 ml PRATI DONADUZZI 6 mg/ml 120 ml c/50 fr, vd, PRATI DONADUZZI 6 mg/ml fr, vd, 120 ml+ cp, med, BIOSINTETICA 6 mg/ml xpe, 120 ml MEPHA-RATIOPHARM 6 mg/ml xpe, 120 ml+ cp, med, MARIOL 6 mg/ml xpe, ad, 120 ml c/50 TEUTO BRAS, 6 mg/ml xpe, cx, 50 frs, plas, amb, x 100 ml+ 50 cp, med, (hosp,) HIPOLABOR 6 mg/ml xpe, fr, vd, 120 ml+ cp, med, FARMASA 6 mg/ml xpe, fr, vd, x 100 ml+ cp, med, ATIVUS 6 mg/ml100 mlc/50fr, PRATI DONADUZZI 7,5 mg/ml sol, oral fr, 50 ml, ABBOTT Ad, 6 mg/ml xpe, fr, 120 ml EMS Ad, 6 mg/ml xpe, fr, 120 ml s/acucar GEN - LEGRAND Ad, 6 mg/ml xpe, vd, 120 ml+ cp, med, DUCTO Inf, 3 mg/ml xpe, fr, 120 ml s/acucar GEN - LEGRAND Inf,3mg/mlxpe,fr,120ml EMS Ped, 3 mg/ml xpe, vd, 120 ml+ cp, med, DUCTO Xpe, 15 mg/5 ml ped, fr, 120 ml BUNKER Xpe, 30 mg/5 ml ad, fr, 120 ml BUNKER Xpe, ad, fr, 120 ml TEUTO BRAS, Xpe, ad, fr, 120 ml - s/acucar GERMED Xpe, inf, fr, 120 ml - s/acucar GERMED 2,5/25 mg, 2 bl, x 15 cprs, GEN - LEGRAND 2,5/50 mg, 2 bl, x 15 cprs, GERMED 5/50mg,3 bl, x 10cprs, GERMED 5/50mg,3 bl, x 10cprs, GEN - LEGRAND 2,5 mg,+ 25 mg, 30 cprs, EMS 2,5 mg,+ 25 mg, 9 bl, x 10 cprs, rev, EMS 5,0 mg,+ 50 mg, 30 cprs, EMS 5,0 mg,+ 50 mg, 9 bl, x 10 cprs, EMS

UNIDADE Pco Unt Base A ML 0,03 ML 0,03 ML 0,06 ML 0,07 ML 0,06 ML 0,04 ML 0,02 ML 0,08 ML 0,11 ML 0,02 ML 0,10 ML 0,10 ML 0,35 ML 0,07 ML 0,04 ML 0,11 ML 0,08 ML 0,03 ML 0,11 ML 0,09 ML 0,10 GOTA 0,00 ML 0,05 ML 0,05 GOTA 0,00 ML 0,08 ML 0,11 ML 0,07 ML 0,10 ML 0,05 COMP 0,19 COMP 0,14 COMP 0,31 COMP 0,32 COMP 0,19 CPR 0,17 COMP 0,32 COMP 0,29

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3494 3495 3496 3497 3498 3499 3500 3501 3502 3503 3504 3505 3506 3507 3508 3509 3510 3511 3512 3513 3514 3515 3516 3517 3518 3519 3520 3521 3522 3523 3524 3525 3526 3527 3528 3529 3530 3531

CODIGO BENEFICIO 95027556 CLORIDRATO 95053484 CLORIDRATO 95027564 CLORIDRATO 95027572 CLORIDRATO 95053492 CLORIDRATO 95891099 CLORIDRATO 95926143 CLORIDRATO 95891102 CLORIDRATO 95891110 CLORIDRATO 95891129 CLORIDRATO 95891137 CLORIDRATO 95926151 CLORIDRATO 95891145 CLORIDRATO 95053522 CLORIDRATO 95071237 CLORIDRATO 95071245 CLORIDRATO 95053514 CLORIDRATO 95053549 CLORIDRATO 95053530 CLORIDRATO 95053506 CLORIDRATO 95891153 CLORIDRATO 95891161 CLORIDRATO 95891170 CLORIDRATO 95891188 CLORIDRATO 95891196 CLORIDRATO 95891200 CLORIDRATO 95891218 CLORIDRATO 95891226 CLORIDRATO 95891234 CLORIDRATO 95891242 CLORIDRATO 95891250 CLORIDRATO 95891269 CLORIDRATO 95891277 CLORIDRATO 95891285 CLORIDRATO 95891293 CLORIDRATO 95036474 CLORIDRATO 95036482 CLORIDRATO 95036490 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

AMIODARONA - GENERICO AMIODARONA - GENERICO AMIODARONA - GENERICO AMIODARONA - GENERICO AMIODARONA - GENERICO AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERI AMITRIPTILINA - GENERICO AMITRIPTILINA - GENERICO AMITRIPTILINA - GENERICO AMITRIPTILINA - GENERICO AMITRIPTILINA - GENERICO AMITRIPTILINA - GENERICO AMITRIPTILINA - GENERICO ANFEPRAMONA - GENERICO ANFEPRAMONA - GENERICO ANFEPRAMONA - GENERICO ANFEPRAMONA - GENERICO ANFEPRAMONA - GENERICO ANFEPRAMONA - GENERICO BENAZEPRIL - GENERICO BENAZEPRIL - GENERICO BENAZEPRIL - GENERICO BENAZEPRIL - GENERICO BETAXOLOL - GENERICO BETAXOLOL - GENERICO BETAXOLOL - GENERICO BROMEXINA - GENERICO BROMEXINA - GENERICO BROMEXINA - GENERICO BROMEXINA - GENERICO BROMEXINA - GENERICO

APRESENTAÇÃO 100 mg, 2 bl, x 10 cprs, 100 mg, bl, 20 cprs, 200 mg, 2 bl, x 10 cprs, 200 mg, 3 bl, x 10 cprs, 200 mg, bl, 20 cprs, 25 mg, 2 bl, x 10 cprs, 25 mg, 20 cprs, 25 mg, 20 cprs, rev, 25 mg, 20 cprs, rev, 25 mg, bl, 20 cprs, 75 mg, 2 bl, x 10 cprs, 75 mg, 20 cprs, 75 mg, 20 cprs, rev, 25 mg, 100 cprs, rev, 25 mg, 2 bl, x 15 cprs, rev, 25 mg, 2 bl, x 15 cprs, rev, 25 mg, 20 cprs, rev, 25 mg, bl, 20 cprs, rev, 75 mg, 2 bl, x 10 cprs, rev, 75 mg, 2 bl, x 15 cprs, rev, 25 mg, 2 bl, x 10 cprs, 25 mg, 2 bl, x 10 cprs, 25 mg, 2 bl, x 10 cprs, 75 mg, 20 cprs, 75 mg, 20 cprs, 75 mg, 20 cprs, 10 mg, fr, 14 cprs, 10 mg, fr, 30 cprs, 5 mg, fr, 14 cprs, 5 mg, fr, 30 cprs, 5mg/mlsol,oft,fr,5 ml 5mg/mlsol,oft,fr,5 ml 5mg/mlsol,oft,fr,5 ml 0,8 mg/ml xpe, cx, 50 fr, vd, x 120 ml+ cp, med, x 10 ml (h 1,6mg/ml xpe,cx, 50 fr,vd, x 120 ml+cp, med, x 10 Xpe, inf, 4 mg/5 ml fr, 120 ml Xpe, inf, 4 mg/5 ml fr, 120 ml Xpe, inf, 4 mg/5 ml fr, 120 ml

Laboratorio RANBAXY SANOFI-AVENTIS RANBAXY RANBAXY SANOFI-AVENTIS RANBAXY MEPHA-RATIOPHARM EUROFARMA MEDLEY NEO QUIMICA RANBAXY MEPHA-RATIOPHARM MEDLEY TEUTO BRAS, EMS GERMED TEUTO BRAS, GEN - LEGRAND GERMED EMS EMS GERMED GEN - LEGRAND EMS GERMED GEN - LEGRAND RANBAXY RANBAXY RANBAXY RANBAXY EMS GERMED EUROGENUS - LEGRAND PRATI DONADUZZI PRATI DONADUZZI EMS GERMED GEN - LEGRAND

UNIDADE Pco Unt Base A CPR 0,32 COMP 0,33 CPR 0,62 CPR 0,53 COMP 0,62 COMP 0,32 CPR 0,34 COMP 0,41 COMP 0,41 COMP 0,41 COMP 0,94 CPR 0,99 COMP 1,19 COMP 0,34 COMP 0,27 COMP 0,27 COMP 0,41 COMP 0,43 COMP 1,31 COMP 0,88 COMP 0,53 COMP 0,53 COMP 0,53 COMP 0,77 COMP 0,76 COMP 0,76 COMP 0,89 COMP 0,86 COMP 0,50 COMP 0,54 GOTA 7,57 GOTA 7,24 GOTA 7,56 ML 2,82 ML 3,63 ML 0,05 ML 0,05 ML 0,04

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3532 3533 3534 3535 3536 3537 3538 3539 3540 3541 3542 3543 3544 3545 3546 3547 3548 3549 3550 3551 3552 3553 3554 3555 3556 3557 3558 3559 3560 3561 3562 3563 3564 3565 3566 3567 3568 3569

CODIGO BENEFICIO 95926160 CLORIDRATO 95926186 CLORIDRATO 95015485 CLORIDRATO 95891307 CLORIDRATO 95891315 CLORIDRATO 95926208 CLORIDRATO 95993967 CLORIDRATO 95899383 CLORIDRATO 95015507 CLORIDRATO 95993975 CLORIDRATO 95027602 CLORIDRATO 95015493 CLORIDRATO 95993959 CLORIDRATO 95899375 CLORIDRATO 95993983 CLORIDRATO 95899391 CLORIDRATO 95015515 CLORIDRATO 95027610 CLORIDRATO 95074619 CLORIDRATO 95027629 CLORIDRATO 95036520 CLORIDRATO 95036512 CLORIDRATO 95027637 CLORIDRATO 95036539 CLORIDRATO 95036504 CLORIDRATO 95053557 CLORIDRATO 95053565 CLORIDRATO 95027645 CLORIDRATO 95891323 CLORIDRATO 95926216 CLORIDRATO 95926224 CLORIDRATO 95027653 CLORIDRATO 95015531 CLORIDRATO 95036547 CLORIDRATO 95994025 CLORIDRATO 95926232 CLORIDRATO 95926240 CLORIDRATO 95994033 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

APRESENTAÇÃO BROMEXINA - GENERICO 0,8 mg/mlxpe, 120 ml BROMEXINA - GENERICO 1,6 mg/ml xpe, 120 ml BUPIVACAINA - GENERICO s/v 0,5% 20 ml - cx, 25 FA BUPROPIONA - GENERICO 150 mg, 30 cprs, rev, BUPROPIONA - GENERICO 150 mg, 60 cprs, rev, BUSPIRONA - GENERICO 10 mg, fr, plast, 20 cprs, CEFEPIMA - GENERICO 1 g 50 FA+ 50 dil, CEFEPIMA - GENERICO 1 g po inj, FA+ bolsa flex, CEFEPIMA - GENERICO 1 g po p/sol, inj, 25 FA vd, CEFEPIMA - GENERICO 1 g po p/sol, inj, 25 FA vd,+ amp, dil, x 3 ml CEFEPIMA - GENERICO 1 g po p/sol, inj, ct, FA vd, x 17 ml CEFEPIMA - GENERICO 1 g po p/sol, inj, FA vd,+ amp, dil, vd, x 3 ml CEFEPIMA - GENERICO 1 gpop/sol,inj,FAvd, CEFEPIMA - GENERICO 1gpoinjFA+amp,dil, CEFEPIMA - GENERICO 2 g 25 FA+ 50 dil, CEFEPIMA - GENERICO 2 g po inj, FA CEFEPIMA - GENERICO 2 g po inj, FA+ bolsa flex, CEFEPIMA - GENERICO 2 g po p/sol, inj, ct, FA vd, x 17 ml CEFEPIMA - GENERICO 2 g po p/sol, inj, FA vd, CICLOBENZAPRINA - GENE 10 mg, bl, 15 cprs, rev, CICLOBENZAPRINA - GENE 10 mg, bl, 30 cprs, CICLOBENZAPRINA - GENE 10mg,bl, 30cprs,rev, CICLOBENZAPRINA - GENE 5 mg, bl, 15 cprs, rev, CICLOBENZAPRINA - GENE 5 mg, bl, 30 cprs, CICLOBENZAPRINA - GENE 5 mg, bl, 30 cprs, rev, CIPRO + DEXAMETASONA - GENERICO Sol, oft, fr, 5 ml CIPROF, + DEXAMETASONA - GENERICO Sol, oft, fr, 5 ml CIPROFLOXACINO - GENER 0,35% sol, oft, fr, 5 ml CIPROFLOXACINO - GENER 0,35% sol, oft, fr, 5 ml CIPROFLOXACINO - GENER 250 mg, 1 bl, 10 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 1 bl, x 6 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 14 cprs, CIPROFLOXACINO - GENER 250 mg, 14 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 14 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 14 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 2 bl, x 10 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 2 bl, x 7 cprs, rev, CIPROFLOXACINO - GENER 250 mg, 6 cprs, rev,

Laboratorio PRATI DONADUZZI PRATI DONADUZZI HYPOFARMA EUROFARMA EUROFARMA APOTEX EUROFARMA ABL AUROBINDO PHARMA AUROBINDO PHARMA NOVAFARMA AUROBINDO PHARMA AUROBINDO PHARMA ABL EUROFARMA ABL ABL NOVAFARMA AUROBINDO PHARMA EUROFARMA BRAINFARMA EUROFARMA EUROFARMA BRAINFARMA EUROFARMA EMS GEN - LEGRAND RANBAXY EMS AUROBINDO PHARMA AUROBINDO PHARMA SANDOZ MEDLEY EUROFARMA ARROW AUROBINDO PHARMA AUROBINDO PHARMA ARROW

UNIDADE Pco Unt Base A ML 0,07 ML 0,06 ML 0,43 COMP 1,80 COMP 1,97 CPR 0,45 F,A, 34,44 FA 38,93 FA 32,38 F,A, 35,25 FA 29,39 FA 35,24 F,A, 35,78 FA 35,58 F,A, 62,61 FA 64,68 FA 68,03 FA 53,42 FA 61,07 CPR 0,60 CP 0,58 CP 0,58 CPR 0,54 CP 0,52 CP 0,54 GOTA 0,35 GOTA 0,35 GOTA 0,07 GOTA 0,09 CPR 3,10 CPR 3,54 CPR 2,06 COMP 1,51 CP 1,22 COMP 3,08 CPR 2,94 CPR 3,35 COMP 3,15

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3570 3571 3572 3573 3574 3575 3576 3577 3578 3579 3580 3581 3582 3583 3584 3585 3586 3587 3588 3589 3590 3591 3592 3593 3594 3595 3596 3597 3598 3599 3600 3601 3602 3603 3604 3605 3606 3607

CODIGO BENEFICIO 95015566 CLORIDRATO 95036610 CLORIDRATO 95036571 CLORIDRATO 95036601 CLORIDRATO 95891331 CLORIDRATO 95891340 CLORIDRATO 95891358 CLORIDRATO 95891366 CLORIDRATO 95926267 CLORIDRATO 95015523 CLORIDRATO 95926259 CLORIDRATO 95994041 CLORIDRATO 95027670 CLORIDRATO 95027688 CLORIDRATO 95015540 CLORIDRATO 95036563 CLORIDRATO 95994050 CLORIDRATO 95926283 CLORIDRATO 95015574 CLORIDRATO 95926275 CLORIDRATO 95027696 CLORIDRATO 95036555 CLORIDRATO 95994068 CLORIDRATO 95015558 CLORIDRATO 95027700 CLORIDRATO 95036598 CLORIDRATO 95891374 CLORIDRATO 95036636 CLORIDRATO 95036628 CLORIDRATO 95036580 CLORIDRATO 95987541 CLORIDRATO 95027661 CLORIDRATO 95071253 CLORIDRATO 95071261 CLORIDRATO 95053573 CLORIDRATO 95027718 CLORIDRATO 95027726 CLORIDRATO 95027734 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

APRESENTAÇÃO CIPROFLOXACINO - GENER 250 mg, 7 cprs, rev, CIPROFLOXACINO - GENER 250 mg, com, rev, ct, bl, al, plas, inc, x 14 CIPROFLOXACINO - GENER 250 mg, com, rev, ct, bl, al, plas, inc, x 300 (emb, hosp,) CIPROFLOXACINO - GENER 250 mg, com, rev, ct, bl, al, plas, inc, x 6 CIPROFLOXACINO - GENER 3,5 mg/g bisn, 3,5 g CIPROFLOXACINO - GENER 3,5 mg/g bisn, 3,5 g CIPROFLOXACINO - GENER 3,5 mg/g pom, oft, bisn, 3,5 g CIPROFLOXACINO - GENER 3,5 mg/ml sol, oft, fr, 5 ml CIPROFLOXACINO - GENER 500 mg, 1 bl, 10 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 1 bl, x 10 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 1 bl,6cprs, rev, CIPROFLOXACINO - GENER 500 mg, 10 ce CIPROFLOXACINO - GENER 500 mg, 10 cprs, CIPROFLOXACINO - GENER 500 mg, 14 cprs, CIPROFLOXACINO - GENER 500 mg, 14 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 14 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 14 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 2 bl, x 7 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 2 x 7 cprs, CIPROFLOXACINO - GENER 500 mg, 2bl,x10cprs, rev, CIPROFLOXACINO - GENER 500 mg, 6 cprs, CIPROFLOXACINO - GENER 500 mg, 6 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 6 cprs, rev, CIPROFLOXACINO - GENER 500 mg, 7 cprs, rev, CIPROFLOXACINO - GENER 500 mg, bl, 14 cprs, rev, CIPROFLOXACINO - GENER 500 mg, bl, 14 cprs, rev, CIPROFLOXACINO - GENER 500 mg, bl, 14 cprs, rev, CIPROFLOXACINO - GENER 500 mg, com, rev, ct, bl, al, plas, inc, x 14 CIPROFLOXACINO - GENER 500 mg, com, rev, ct, bl, al, plas, inc, x 300 (emb, hosp,) CIPROFLOXACINO - GENER 500 mg, com, rev, ct, bl, al, plas, inc, x 6 CIPROFLOXACINO - GENER 500 mg, cx, 6 cprs, CIPROFLOXACINO - GENER 500mg,bl,6cprs,rev, CIPROFLOXACINO + DEXAMETASONA -Sol, GENERICO oft, fr, 5 ml CIPROFLOXACINO + DEXAMETASONA -Sol, GENERICO oft, fr, 5 ml CIPROFLOXACINO + DEXAMETASONA - 3,5 GENERICO mg/ml+ 1 mg/ml sol, oft, fr, 5 ml CLINDAMICINA - GENERIC 300 mg, 12 bl, x 6 caps, CLINDAMICINA - GENERIC 300 mg, 2 bl, x 8 caps, CLINDAMICINA - GENERIC 300 mg, 2 bl, x 8 caps,

Laboratorio MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GERMED GEN - LEGRAND EMS GERMED AUROBINDO PHARMA EMS AUROBINDO PHARMA NOVARTIS SANDOZ SANDOZ MEDLEY EUROFARMA ARROW AUROBINDO PHARMA ZYDUS AUROBINDO PHARMA SANDOZ EUROFARMA ARROW MEDLEY MERCK NEO QUIMICA BIOSINTETICA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA MERCK EMS GEN - LEGRAND GERMED EMS GERMED GEN - LEGRAND

UNIDADE Pco Unt Base A COMP 2,65 CP 1,14 CP 1,31 CP 2,42 GRAMA 2,09 GRAMA 2,09 GRAMA 2,42 GOTA 0,09 CPR 5,26 COMP 5,26 CPR 5,64 COMP 4,20 CPR 4,70 CPR 1,46 COMP 2,15 CP 3,05 COMP 4,93 CPR 1,51 COMP 2,16 CPR 4,50 CPR 5,39 CP 3,98 COMP 5,07 COMP 3,85 CPR 5,56 CP 2,27 COMP 4,30 CP 1,64 CP 2,13 CP 3,92 COMP 3,63 CPR 3,97 GOTA 0,14 GOTA 0,14 GOTA 0,14 CPR 2,29 CPR 2,27 CPR 2,03

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3608 3609 3610 3611 3612 3613 3614 3615 3616 3617 3618 3619 3620 3621 3622 3623 3624 3625 3626 3627 3628 3629 3630 3631 3632 3633 3634 3635 3636 3637 3638 3639 3640 3641 3642 3643 3644 3645

CODIGO BENEFICIO 95027742 CLORIDRATO 95015582 CLORIDRATO 95891390 CLORIDRATO 95036652 CLORIDRATO 95036687 CLORIDRATO 95994084 CLORIDRATO 95891404 CLORIDRATO 95036660 CLORIDRATO 95036644 CLORIDRATO 95036679 CLORIDRATO 95891412 CLORIDRATO 95036695 CLORIDRATO 95994092 CLORIDRATO 95891420 CLORIDRATO 95926291 CLORIDRATO 95994122 CLORIDRATO 95994130 CLORIDRATO 95994149 CLORIDRATO 95994157 CLORIDRATO 95994165 CLORIDRATO 95994173 CLORIDRATO 95036709 CLORIDRATO 95036717 CLORIDRATO 95053581 CLORIDRATO 95015590 CLORIDRATO 95015604 CLORIDRATO 95994181 CLORIDRATO 95994190 CLORIDRATO 95994203 CLORIDRATO 95053590 CLORIDRATO 95053603 CLORIDRATO 95015612 CLORIDRATO 95015620 CLORIDRATO 95891439 CLORIDRATO 95994211 CLORIDRATO 95027750 CLORIDRATO 95891447 CLORIDRATO 95994220 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

CLINDAMICINA - GENERIC CLINDAMICINA - GENERIC CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL - GENERICO CLOBUTINOL + SUCCINATO CLOBUTINOL + SUCCINATO CLOBUTINOL + SUCCINATO CLOBUTINOL + SUCCINATO CLOBUTINOL + SUCCINATO CLOMIPRAMINA - GENERIC CLOMIPRAMINA - GENERIC CLOMIPRAMINA - GENERIC CLOMIPRAMINA - GENERIC CLOMIPRAMINA - GENERIC CLOMIPRAMINA - GENERIC DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO DILTIAZEM - GENERICO

APRESENTAÇÃO 300 mg, 2 bl, x 8 cprs, 300 mg, bl, 16 caps, gel, dura 4 mg/ml xpe, fr, vd, x 120 ml+ cp, med, 4 mg/ml, xpe, ct, fr, vd, amb, x 120 ml,+ cp, med, 4 mg/ml, xpe, cx, 50 fr, vd, amb, x 120 ml,+ cp, med, (emb, 6 mg/ml sol, oral fr,20 ml 60 mg/ml sol, oral cx, 200 frs, 20 ml Fr, 120 ml Xpe, 4 mg/ml fr, 120 ml Xpe, 4 mg/ml fr, 120 ml 4+ 0,75 mg/ml xpe, fr, vd, 120 ml+ cp, med, 40 mg/ml+ 0,75 mg/ml xpe, 120 ml 48 mg/ml+ 9 mg/ml sol, oral, x 20 ml 48+ 9 mg/ml sol, oral, fr, plast, 20 ml Xpe, 120 ml 10 mg, 2 bl, x 10 cprs, 10 mg, 2 bl, x 10 cprs, 10 mg, 20 cprs, rev, 25 mg, 2 bl, 10 cprs, rev, 25 mg, 2 bl, x 10 cprs, 25 mg, 20 cprs, rev, 30 mg, 2 bl, x 25 cprs, 30 mg, 2 bl, x 25 cprs, 30 mg, 50 cprs, 30 mg, est, strip, 30 cprs, 30 mg, est, strip, 50 cprs, 30 mg, fr, 50 cprs, 30 mg, fr, 50 cprs, 30 mg, fr, x 50 cprs, 60 mg, 50 cprs, 60 mg, bl, 25 cprs, 60 mg, est, strip, 30 cprs, 60 mg, est, strip, 50 cprs, 60 mg, fr, 25 cprs, 60 mg, fr, 25 cprs, 60 mg, fr, 50 cprs, 60 mg, fr, 50 cprs, 60 mg, fr, 60 cprs,

Laboratorio EMS UNIAO QUIMICA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GERMED EMS GEN - LEGRAND PRATI DONADUZZI MEDLEY UNIAO QUIMICA PRATI DONADUZZI UNIAO QUIMICA GERMED GEN - LEGRAND EMS GEN - LEGRAND GERMED EMS EMS GERMED MEPHA-RATIOPHARM RANBAXY RANBAXY EMS GERMED GEN - LEGRAND MEPHA-RATIOPHARM GEN - LEGRAND RANBAXY RANBAXY EUROGENUS - LEGRAND GERMED GERMED EUROGENUS - LEGRAND GERMED

UNIDADE Pco Unt Base A CPR 2,29 CAPS 2,83 ML 0,04 ML 0,04 ML 0,02 GOTA 0,02 GOTA 4,28 ML 0,04 ML 0,04 ML 0,04 ML 0,06 ML 0,06 GOTA 0,02 GOTA 7,87 ML 0,06 COMP 0,26 COMP 0,31 COMP 0,32 COMP 0,68 COMP 0,70 COMP 0,70 CP 0,19 CP 0,19 COMP 0,19 COMP 0,18 COMP 0,18 COMP 0,15 COMP 0,17 COMP 0,19 COMP 0,37 COMP 0,31 COMP 0,35 COMP 0,35 COMP 0,26 COMP 0,27 CPR 0,37 COMP 0,26 COMP 0,20

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3646 3647 3648 3649 3650 3651 3652 3653 3654 3655 3656 3657 3658 3659 3660 3661 3662 3663 3664 3665 3666 3667 3668 3669 3670 3671 3672 3673 3674 3675 3676 3677 3678 3679 3680 3681 3682 3683

CODIGO BENEFICIO 95053611 CLORIDRATO 95036733 CLORIDRATO 95036725 CLORIDRATO 95027769 CLORIDRATO 95027777 CLORIDRATO 95027785 CLORIDRATO 95036741 CLORIDRATO 95065083 CLORIDRATO 95926321 CLORIDRATO 95984585 CLORIDRATO 95994246 CLORIDRATO 95027793 CLORIDRATO 95891463 CLORIDRATO 95891455 CLORIDRATO 95926356 CLORIDRATO 95015647 CLORIDRATO 95015639 CLORIDRATO 95027807 CLORIDRATO 95027815 CLORIDRATO 95027823 CLORIDRATO 95027831 CLORIDRATO 95036768 CLORIDRATO 95036750 CLORIDRATO 95994254 CLORIDRATO 95891471 CLORIDRATO 95994262 CLORIDRATO 95994270 CLORIDRATO 95891480 CLORIDRATO 95994289 CLORIDRATO 95027840 CLORIDRATO 95027858 CLORIDRATO 95994297 CLORIDRATO 95994300 CLORIDRATO 95027866 CLORIDRATO 95027874 CLORIDRATO 95027882 CLORIDRATO 95027890 CLORIDRATO 95015671 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

DILTIAZEM - GENERICO DOBUTAMINA - GENERICO DOBUTAMINA - GENERICO DOBUTAMINA - GENERICO DOBUTAMINA - GENERICO DOBUTAMINA - GENERICO DOPAMINA - GENERICO DOPAMINA - GENERICO DORZOLAMIDA - GENERICO DOXICICLINA - GENERICO DOXICICLINA - GENERICO DOXICICLINA - GENERICO DOXICICLINA - GENERICO DOXICICLINA - GENERICO DOXICICLINA - GENERICO DOXORRUBICINA - GENERI DOXORRUBICINA - GENERI FENOXAZOLINA - GENERIC FENOXAZOLINA - GENERIC FENOXAZOLINA - GENERIC FENOXAZOLINA - GENERIC FENOXAZOLINA - GENERIC FENOXAZOLINA - GENERIC FEXOFENADINA - GENERIC FEXOFENADINA - GENERIC FEXOFENADINA - GENERIC FEXOFENADINA - GENERIC FEXOFENADINA - GENERIC FEXOFENADINA - GENERIC FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO

APRESENTAÇÃO 60 mg,2 bl,x25cprs, 12,5 mg/ml sol, inj, IV amp, vd, x 20 ml 14,0 mg/ml cx, 10 amps, vd, x 20 ml 250 mg, inj, 50 amps, x 20 ml 250 mg, inj, 50 amps, x 20 ml 250 mg, inj, 50 amps, x 20 ml 5 mg/ml cx, 10 amps, 10 ml 5 mg/ml sol, inj, cx, 50 amps, vd, x 10 ml (hosp,) 2% sol, oft, fr, plast, got, x 5 ml 100 mg, 1 bl, x 15 100 mg, 1 bl, x 15 cprs, rev, 100 mg, 6 bl, x 10 cprs, rev, 100 mg, bl, 15 cprs, 100mg,1 bl,x15 cprs, Cx, 1 bl, x15 cprs, 10 mg, po liof, p/sol, inj, FA vd, 50 mg, po liof, p/sol, inj, FA vd, 0,5 mg/ml fr, 10 ml 0,5 mg/ml fr, 10 ml 1 mg/ml fr, 10 ml 1 mg/ml fr, 10 ml Sol, nasal ad, 1,0 mg/ml fr, 10 ml Sol, nasal inf, 0,5 mg/ml fr, 10 ml 120 mg, 10 cprs, 120 mg, bl, 10 cprs, 120 mg, bl, al, plast, opc x 10 cprs, rev, 180 mg, 10 cprs, 180 mg, bl, 10 cprs, 180 mg, bl, al, plast, opc x 10 cprs, rev, (C1) 10 mg, 2 bl, x 10 caps, (C1) 10 mg, 4 bl, x 10 caps, (C1) Capsulas - 4 blist, x 7 cprs, (C1) Gotas - Fr, x 20 ml 10 mg, 2 bl, x 10 caps, 10 mg, 2 bl, x 10 caps, 10 mg, 4 bl, x 7 caps, 10 mg, 4 bl, x 7 caps, 20 mg, 10 cprs,

Laboratorio GEN - LEGRAND NOVAFARMA HYPOFARMA EMS GERMED GEN - LEGRAND TEUTO BRAS, TEUTO BRAS, BIOSINTETICA GERMED GEN - LEGRAND EMS RANBAXY EMS EMS GLENMARK GLENMARK GERMED GEN - LEGRAND GERMED GEN - LEGRAND EMS EMS MEPHA-RATIOPHARM RANBAXY BRAINFARMA MEPHA-RATIOPHARM RANBAXY BRAINFARMA GEN - LEGRAND GEN - LEGRAND GEN - LEGRAND GEN - LEGRAND EMS GERMED EMS GERMED HEXAL

UNIDADE Pco Unt Base A COMP 0,35 AMP 14,80 AMP 14,83 AMP 6,67 AMP 6,67 AMP 6,30 AMP 0,91 AMP 0,83 GOTAS 0,30 COMP 1,27 COMP 1,35 CPR 1,58 COMP 1,48 COMP 1,47 CPR 1,85 FA 19,08 FA 79,32 GOTA 0,02 GOTA 0,02 GOTA 0,02 GOTA 0,02 ML 0,25 GOTA 0,02 COMP 2,04 COMP 2,04 COMP 1,93 COMP 2,93 COMP 3,11 COMP 2,95 CAPS 0,54 CPR 0,38 CAPS 1,39 GOTA 0,04 CPR 0,54 CPR 0,61 CPR 0,54 CPR 0,61 COMP 1,33

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3684 3685 3686 3687 3688 3689 3690 3691 3692 3693 3694 3695 3696 3697 3698 3699 3700 3701 3702 3703 3704 3705 3706 3707 3708 3709 3710 3711 3712 3713 3714 3715 3716 3717 3718 3719 3720 3721

CODIGO BENEFICIO 95053638 CLORIDRATO 95027904 CLORIDRATO 95926380 CLORIDRATO 95015663 CLORIDRATO 95027912 CLORIDRATO 95053620 CLORIDRATO 95027920 CLORIDRATO 95027939 CLORIDRATO 95926399 CLORIDRATO 95015698 CLORIDRATO 95053646 CLORIDRATO 95015680 CLORIDRATO 95027947 CLORIDRATO 95994319 CLORIDRATO 95926402 CLORIDRATO 95027955 CLORIDRATO 95036776 CLORIDRATO 95036784 CLORIDRATO 95891501 CLORIDRATO 95984593 CLORIDRATO 95891510 CLORIDRATO 95015655 CLORIDRATO 95994343 CLORIDRATO 95891528 CLORIDRATO 95994351 CLORIDRATO 95074643 CLORIDRATO 95074678 CLORIDRATO 95074660 CLORIDRATO 95074651 CLORIDRATO 95015701 CLORIDRATO 95994360 CLORIDRATO 95036792 CLORIDRATO 95036806 CLORIDRATO 95891536 CLORIDRATO 95071270 CLORIDRATO 95891552 CLORIDRATO 95027963 CLORIDRATO 95027971 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO FLUOXETINA - GENERICO GENCITABINA - GENERICO GENCITABINA - GENERICO GENCITABINA - GENERICO GENCITABINA - GENERICO IRINOTECANA - GENERICO IRINOTECANO - GENERICO IRINOTECANO - GENERICO IRINOTECANO - GENERICO LIDOCAINA - GENERICO LIDOCAINA - GENERICO LIDOCAINA - GENERICO LIDOCAINA - GENERICO LIDOCAINA - GENERICO

APRESENTAÇÃO 20 mg, 14 caps, 20 mg, 14 caps, gel, dura 20 mg, 14 cprs, 20 mg, 20 cprs, 20 mg, 20 cprs, 20 mg, 28 caps, 20 mg, 28 caps, gel, dura 20 mg, 28 cprs, 20 mg, 28 cprs, 20 mg, 3 x 10 caps, 20 mg, 30 caps, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, rev, 20 mg, 7 cprs, 20 mg, 70 cprs, 20 mg, bl, 30 cprs, 20 mg, bl, x 20 cprs, rev, 20 mg, cx, 2 bl, x 7 cprs, 20 mg, cx, 30 caps, 20 mg, cx, 4 bl, x 7 cprs, 20 mg, fr, plast, x 30 caps, gel, dura 20 mg, Reves - 3 blist, x 10 cprs, 20 mg/ml sol, oral fr, 20 ml 20 ml, gts, fr, 20 ml 1 g po liof, sol, inj, IV FA vd, x 50 ml 1000 mg, po liof, inj, FA vd, x 50 ml 200 mg, po liof, inj, FA vd, x 10 ml 200 mg, po liof, sol, inj, IV FA vd, x 10 ml 20 mg/ml sol, inj, FA vd, x 5 ml 100 mg, sol, inj, cx, 1 FA 5 ml 20 mg/ml sol, inj, IV FA vd, x 2 ml 20 mg/ml sol, inj, IV FA vd, x 5 ml 20 mg/g gel bisn, 30 g 20 mg/g gel top cx, 100 bg, al, x 30 g (hosp,) 20 mg/g geleia bisn, 30 g 20 mg/ml sol, inj, 12 FA vd, x 20 ml 20 mg/ml sol, inj, FA vd, x 20 ml

Laboratorio MEPHA-RATIOPHARM MEDLEY RATIOPHARM HEXAL SANDOZ MEPHA-RATIOPHARM MEDLEY TEUTO BRAS, RATIOPHARM ZYDUS MEPHA-RATIOPHARM HEXAL SANDOZ GERMED RATIOPHARM TEUTO BRAS, RANBAXY GERMED GERMED BIOSINTETICA GERMED MERCK GEN - LEGRAND MEDLEY GERMED EUROFARMA ACCORD ACCORD EUROFARMA BIOCHIMICO EUROFARMA GLENMARK GLENMARK EMS HIPOLABOR GEN - LEGRAND BLAUSIEGEL BLAUSIEGEL

UNIDADE Pco Unt Base A CAPS 1,34 CPR 1,75 CPR 1,13 COMP 0,78 CPR 1,17 CAPS 1,21 CPR 1,65 CPR 1,59 CPR 1,02 CAPS 1,17 CAPS 1,21 COMP 1,19 CPR 1,02 COMP 0,79 CPR 1,80 CPR 1,27 CP 0,74 CP 0,74 COMP 1,65 CAPS 1,79 COMP 1,39 COMP 1,28 COMP 0,79 GOTA 0,04 GOTA 0,04 FA 351,68 FA 351,71 FA 70,67 FA 70,67 FA 803,85 F,A, 736,31 FA 227,16 FA 563,41 GRAMA 0,34 G 0,10 GRAMA 0,34 FA 3,90 FA 3,59

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3722 3723 3724 3725 3726 3727 3728 3729 3730 3731 3732 3733 3734 3735 3736 3737 3738 3739 3740 3741 3742 3743 3744 3745 3746 3747 3748 3749 3750 3751 3752 3753 3754 3755 3756 3757 3758 3759

CODIGO BENEFICIO 95987550 CLORIDRATO 95987568 CLORIDRATO 95036814 CLORIDRATO 95891560 CLORIDRATO 95065105 CLORIDRATO 95065091 CLORIDRATO 95053654 CLORIDRATO 95926410 CLORIDRATO 95926429 CLORIDRATO 95027980 CLORIDRATO 95926437 CLORIDRATO 95891595 CLORIDRATO 95071300 CLORIDRATO 95926445 CLORIDRATO 95994386 CLORIDRATO 95053719 CLORIDRATO 95891609 CLORIDRATO 95015752 CLORIDRATO 95994394 CLORIDRATO 95994408 CLORIDRATO 95926453 CLORIDRATO 95015710 CLORIDRATO 95994416 CLORIDRATO 95994424 CLORIDRATO 95926461 CLORIDRATO 95891625 CLORIDRATO 95984607 CLORIDRATO 95994432 CLORIDRATO 95994440 CLORIDRATO 95926470 CLORIDRATO 95926488 CLORIDRATO 95891633 CLORIDRATO 95891641 CLORIDRATO 95891650 CLORIDRATO 95071296 CLORIDRATO 95926496 CLORIDRATO 95015736 CLORIDRATO 95015744 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

LINCOMICINA LINCOMICINA LINCOMICINA LINCOMICINA LINCOMICINA LINCOMICINA MEMANTINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA METFORMINA

- GENERI - GENERI - GENERI - GENERI - GENERICO - GENERICO GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO - GENERICO

APRESENTAÇÃO Inj, 300mg,cx,1 amp,1 ml Inj, 600 mg, cx,1 amp,2 ml Sol, inj, 600 mg/2mg cx, 1 amp, 2 ml Sol, inj, 600 mg/2mg cx, 1 amp, 2 ml 300 mg/ml 50 amps, c/1 ml (hosp,) 600 mg/2 ml 50 amps, c/2 ml (hosp,) Cx, 60 cprs, rev, 500 mg, cprs, rev, ct, 3 bl, al, plas, inc, x 10 850 mg, cprs, rev, ct, 3 bl, al, plas, inc, x 10 1 g 15 bl, x 6 cprs, rev, 1 g 3 bl, x 10 cprs, rev, 1 g 30 ce 1 g 30 cprs, rev, 1 g 30 cprs, rev, 1 g 30 cprs, rev, 1 g bl, 30 cprs, rev, 1 g bl, 30 cprs, rev, 1 g cx, c/30 1 mg, 3 bl, x 10 cprs, 1 mg, 3 bl, x 10 cprs, 500 mg 60 cprs, 500 mg, 15 bl, x 6 cprs, rev, 500 mg, 20 bl, x 10 cprs, rev, 500 mg, 3 bl, x 10 cprs, 500 mg, 3 bl, x 10 cprs, rev, 500 mg, 30 ce 500 mg, 30 cprs, 500 mg, 30 cprs, 500 mg, 30 cprs, rev, 500 mg, 5 bl, x 6 cprs, rev, 500 mg, 6 bl, x 10 cprs, rev, 500 mg, 60 cprs, rev, 500 mg, 60 cprs, ver 500 mg, bl, 60 cprs, rev, 500 mg, cx, 30 cprs, rev, 500 mg, cx, 30 cprs,rev, 500 mg, cx, c/30 500 mg, cx, c/60

Laboratorio NEO QUIMICA NEO QUIMICA TEUTO BRAS, TEUTO BRAS, NEO QUIMICA NEO QUIMICA APSEN PHARMACIA/PFIZER PHARMACIA/PFIZER EMS MEDLEY NOVARTIS AUROBINDO PHARMA MERCK EMS SANDOZ BIOSINTETICA AB FARMO QUIMICA GERMED GEN - LEGRAND MERCK EMS IPCA DO BRASIL GERMED MEDLEY NOVARTIS MERCK MEPHA-RATIOPHARM EMS RANBAXY MEDLEY EMS GERMED BIOSINTETICA AUROBINDO PHARMA BIOSINTETICA AB FARMO QUIMICA AUROBINDO PHARMA

UNIDADE Pco Unt Base A AMP 3,75 AMP 5,28 AMP 6,02 AMP 5,36 AMP 3,69 AMP 6,10 COMP 1,70 CPR 0,17 CPR 0,23 CPR 0,41 CPR 0,50 COMP 0,33 COMP 0,47 CPR 0,44 COMP 0,46 COMP 0,48 COMP 0,44 COMP 0,34 COMP 0,39 COMP 0,42 CPR 0,22 COMP 0,21 COMP 0,17 COMP 0,21 CPR 0,23 COMP 0,16 COMP 0,24 COMP 0,24 COMP 0,23 CPR 0,22 CPR 0,19 COMP 0,19 COMP 0,20 COMP 0,16 COMP 0,20 CPR 0,19 COMP 0,17 COMP 0,19

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3760 3761 3762 3763 3764 3765 3766 3767 3768 3769 3770 3771 3772 3773 3774 3775 3776 3777 3778 3779 3780 3781 3782 3783 3784 3785 3786 3787 3788 3789 3790 3791 3792 3793 3794 3795 3796 3797

CODIGO BENEFICIO 95053727 CLORIDRATO 95891617 CLORIDRATO 95926500 CLORIDRATO 95015728 CLORIDRATO 95994467 CLORIDRATO 95994475 CLORIDRATO 95926518 CLORIDRATO 95891684 CLORIDRATO 95053662 CLORIDRATO 95994483 CLORIDRATO 95071288 CLORIDRATO 95994491 CLORIDRATO 95926526 CLORIDRATO 95053670 CLORIDRATO 95926534 CLORIDRATO 95053689 CLORIDRATO 95891692 CLORIDRATO 95891706 CLORIDRATO 95071326 CLORIDRATO 95071342 CLORIDRATO 95071350 CLORIDRATO 95071318 CLORIDRATO 95071334 CLORIDRATO 95891714 CLORIDRATO 95071369 CLORIDRATO 95053697 CLORIDRATO 95053700 CLORIDRATO 95926542 CLORIDRATO 95015760 CLORIDRATO 95015779 CLORIDRATO 95891668 CLORIDRATO 95053735 CLORIDRATO 95891676 CLORIDRATO 95994521 CLORIDRATO 95994530 CLORIDRATO 95926550 CLORIDRATO 95994513 CLORIDRATO 95071377 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METFORMINA - GENERICO METOCLOPRAMIDA - GENER METOCLOPRAMIDA - GENER METOCLOPRAMIDA - GENER METOCLOPRAMIDA - GENER METOCLOPRAMIDA - GENERICO

APRESENTAÇÃO 500mg,bl,30cprs, rev, 500mg,bl,30cprs,rev, 850 mg 60 cprs, 850 mg, 15 bl, x 6 cprs, rev, 850 mg, 20 bl, x 10 cprs, rev, 850 mg, 3 bl, x 10 cprs, 850 mg, 3 bl, x 10 cprs, rev, 850 mg, 30 ce 850 mg, 30 cprs, 850 mg, 30 cprs, 850 mg, 30 cprs, rev, 850 mg, 30 cprs, rev, 850 mg, 5 bl, x 6 cprs, rev, 850 mg, 50 cprs, (hosp,) 850 mg, 6 bl, x 10 cprs, rev, 850 mg, 60 cprs, 850 mg, 60 cprs, rev, 850 mg, 60 cprs, ver 850 mg, bl, 105 cprs, rev, (hosp,) 850 mg, bl, 15 cprs, rev, 850 mg, bl, 210 cprs, rev, (hosp,) 850 mg, bl, 30 cprs, rev, 850 mg, bl, 450 cprs, rev, (hosp,) 850 mg, bl, 60 cprs, rev, 850 mg, bl, 600 cprs, rev, (hosp,) 850 mg, com, ct, bl, al, plas, inc, x 30 850 mg, com, ct, bl, al, plas, inc, x 400 (hosp,) 850 mg, cx, 30 cprs,rev, 850 mg, cx, c/30 850 mg, cx, c/60 850mg,6 bl,x10 cprs, 850mg,bl,30cprs, rev, 850mg,bl,30cprs,rev, 4 mg/ml fr, x 10 ml 4 mg/ml fr, x 10 ml 4 mg/ml, sol, oral 10 ml+ cgt, 4mg/mlgts,1fr,x10 ml 10 mg, bl, 20 cprs,

Laboratorio SANDOZ BRAINFARMA MERCK EMS IPCA DO BRASIL GERMED MEDLEY NOVARTIS TEUTO BRAS, MEPHA-RATIOPHARM AUROBINDO PHARMA EMS RANBAXY TEUTO BRAS, MEDLEY TEUTO BRAS, EMS GERMED ACCORD ACCORD ACCORD ACCORD ACCORD BIOSINTETICA ACCORD PRATI DONADUZZI PRATI DONADUZZI BIOSINTETICA AB FARMO QUIMICA AUROBINDO PHARMA RANBAXY SANDOZ BRAINFARMA GERMED GEN - LEGRAND MEDLEY EMS SANOFI-AVENTIS

UNIDADE Pco Unt Base A COMP 0,24 COMP 0,17 CPR 0,30 COMP 0,29 COMP 0,22 COMP 0,28 CPR 0,32 COMP 0,23 COMP 0,31 COMP 0,33 COMP 0,31 COMP 0,32 CPR 0,30 COMP 0,30 CPR 0,55 COMP 0,27 COMP 0,27 COMP 0,29 COMP 0,28 COMP 0,35 COMP 0,25 COMP 0,32 COMP 0,25 COMP 0,24 COMP 0,25 COMP 0,33 COMP 0,12 CPR 0,29 COMP 0,22 COMP 0,27 COMP 0,26 COMP 0,33 COMP 0,24 GOTA 0,01 GOTA 0,01 GOTAS 0,02 GOTA 0,02 COMP 0,17

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3798 3799 3800 3801 3802 3803 3804 3805 3806 3807 3808 3809 3810 3811 3812 3813 3814 3815 3816 3817 3818 3819 3820 3821 3822 3823 3824 3825 3826 3827 3828 3829 3830 3831 3832 3833 3834 3835

CODIGO BENEFICIO 95071393 CLORIDRATO 95053751 CLORIDRATO 95053743 CLORIDRATO 95071385 CLORIDRATO 95071407 CLORIDRATO 95926577 CLORIDRATO 95926569 CLORIDRATO 95994548 CLORIDRATO 95043403 CLORIDRATO 95043411 CLORIDRATO 95926585 CLORIDRATO 95036822 CLORIDRATO 95036830 CLORIDRATO 95994556 CLORIDRATO 95891722 CLORIDRATO 95994564 CLORIDRATO 95053760 CLORIDRATO 95015787 CLORIDRATO 95891730 CLORIDRATO 95891749 CLORIDRATO 95053840 CLORIDRATO 95015795 CLORIDRATO 95027998 CLORIDRATO 95053832 CLORIDRATO 95891757 CLORIDRATO 95028005 CLORIDRATO 95015809 CLORIDRATO 95053786 CLORIDRATO 95053824 CLORIDRATO 95053778 CLORIDRATO 95891765 CLORIDRATO 95028013 CLORIDRATO 95053794 CLORIDRATO 95053816 CLORIDRATO 95053808 CLORIDRATO 95028021 CLORIDRATO 95036849 CLORIDRATO 95994610 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

METOCLOPRAMIDA - GENERICO METOCLOPRAMIDA - GENERICO METOCLOPRAMIDA - GENERICO METOCLOPRAMIDA - GENERICO METOCLOPRAMIDA - GENERICO MINOCICLINA - GENERICO MINOCICLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NAFAZOLINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO NORTRIPTILINA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO

APRESENTAÇÃO 4 mg/ml sol, or, cx, 200 frs, plas, opc, got, x 10 ml (hosp,) 4 mg/ml sol, or, cx, 48 fr, plast, got, x 10 ml (hosp,) 4 mg/ml sol, or, fr, plast, got, x 10 ml 4 mg/ml sol, oral fr, vd, got, x 10 ml 5 mg/ml sol, inj, cx, 100 amps, vd, amb, x 2 ml (hosp,) 100 mg, 1 bl, x 9 cprs, 100mg,1bl,x30cprs, 0,5 mg/ml gts, fr, 30 ml 0,5 mg/ml sol, nas, ct, fr, plas, opc got, x 30 ml 0,5 mg/ml sol, nas, cx, 100 fr, plas, opc got, x 30 ml (emb, 0,5 mg/ml sol, nasal 1 fr, plast, transp, got, x 30 ml 0,5 mg/ml sol, nasal fr, 30 ml 0,5 mg/ml sol, nasal fr, plast, got, x 30 ml 0,5 mg/ml sol, nasal gts, fr, x 30 ml Sol, nasal 0,5 mg/ml Sol, nasal fr, 30 ml Sol, nasalfr, 30 ml 10 mg, bl, 20 caps, gel, dura 10 mg, bl, 30 caps, gel, dura 25 mg, 20 cs, 25 mg, bl, 20 caps, 25 mg, bl, 20 caps, gel, dura 25 mg, bl, 20 cprs, 25 mg, bl, 30 caps, 25 mg, bl, 30 caps, gel, dura 25 mg, bl, 30 cprs, 50 mg, bl, 20 caps, gel, dura 50 mg, bl, 20 caps, gel, dura 50 mg, bl, 30 caps, 50 mg, bl, 30 caps, gel, dura 50 mg, bl, 30 caps, gel, dura 50 mg, bl, 30 cprs, 75 mg, bl, 20 caps, gel, dura 75 mg, bl, 30 caps, 75 mg, bl, 30 caps, gel, dura 75 mg, bl, 30 cprs, 2 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml (hosp,) 4 mg, 1 bl, x 10 cprs, rev,

Laboratorio HIPOLABOR MARIOL MARIOL SANOFI-AVENTIS HIPOLABOR RANBAXY RANBAXY GEN - LEGRAND PRATI DONADUZZI PRATI DONADUZZI MEDLEY ARROW NEO QUIMICA EMS TEUTO BRAS, GERMED MEPHA-RATIOPHARM EUROFARMA EUROFARMA NOVARTIS RANBAXY EUROFARMA RANBAXY RANBAXY EUROFARMA RANBAXY EUROFARMA MEDLEY RANBAXY MEDLEY EUROFARMA RANBAXY MEDLEY RANBAXY MEDLEY RANBAXY NOVAFARMA IPCA DO BRASIL

UNIDADE Pco Unt Base A GOTA 0,00 GOTA 0,27 GOTA 0,01 GOTA 0,02 AMP 0,52 CPR 2,03 CPR 1,85 GOTA 0,01 GOTA 0,01 GOTA 0,60 GOTAS 0,01 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTA 6,35 GOTA 0,01 GOTA 0,35 CAPS 0,21 CAPS 0,32 CAPS 0,34 CAPS 0,50 CAPS 0,34 CPR 0,36 CAPS 0,50 CAPS 0,50 CPR 0,36 CAPS 0,49 CAPS 0,73 CAPS 0,73 CAPS 0,73 CAPS 0,73 CPR 0,65 CAPS 0,93 CAPS 0,98 CAPS 0,98 CPR 0,70 AMP 23,76 COMP 8,12

100

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3836 3837 3838 3839 3840 3841 3842 3843 3844 3845 3846 3847 3848 3849 3850 3851 3852 3853 3854 3855 3856 3857 3858 3859 3860 3861 3862 3863 3864 3865 3866 3867 3868 3869 3870 3871 3872 3873

CODIGO BENEFICIO 95994629 CLORIDRATO 95994637 CLORIDRATO 95994645 CLORIDRATO 95994653 CLORIDRATO 95015817 CLORIDRATO 95015825 CLORIDRATO 95028030 CLORIDRATO 95994661 CLORIDRATO 95015833 CLORIDRATO 95015841 CLORIDRATO 95015850 CLORIDRATO 95891790 CLORIDRATO 95891803 CLORIDRATO 95891781 CLORIDRATO 95891773 CLORIDRATO 95891811 CLORIDRATO 95891820 CLORIDRATO 95891838 CLORIDRATO 95891846 CLORIDRATO 95891854 CLORIDRATO 95994670 CLORIDRATO 95994688 CLORIDRATO 95926607 CLORIDRATO 95891862 CLORIDRATO 95994700 CLORIDRATO 95926623 CLORIDRATO 95891870 CLORIDRATO 95891889 CLORIDRATO 95053859 CLORIDRATO 95891897 CLORIDRATO 95891900 CLORIDRATO 95053867 CLORIDRATO 95891919 CLORIDRATO 95891927 CLORIDRATO 95891935 CLORIDRATO 95891943 CLORIDRATO 95891951 CLORIDRATO 95015868 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO ONDANSETRONA - GENERICO OXIBUTININA - GENERICO OXIBUTININA - GENERICO OXIBUTININA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO OXIMETAZOLINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO PAROXETINA - GENERICO

APRESENTAÇÃO 4 mg, 10 bl, x 10 cprs, rev, 4 mg, 3 bl, x 10 cprs, rev, 8 mg, 1 bl, x 10 cprs, rev, 8 mg, 10 bl, x 10 cprs, rev, 8 mg, 10 cprs, rev, 8 mg, 10 cprs, rev, 8 mg, 10 cprs, rev, 8 mg, 3 bl, x 10 cprs, rev, 1mg/mlxpe,fr,120ml 1mg/mlxpe,fr,120ml 1mg/mlxpe,fr,120ml 0,25 mg/ml sol, nasal fr, 20 ml ped, 0,25 mg/ml sol, nasal inf,20 ml 0,25 mg/ml sol, nasal20 ml 0,25mg/ml inf,fr,20 ml 0,5 mg/ml ad, fr, 20 ml 0,5 mg/ml sol, nasal ad, 10 ml 0,5 mg/ml sol, nasal ad, 30 ml 0,5 mg/ml sol, nasal fr, 30 ml ad, 0,50 mg/ml sol, nasal fr, 30 ml 20 mg, 2 bl, x 10 cprs, 20 mg, 2 bl, x 10 cprs, 20 mg, 20 cprs 20 mg, 20 cprs, rev, 20 mg, 3 bl, x 10 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, rev, 20 mg, bl, 20 cprs, 20 mg, bl, 20 cprs, rev, 20 mg, bl, 20 cprs, rev, 20 mg, bl, 30 cprs, 20 mg, bl, 30 cprs, rev, 20 mg, bl, 30 cprs, rev, 20 mg, cx, 20 cprs, 20 mg, cx, 30 cprs, 20 mg, fr, plast, 20 cprs, rev, 20 mg, fr, plast, 30 cprs, rev, 20 mg,3 x 10cprs,

Laboratorio IPCA DO BRASIL IPCA DO BRASIL IPCA DO BRASIL IPCA DO BRASIL EMS GERMED GEN - LEGRAND IPCA DO BRASIL EMS GERMED GEN - LEGRAND GEN - LEGRAND TEUTO BRAS, EMS GERMED GERMED TEUTO BRAS, TEUTO BRAS, GEN - LEGRAND EMS BIOSINTETICA BRAINFARMA MEPHA-RATIOPHARM EUROFARMA BRAINFARMA MEPHA-RATIOPHARM EUROFARMA RANBAXY MEDLEY FARMASA RANBAXY MEDLEY FARMASA ARROW ARROW MERCK MERCK ZYDUS

UNIDADE Pco Unt Base A COMP 7,52 COMP 7,51 COMP 8,12 COMP 7,52 COMP 9,16 COMP 6,87 CPR 8,02 COMP 7,52 ML 0,13 ML 0,12 ML 0,13 GOTA 4,86 GOTA 5,10 GOTA 4,74 GOTA 4,75 GOTA 0,02 GOTA 4,08 GOTA 7,31 GOTA 7,04 GOTA 7,30 COMP 2,39 COMP 2,39 CPR 2,47 COMP 2,50 COMP 2,39 CPR 2,33 COMP 2,43 COMP 2,13 COMP 1,88 COMP 2,26 COMP 2,13 COMP 1,84 COMP 1,84 COMP 1,72 COMP 1,93 COMP 2,62 COMP 2,57 COMP 1,68

101

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3874 3875 3876 3877 3878 3879 3880 3881 3882 3883 3884 3885 3886 3887 3888 3889 3890 3891 3892 3893 3894 3895 3896 3897 3898 3899 3900 3901 3902 3903 3904 3905 3906 3907 3908 3909 3910 3911

CODIGO BENEFICIO 95028048 CLORIDRATO 95994718 CLORIDRATO 95926666 CLORIDRATO 95053905 CLORIDRATO 95053930 CLORIDRATO 95053948 CLORIDRATO 95891960 CLORIDRATO 95994726 CLORIDRATO 95891978 CLORIDRATO 95891986 CLORIDRATO 95926674 CLORIDRATO 95053883 CLORIDRATO 95053921 CLORIDRATO 95053913 CLORIDRATO 95053875 CLORIDRATO 95926682 CLORIDRATO 95926690 CLORIDRATO 95994734 CLORIDRATO 95926712 CLORIDRATO 95053891 CLORIDRATO 95053956 CLORIDRATO 95053964 CLORIDRATO 95926720 CLORIDRATO 95926739 CLORIDRATO 95891994 CLORIDRATO 95892001 CLORIDRATO 95892010 CLORIDRATO 95892028 CLORIDRATO 95028056 CLORIDRATO 95028064 CLORIDRATO 95926755 CLORIDRATO 95015876 CLORIDRATO 95053999 CLORIDRATO 95028072 CLORIDRATO 95926763 CLORIDRATO 95926771 CLORIDRATO 95015922 CLORIDRATO 95926780 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

PETIDINA - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL - GENERICO PROPRANOLOL + HIDRO PROPRANOLOL + HIDRO PROPRANOLOL + HIDRO PROPRANOLOL + HIDRO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO RANITIDINA - GENERICO

APRESENTAÇÃO 50 mg/ml sol, inj, 25 amps, x 2 ml 10 mg, 2 bl, x 15 cprs, 10 mg, 4 bl, x 15 cprs, 10 mg, bl, 30 cprs, 10 mg, com, ct, bl, al, plas, inc, x 20 10 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 40 mg, 2 bl, x 10 cprs, 40 mg, 2 bl, x 15 cprs, 40 mg, 3 bl, x 10 cprs, 40 mg, 4 bl, x 10 cprs, 40 mg, 4 bl, x 15 cprs, 40 mg, bl, 30 cprs, 40 mg, com, ct, bl, al, plas, inc, x 20 40 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 40 mg, cx, 100 cprs, 40 mg, cx, 30 cprs, 40 mg, cx, 30 cprs, 80 mg, 2 bl, x 15 cprs, 80 mg, 4 bl, x 15 cprs, 80 mg, bl, 30 cprs, 80 mg, com, ct, bl, al, plas, inc, x 20 80 mg, com, ct, bl, al, plas, inc, x 600 (emb, hosp,) 80 mg, cx, 30 cprs, 80 mg, cx, 30 cprs, 40 mg,+ 25 mg, 2 bl, x 15 cprs, 40 mg,+ 25 mg, 2 bl, x 15 cprs, 80 mg,+ 25 mg, 2 bl, x 15 cprs, 80 mg,+ 25 mg, 2 bl, x 15 cprs, 150 mg 10 cprs, rev, 150 mg 20 cprs, rev, 150 mg cx, 2 str, x 10 cprs, 150 mg, 10 cprs, rev, 150 mg, 2 bl, x 10 cprs, 150 mg, 2 str, x 10 cprs, 150 mg, 20 ce 150 mg, 20 cprs, 150 mg, 3 str, x 10 cprs, rev, 150 mg, cx, 10 cprs,

Laboratorio UNIAO QUIMICA GERMED GERMED MEDLEY PRATI DONADUZZI PRATI DONADUZZI UNIAO QUIMICA GERMED UNIAO QUIMICA UNIAO QUIMICA GERMED MEDLEY PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, TEUTO BRAS, NEO QUIMICA GERMED GERMED MEDLEY PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, NEO QUIMICA GERMED GEN - LEGRAND GERMED GEN - LEGRAND SANDOZ SANDOZ APOTEX EMS GERMED AB FARMO QUIMICA NOVARTIS MEDLEY AB FARMO QUIMICA TEUTO BRAS,

UNIDADE Pco Unt Base A CPR 1,49 COMP 0,11 CPR 0,06 COMP 0,08 COMP 0,06 COMP 0,06 COMP 0,10 COMP 0,16 COMP 0,12 COMP 0,13 CPR 0,14 COMP 0,13 COMP 0,00 COMP 0,10 COMP 0,10 CPR 0,12 CPR 0,12 COMP 0,27 CPR 0,19 COMP 0,22 COMP 0,17 COMP 0,12 CPR 0,20 CPR 0,20 COMP 0,11 COMP 0,11 COMP 0,20 COMP 0,20 CPR 0,59 CPR 0,77 CPR 0,57 COMP 0,85 COMP 0,97 CPR 0,49 CPR 0,56 CPR 0,81 COMP 0,49 CPR 0,75

102

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3912 3913 3914 3915 3916 3917 3918 3919 3920 3921 3922 3923 3924 3925 3926 3927 3928 3929 3930 3931 3932 3933 3934 3935 3936 3937 3938 3939 3940 3941 3942 3943 3944 3945 3946 3947 3948 3949

CODIGO BENEFICIO 95053972 CLORIDRATO 95926798 CLORIDRATO 95994742 CLORIDRATO 95926801 CLORIDRATO 95926810 CLORIDRATO 95015930 CLORIDRATO 95892036 CLORIDRATO 95926747 CLORIDRATO 95036857 CLORIDRATO 95028080 CLORIDRATO 95015906 CLORIDRATO 95065121 CLORIDRATO 95045376 CLORIDRATO 95065113 CLORIDRATO 95028099 CLORIDRATO 95028102 CLORIDRATO 95926828 CLORIDRATO 95926836 CLORIDRATO 95036865 CLORIDRATO 95015884 CLORIDRATO 95028110 CLORIDRATO 95926852 CLORIDRATO 95926860 CLORIDRATO 95036890 CLORIDRATO 95053980 CLORIDRATO 95926879 CLORIDRATO 95926887 CLORIDRATO 95926895 CLORIDRATO 95071423 CLORIDRATO 95071415 CLORIDRATO 95926909 CLORIDRATO 95926917 CLORIDRATO 95028129 CLORIDRATO 95892044 CLORIDRATO 95028137 CLORIDRATO 95036873 CLORIDRATO 95994769 CLORIDRATO 95994777 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA RANITIDINA

APRESENTAÇÃO 150 mg, cx, 10 envs, x 10 cprs, rev, 150 mg, cx, 20 cprs, 150 mg, cx, 20 cprs, 150 mg, cx, 20 cprs, rev, 150 mg, fr, 20 cprs, 150 mg, str, 10 cprs, rev, 150mg,2 bl,x10 cprs, 150mg,cx,10cprs,rev, 150mg/10mlfr,120 ml 25 mg, cx, 100 x 2 ml 25 mg/ml cx, 100 amps, x 2 ml 25 mg/ml sol, inj, 2 ml c/120 25 mg/ml sol, inj, cx, 100 amps, x 2 ml 25 mg/ml sol, inj, cx, 100 amps, x 2 ml 25 mg/ml sol, inj, cx, 50 amps, vd, amb, x 2 ml 300 mg 10 cprs, rev, 300 mg cx, 2 str, x 10 cprs, 300 mg, 10 ce 300 mg, 10 cprs, 300 mg, 10 cprs, rev, 300 mg, 2 str, x 10 cprs, 300 mg, 20 ce 300 mg, 20 cprs, 300 mg, 20 cprs, rev, 300 mg, 4 bl, x 5 cprs, 300 mg, 5 str, x 4 cprs, 300 mg, cx, 10 cprs, 300 mg, cx, 10 cprs, rev, 300 mg, cx, 100 cprs, (hosp,) 300 mg, cx, 20 cprs, rev, 300 mg, cx, 20 cprs, rev, 300 mg, cx, 30 cprs, rev, 300 mg, str, 10 cprs, 300mg,2 bl,x10 cprs, 50 mg, inj, 100 amps, x 2 ml Fr, 120 ml Sol, inj, 25 mg/ml cx, 5 amps, x 2 ml Sol, inj, 5 amps, 2 ml

Laboratorio TEUTO BRAS, TEUTO BRAS, EMS ATIVUS MERCK AB FARMO QUIMICA RANBAXY ATIVUS EMS HYPOFARMA FARMACE TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, NOVAFARMA SANDOZ APOTEX NOVARTIS MEDLEY EMS AB FARMO QUIMICA NOVARTIS MEDLEY SANDOZ GERMED EMS TEUTO BRAS, ATIVUS TEUTO BRAS, TEUTO BRAS, ATIVUS ATIVUS AB FARMO QUIMICA RANBAXY EMS GERMED TEUTO BRAS, UNIAO QUIMICA

UNIDADE Pco Unt Base A COMP 0,49 CPR 0,70 COMP 0,81 CPR 0,71 CPR 0,72 COMP 0,50 COMP 0,64 CPR 0,51 ML 0,17 FR 0,58 AMP 1,02 AMP 1,09 COMP 0,70 AMP 0,76 AMP 0,93 CPR 1,54 CPR 1,03 CPR 1,06 CP 1,60 COMP 1,61 CPR 0,76 CPR 1,04 CPR 1,55 CP 1,53 COMP 1,81 CPR 1,55 CPR 1,26 CPR 1,12 COMP 1,10 COMP 1,26 CPR 1,42 CPR 0,89 CPR 1,03 COMP 1,05 AMP 0,76 ML 0,16 AMP 1,06 AMP 0,86

103

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3950 3951 3952 3953 3954 3955 3956 3957 3958 3959 3960 3961 3962 3963 3964 3965 3966 3967 3968 3969 3970 3971 3972 3973 3974 3975 3976 3977 3978 3979 3980 3981 3982 3983 3984 3985 3986 3987

CODIGO BENEFICIO 95994785 CLORIDRATO 95036881 CLORIDRATO 95028145 CLORIDRATO 95028153 CLORIDRATO 95028161 CLORIDRATO 95994793 CLORIDRATO 95015965 CLORIDRATO 95016015 CLORIDRATO 95016040 CLORIDRATO 95015973 CLORIDRATO 95036920 CLORIDRATO 95054014 CLORIDRATO 95926925 CLORIDRATO 95071440 CLORIDRATO 95016007 CLORIDRATO 95016031 CLORIDRATO 95071431 CLORIDRATO 95015990 CLORIDRATO 95016023 CLORIDRATO 95015981 CLORIDRATO 95926933 CLORIDRATO 95015949 CLORIDRATO 95054006 CLORIDRATO 95015957 CLORIDRATO 95016058 CLORIDRATO 95994807 CLORIDRATO 95926941 CLORIDRATO 95043420 CLORIDRATO 95892087 CLORIDRATO 95043438 CLORIDRATO 95926950 CLORIDRATO 95926968 CLORIDRATO 95926976 CLORIDRATO 95926984 CLORIDRATO 95036903 CLORIDRATO 95036911 CLORIDRATO 95892052 CLORIDRATO 95892060 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

RANITIDINA - GENERICO RANITIDINA - GENERICO ROPIVACAINA - GENERICO ROPIVACAINA - GENERICO ROPIVACAINA - GENERICO SELEGILINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO SERTRALINA - GENERICO

APRESENTAÇÃO Sol, inj, 50 amps, 2 ml Xpe, fr, 120 ml 10 mg/ml sol, inj, 5 amps, x 20 ml 2 mg/ml sol, inj, 5 amps, x 20 ml 7,5 mg/ml sol, inj, 5 amps, x 20 ml Compr, 5 mg, fl, plast, x 30 100 mg, 14 cprs, rev, 100 mg, 2 bl, x 7 cprs, rev, 100 mg, 2 bl, x 7 cprs, rev, 100 mg, bl, 20 cprs, rev, 100 mg, x 14 100mg,bl,14cprs,rev, 50 mg, 10 cprs, 50 mg, 2 bl, x 10 cprs, 50 mg, 2 bl, x 10 cprs, rev, 50 mg, 2 bl, x 10 cprs, rev, 50 mg, 2 bl, x 14 cprs, 50 mg, 2 bl, x 14 cprs, rev, 50 mg, 2 bl, x 14 cprs, rev, 50 mg, 20 ce 50 mg, 20 cprs, 50 mg, 20 cprs, rev, 50 mg, 28 cprs, 50 mg, 28 cprs, rev, 50 mg, 3 x 10 cprs, 50 mg, 30 ce 50 mg, 30 cprs, 50 mg, bl, 20 cprs, rev, 50 mg, bl, 30 cprs, 50 mg, bl, 30 cprs, rev, 50 mg, rev, ct, 2 bl, al, plast, inc, x 15 50 mg, rev, ct, bl, al, plast, inc, x 10 50 mg, rev, ct, bl, al, plast, inc, x 20 50 mg, rev, ct, bl, al, plast, inc, x 28 50 mg, x 20 50 mg, x 60 50mg,bl,10cprs,rev, 50mg,bl,20cprs,rev,

Laboratorio UNIAO QUIMICA GEN - LEGRAND EUROFARMA EUROFARMA EUROFARMA APOTEX EMS GERMED GEN - LEGRAND EUROFARMA MEDLEY AUROBINDO PHARMA RATIOPHARM EUROFARMA GERMED GEN - LEGRAND EUROFARMA GERMED GEN - LEGRAND NOVARTIS MEPHA-RATIOPHARM EMS MEPHA-RATIOPHARM EMS ZYDUS NOVARTIS MEPHA-RATIOPHARM SANDOZ RANBAXY SANDOZ BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA MEDLEY MEDLEY BRAINFARMA BRAINFARMA

UNIDADE Pco Unt Base A AMP 0,91 ML 0,17 AMP 24,58 AMP 13,33 AMP 18,17 COMP 0,71 COMP 3,83 COMP 3,82 COMP 3,75 COMP 3,72 CP 2,88 COMP 4,22 CPR 1,43 COMP 1,96 COMP 2,02 COMP 1,97 COMP 1,78 COMP 1,90 COMP 1,87 COMP 1,36 CPR 1,60 COMP 2,02 COMP 1,71 COMP 1,91 COMP 1,38 COMP 1,61 CPR 1,70 CP 1,43 COMP 1,38 CP 1,68 CPR 2,27 CPR 1,97 CPR 1,81 CPR 1,71 CP 1,38 CP 1,22 COMP 1,45 COMP 1,37

104

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 3988 3989 3990 3991 3992 3993 3994 3995 3996 3997 3998 3999 4000 4001 4002 4003 4004 4005 4006 4007 4008 4009 4010 4011 4012 4013 4014 4015 4016 4017 4018 4019 4020 4021 4022 4023 4024 4025

CODIGO BENEFICIO 95892079 CLORIDRATO 95054022 CLORIDRATO 95016066 CLORIDRATO 95036938 CLORIDRATO 95036954 CLORIDRATO 95054030 CLORIDRATO 95036989 CLORIDRATO 95016074 CLORIDRATO 95036962 CLORIDRATO 95054057 CLORIDRATO 95036997 CLORIDRATO 95054049 CLORIDRATO 95036970 CLORIDRATO 95926992 CLORIDRATO 95028170 CLORIDRATO 95927000 CLORIDRATO 95892095 CLORIDRATO 95994823 CLORIDRATO 95037020 CLORIDRATO 95994831 CLORIDRATO 95994840 CLORIDRATO 95994815 CLORIDRATO 95028188 CLORIDRATO 95016090 CLORIDRATO 95016104 CLORIDRATO 95927018 CLORIDRATO 95028226 CLORIDRATO 95892109 CLORIDRATO 95994858 CLORIDRATO 95028196 CLORIDRATO 95028200 CLORIDRATO 95028218 CLORIDRATO 95927050 CLORIDRATO 95016082 CLORIDRATO 95037004 CLORIDRATO 95037012 CLORIDRATO 95892117 CLORIDRATO 95892125 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

SERTRALINA - GENERICO SERTRALINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SIBUTRAMINA - GENERICO SOTALOL - GENERICO SOTALOL - GENERICO SOTALOL - GENERICO SOTALOL - GENERICO TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI TERBINAFINA - GENERI

APRESENTAÇÃO 50mg,bl,28 cprs, rev, 50mg,bl,28cprs,rev, 10 mg, 3 bl, x 10 caps, gel, dura 10 mg, 30 cprs, 10 mg, 30 cprs, 10 mg, est, bl, 3 x 10 cprs, 10mg,10caps,geldura 15 mg, 3 bl, x 10 caps, gel, dura 15 mg, 30 cprs, 15 mg, bl, 10 caps, gel, dura 15 mg, bl, 30 caps, gel dura 15 mg, est, bl, 3 x 10 cprs, 15mg,10caps,geldura 120 mg, ct, 3 bl, al, plast, inc, x 10 160 mg, 20 cprs, 160 mg, ct, 2 bl, al, plast, inc, x 10 160mg,2 bl,x10 cprs, 10 mg/g - sol, top, fr, x 30 ml 10 mg/g crem, ct, bg, al, x 20 g 10 mg/g sol, gts, fr, x 30 ml 10 mg/g spray - fr, x 30 ml 10 mg/g -spray - fr, x 30 ml 125 mg,1bl,x14cprs, 250 mg cx, 14 cprs, 250 mg cx, 28 cprs, 250 mg, 4 bl, x 7 cprs, 250 mg, 9 bl, x 10 cprs, 250 mg, bl, 14 cprs, 250 mg, cx, 1 bl, x 14 cprs, 250 mg,1bl,x14cprs, 250 mg,1bl,x7cprs, 250 mg,2bl,x14cprs, Creme 20 g Creme bisn, 20 g Creme bisn, 20 g Creme bisn, x 20 g Sol, top, 30 ml Sol, top, fr, 30 ml

Laboratorio MERCK AUROBINDO PHARMA MEDLEY BIOSINTETICA EUROFARMA RANBAXY MEDLEY MEDLEY EUROFARMA SANDOZ SANDOZ RANBAXY MEDLEY BIOSINTETICA SANDOZ BIOSINTETICA RANBAXY EMS PRATI DONADUZZI GEN - LEGRAND GEN - LEGRAND EMS MEDLEY EMS EMS RANBAXY EMS RANBAXY APOTEX MEDLEY MEDLEY MEDLEY PRATI DONADUZZI EMS GERMED GEN - LEGRAND PRATI DONADUZZI GERMED

UNIDADE Pco Unt Base A COMP 1,14 COMP 1,87 CAPS 1,44 CP 1,30 CP 1,72 COMP 1,14 CP 1,44 CAPS 1,66 CP 1,97 CAPS 1,59 CP 1,59 COMP 1,34 CP 1,66 CPR 1,05 CPR 1,56 CPR 1,52 COMP 0,94 JATO 0,09 G 0,67 GOTA 0,03 JATO 0,08 JATO 0,09 CPR 2,26 COMP 4,06 COMP 4,04 CPR 2,95 CPR 4,04 COMP 2,97 COMP 2,59 CPR 3,98 CPR 4,25 CPR 3,96 G 0,41 GRAMA 0,69 G 0,48 G 0,40 GOTAS 0,04 ML 0,55

105

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4026 4027 4028 4029 4030 4031 4032 4033 4034 4035 4036 4037 4038 4039 4040 4041 4042 4043 4044 4045 4046 4047 4048 4049 4050 4051 4052 4053 4054 4055 4056 4057 4058 4059

CODIGO BENEFICIO 95892133 CLORIDRATO 95071504 CLORIDRATO 95071466 CLORIDRATO 95071474 CLORIDRATO 95071490 CLORIDRATO 95071482 CLORIDRATO 95071458 CLORIDRATO 95927069 CLORIDRATO 95037047 CLORIDRATO 95037039 CLORIDRATO 95892141 CLORIDRATO 95927077 CLORIDRATO 95892150 CLORIDRATO 95892168 CLORIDRATO 95054065 CLORIDRATO 95054090 CLORIDRATO 95054103 CLORIDRATO 95054073 CLORIDRATO 95054081 CLORIDRATO 95043446 CLORIDRATO 95043462 CLORIDRATO 95054111 CLORIDRATO 95043454 CLORIDRATO 95043470 CLORIDRATO 95054120 CLORIDRATO 95054138 CLORIDRATO 95054154 CLORIDRATO 95071512 CLORIDRATO 95054146 CLORIDRATO 95054162 CLORIDRATO 95071520 CLORIDRATO 95071539 CLORIDRATO 95016139 CLORIDRATO 95071547 CLORIDRATO

DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE

TERBINAFINA - GENERI TERBINAFINA - GENERICO TERBINAFINA - GENERICO TERBINAFINA - GENERICO TERBINAFINA - GENERICO TERBINAFINA - GENERICO TERBINAFINA - GENERICO TETRAC, + ANFOTER, B TETRAC, + ANFOTER, B TETRAC, + ANFOTER, B TETRAC, + ANFOTER, B TETRAC, + ANFOTER, B TETRAC, + ANFOTER, B TETRAC, + ANFOTER, B TETRACICLINA - GENERICO TETRACICLINA - GENERICO TETRACICLINA - GENERICO TETRACICLINA - GENERICO TETRACICLINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TICLOPIDINA - GENERICO TIZANIDINA - GENERICO TIZANIDINA - GENERICO TRAMADOL - GENERICO TRAMADOL - GENERICO

APRESENTAÇÃO Laboratorio Spray fr, 30 ml GERMED 10 mg/g crem, cx, 100 bg al, x 20 g (hosp,) HIPOLABOR 250 mg, com, ct, bl, al, plas, inc, x 14 PRATI DONADUZZI 250 mg, com, ct, bl, al, plas, inc, x 140 PRATI DONADUZZI 250 mg, com, ct, bl, al, plas, inc, x 28 PRATI DONADUZZI 250 mg, com, ct, bl, al, plas, inc, x 420 (hosp,) PRATI DONADUZZI 250 mg, com, ct, bl, al, plas, inc, x 7 PRATI DONADUZZI 1 bisn, 45 g creme vag, CRISTALIA 25 mg/g+ 12,5 mg/g crem, vag, ct, bg, al, x 60 g+ 14 aplic PRATI DONADUZZI 25 mg/g+ 12,5 mg/g crem, vag, cx, 50 bg, al, x 45 g+ 500 a PRATI DONADUZZI 25 mg/g+ 12,5 mg/g creme vag, bisn, 45 g+ 10 aplic, vag, PRATI DONADUZZI Creme vag, bisn, 45 g EMS Creme vag, bisn, 45 g+ 10 aplic, GERMED Creme vag, bisn, 45 g+ 10 aplic, GEN - LEGRAND 500 mg, cap gel, dura ct, bl, al, plas, inc, x 12 PRATI DONADUZZI 500 mg, cx, 8 caps, MEDQUIMICA 500 mg, cx, 80 caps, MEDQUIMICA 500mg,cap gel, duract, bl, al, plas, inc, x 100(emb, hosp,) PRATI DONADUZZI 500mg,cap gel, duract, bl, al, plas, inc, x 300(emb, hosp,) PRATI DONADUZZI 250 mg, 2 bl, x 10 cprs, rev, GERMED 250 mg, 2 bl, x 10 cprs, rev, GEN - LEGRAND 250 mg, 2 bl, x 10 cprs, rev, EMS 250 mg, 3 bl, x 10 cprs, rev, GERMED 250 mg, 3 bl, x 10 cprs, rev, GEN - LEGRAND 250 mg, 3 bl, x 15 cprs, rev, EMS 250 mg, bl, 20 cprs, rev, EUROFARMA 250 mg, bl, 20 cprs, rev, MEDLEY 250 mg, bl, 20 cprs, rev, SANOFI-AVENTIS 250 mg, bl, 30 cprs, rev, EUROFARMA 250 mg, bl, 30 cprs, rev, MEDLEY 2 mg, 2 bl, x 10 cprs, RANBAXY 2 mg, 3 bl, x 10 cprs, RANBAXY 100 mg,sol,gts,10 ml RATIOPHARM 100 mg/ml sol, oral fr, plast, got, x 10 ml NEO QUIMICA

4060 95028242 CLORIDRATO DE TRAMADOL - GENERICO

50 mg 10 cprs,

SANDOZ

4061 95892176 CLORIDRATO DE TRAMADOL - GENERICO 4062 95892184 CLORIDRATO DE TRAMADOL - GENERICO 4063 95994866 CLORIDRATO DE TRAMADOL - GENERICO

50 mg, 1 bl, x 10 cprs, 50 mg, 1 bl, x 10 cprs, 50 mg, 1 blist, x 10 caps, gel

GERMED GEN - LEGRAND EMS

UNIDADE Pco Unt Base A DOSE 0,03 G 0,37 COMP 2,84 COMP 2,22 COMP 2,31 COMP 1,98 COMP 3,29 G 0,30 G 0,19 G 0,23 GRAMA 20,47 G 0,43 G 0,34 G 0,40 CAPS 1,12 CAPS 1,07 CAPS 0,86 CAPS 0,68 CAPS 0,37 CP 1,28 CP 1,14 COMP 1,28 CP 1,28 CP 1,28 COMP 0,65 COMP 1,28 COMP 1,21 COMP 1,08 COMP 1,28 COMP 1,28 COMP 0,58 COMP 0,60 GOTA 0,16 GOTA 0,17 CPR

1,58

COMP COMP CAPS

1,72 1,71 1,81

106

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4064 4065 4066 4067 4068 4069 4070 4071 4072 4073 4074 4075 4076 4077 4078 4079 4080 4081 4082 4083 4084 4085 4086 4087 4088 4089 4090 4091 4092 4093 4094 4095 4096 4097 4098 4099 4100 4101

CODIGO BENEFICIO 95054170 CLORIDRATO DE TRAMADOL - GENERICO 95994874 CLORIDRATO DE TRAMADOL - GENERICO 95054189 CLORIDRATO DE TRAMADOL - GENERICO 95048413 CLORIDRATO DE TRAMADOL - GENERICO 95048421 CLORIDRATO DE TRAMADOL - GENERICO 95994882 CLORIDRATO DE TRAMADOL - GENERICO 95994890 CLORIDRATO DE TRAMADOL - GENERICO 95984615 CLORIDRATO DE TRAMADOL - GENERICO 95994920 CLORIDRATO DE TRAMADOL - GENERICO 95994912 CLORIDRATO DE TRAMADOL - GENERICO 95016147 CLORIDRATO DE VANCOMICINA - GENERICO 95071563 CLORIDRATO DE VENLAFAXINA - GENERICO 95028250 CLORIDRATO DE VENLAFAXINA - GENERICO 95054227 CLORIDRATO DE VENLAFAXINA - GENERICO 95028269 CLORIDRATO DE VENLAFAXINA - GENERICO 95054200 CLORIDRATO DE VENLAFAXINA - GENERICO 95054219 CLORIDRATO DE VENLAFAXINA - GENERICO 95071555 CLORIDRATO DE VENLAFAXINA - GENERICO 95028277 CLORIDRATO DE VENLAFAXINA - GENERICO 95028285 CLORIDRATO DE VENLAFAXINA - GENERICO 95054197 CLORIDRATO DE VENLAFAXINA - GENERICO 95028293 CLORIDRATO DE VERAPAMIL - GENERICO 95028307 CLORIDRATO DE VERAPAMIL - GENERICO 95994939 CLORIDRATO DE VERAPAMIL - GENERICO 95994947 CLORIDRATO DE VERAPAMIL - GENERICO 95028315 CLORIDRATO DE VERAPAMIL - GENERICO 95994955 CLORIDRATO DE VERAPAMIL - GENERICO 95028323 CLORIDRATO DE VERAPAMIL - GENERICO 95054243 CLORIDRATO DE VERAPAMIL - GENERICO 95054251 CLORIDRATO DE VERAPAMIL - GENERICO 95054235 CLORIDRATO DE VERAPAMIL - GENERICO 95043489 CLORIDRATO DE VERAPAMIL - GENERICO 95096876 CLORIDRATO DE AMBROXOL - GENERICO

APRESENTAÇÃO 50 mg, bl, 10 caps, gel, dura 50 mg, bl, 10 caps, gel, dura 50 mg, bl, 50 caps, gel, dura (hosp,) 50 mg/ml sol, inj, 60 amps, vd, amb, x 1 ml (hosp,) 50 mg/ml sol, inj, 60 amps, vd, amb, x 2 ml (hosp,) 50 mg/ml sol, inj, cx, 50 amps, x 1 ml 50 mg/ml sol, inj, cx, 50 amps, x 2 ml 50 mg/ml sol, inj, cx, 6 amps,x1 ml Sol,oral100 mg,fr,15 ml Sol,oral100mg,15ml 500 mg, po liof, inj, 50 FA vd, (hosp,) 150 mg, 14 caps, 150 mg, 15 cprs, 150 mg, 30 caps, gel, dura lib, control, 150 mg, 30 cprs, 37,5 mg, x 28 50 mg, x 30 75 mg, 14 caps, 75 mg, 15 cprs, 75 mg, 30 cprs, 75 mg, x 28 120 mg 20 cprs, AP 240 mg, 30 cprs, RT 80 mg, 3 bl, x 10 cprs, 80 mg, 3 bl, x 10 cprs, 80 mg, 30 cprs, 80 mg, 30 cprs, rev, 80 mg, 9 bl, x 10 cprs, rev, 80 mg, com, ct, bl, al, plas, opc, x 30 80 mg, com, rev, ct, bl, al, plas, opc, x 800 (hosp,) 80 mg, cx, 150 cprs, 80 mg, cx, 30 cprs, 3 mg/ml xpe, 100 ml cx, c/60

Laboratorio TEUTO BRAS, MEDLEY TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA GEN - LEGRAND GERMED EUROFARMA EUROFARMA MEDLEY MEDLEY MEDLEY BIOSINTETICA BIOSINTETICA EUROFARMA MEDLEY MEDLEY BIOSINTETICA SANDOZ SANDOZ GERMED GEN - LEGRAND SANDOZ EMS EMS PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, BIOSINTETICA FARMACE

95096884 CLORIDRATO DE AMBROXOL - GENERICO 95083723 CLORIDRATO DE AMBROXOL - GENERICO 95096892 CLORIDRATO DE AMBROXOL - GENERICO 95250506 CLORIDRATO DE AMBROXOL - GENERICO 95250565 CLORIDRATO DE AMBROXOL - GENERICO

3 mg/ml xpe, 120 ml cx, c/60 3 mg/ml xpe, 50 frs, pet, 120 ml+ 50 cp, med, (hosp,) 3 mg/ml xpe, CT 100 ml - frasco 3 mg/ml xpe, ped, 120 ml,+ CM 3 mg/ml xpe, ped, fr, 120 ml+ cp-med,

FARMACE TEUTO BRAS, FARMACE ABBOTT MEDLEY

UNIDADE Pco Unt Base A CAPS 1,63 CAPS 1,72 CAPS 1,41 AMP 2,84 AMP 4,06 AMP 2,91 AMP 4,17 AMP 3,25 GOTA 0,17 GOTA 0,13 FA 12,13 CAPS 5,41 CPR 5,44 CAPS 5,44 CPR 4,85 COMP 1,70 COMP 1,95 CAPS 3,77 CPR 3,84 CPR 2,63 COMP 2,52 CPR 0,89 CPR 1,29 COMP 0,43 COMP 0,36 CPR 0,46 COMP 0,49 CPR 0,44 COMP 0,48 COMP 0,21 COMP 0,32 CP 0,41 ML 0,03 ML ML ML ML ML

0,04 0,05 0,06 0,06 0,09

107

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4102 4103 4104 4105 4106 4107 4108 4109 4110 4111 4112 4113 4114 4115 4116 4117 4118 4119 4120 4121 4122 4123 4124 4125 4126 4127 4128 4129 4130 4131 4132 4133 4134 4135 4136 4137 4138 4139

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95096906 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, 100 ml cx, c/60 FARMACE 95096914 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, 120 ml cx, c/60 FARMACE 95083731 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, 50 frs, pet, 120 ml+ 50 cp, med, (hosp,) TEUTO BRAS, 95250492 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, ad, 120 ml,+ CM ABBOTT 95250573 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, ad, fr, 120 ml+ cp-med, MEDLEY 95096922 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, CT 100 ml - frasco FARMACE 95250581 CLORIDRATO DE AMBROXOL - GENERICO 6 mg/ml xpe, fr, 120 ml CRISTALIA 95250654 CLORIDRATO DE AMBROXOL - GENERICO 7,5 mg/ml 50 ml PRATI DONADUZZI 95250530 CLORIDRATO DE AMBROXOL - GENERICO 7,5 mg/ml sol, oral fr, 60 ml, ABBOTT 95250514 CLORIDRATO DE AMBROXOL - GENERICO Inf, 15 mg/5 ml fr, 120 ml, EMS 95096930 CLORIDRATO DE AMBROXOL - GENERICO Inf, 3 mg/ml xpe, fr, 120 ml s/acucar EMS 95250603 CLORIDRATO DE AMBROXOL - GENERICO Xpe, ad, 6 mg/ml vd, 120 ml, NEO QUIMICA 95250611 CLORIDRATO DE AMBROXOL - GENERICO Xpe, inf, 3 mg/ml vd, 120 ml, NEO QUIMICA 95121781 CLORIDRATO DE AMBROXOL - GENERICO (Restrito Hosp,) 3 mg/ml, xpe, cx, 50 fr, plas, opc, x 100 ml, c/cp, med, (hosp,) PRATI DONADUZZI 95121790 CLORIDRATO DE AMBROXOL - GENERICO (Restrito Hosp,) 3 mg/ml, xpe, cx, 50 fr, plas, opc, x 120 ml, c/cp, med, (hosp,) PRATI DONADUZZI 95121803 CLORIDRATO DE AMBROXOL - GENERICO (Restrito Hosp,) 6 mg/ml xpe, cx, 50 fr, plas, opc x 120 ml c/50 cp, med, (hosp,) PRATI DONADUZZI 95121811 CLORIDRATO DE AMBROXOL - GENERICO (Restrito Hosp,) 6 mg/ml, xpe, cx, 50 fr, plas, opc, x 100 ml, c/cp, med, (hosp,) PRATI DONADUZZI 95136355 CLORIDRATO DE AMBROXOL - GENERICO (Restrito Hosp,) (Liberado) 3 mg/ml xpe, fr, vd, 120 ml c/50 + 50 cp, med, (hosp,) TEUTO BRAS, 95136363 CLORIDRATO DE AMBROXOL - GENERICO (Restrito Hosp,) (Liberado) 6 mg/ml xpe, fr, vd, 120 ml c/50 + 50 cp, med, (hosp,) TEUTO BRAS, 95132139 CLORIDRATO DE AMILORIDA + HCT- GENERICO 5 mg+ 50 mg, 2 bl, x 15 cprs, BIOSINTETICA 95096949 CLORIDRATO DE AMIODARONA - GENERICO 100 mg, bl, 30 cprs, BIOSINTETICA 95110216 CLORIDRATO DE AMIODARONA - GENERICO 200 mg, 2 bl, x 15 cprs, BIOSINTETICA 95096957 CLORIDRATO DE AMIODARONA - GENERICO 200 mg, 3 bl, x 10 cprs, RANBAXY 95096965 CLORIDRATO DE AMITRIPTILINA - GENERICO (Restrito Hosp,) 25 mg, 100 cprs, rev, (hosp,) TEUTO BRAS, 95750363 CLORIDRATO DE AZELASTINA - GENERICO Sol, nasal fr, 10 ml, EMS 95720111 CLORIDRATO DE BETAXOLOL - GENERICO 0,5% fr, 5 ml ALCON 95720120 CLORIDRATO DE BETAXOLOL - GENERICO 0,5% sol, oft, est, 1 fr, 5 ml CRISTALIA 95082107 CLORIDRATO DE BETAXOLOL - GENERICO 5 mg/ml sol, oft, fr, 5 ml GERMED 95096973 CLORIDRATO DE BETAXOLOL - GENERICO 5 mg/ml sol, oft, fr, 5 ml EMS 95096981 CLORIDRATO DE BETAXOLOL - GENERICO 5 mg/ml sol, oft, fr, plast, opc got, x 5 ml COSMED 95350101 CLORIDRATO DE BIPERIDENO - GENERICO 2 mg, 4 bl, x 20 cprs, ABBOTT 95250689 CLORIDRATO DE BROMEXINA - GENERICO 0,8 mg/ml xpe, 120 ml MEDLEY 95096990 CLORIDRATO DE BROMEXINA - GENERICO 0,8 mg/ml xpe, fr, 120 ml inf, COSMED 95250697 CLORIDRATO DE BROMEXINA - GENERICO 1,6 mg/ml xpe, 120 ml, MEDLEY 95082115 CLORIDRATO DE BROMEXINA - GENERICO 1,6 mg/ml xpe, ad, fr, 120 ml GERMED 95097007 CLORIDRATO DE BROMEXINA - GENERICO 1,6 mg/ml xpe, fr, 120 ml ad, COSMED 95097015 CLORIDRATO DE BROMEXINA - GENERICO 8 mg/5 ml xpe, ad, fr, 120 ml GEN - LEGRAND 95121820 CLORIDRATO DE BROMEXINA - GENERICO (Restrito Hosp,) 0,8 mg/ml, xpe, cx, 50 fr, vd, amb, x 120 ml, c/cp, med, x 10PRATI ml, (hosp,) DONADUZZI

UNIDADE Pco Unt Base A ML 0,05 ML 0,06 ML 0,08 ML 0,10 ML 0,14 ML 0,09 ML 0,10 ML 0,17 ML 0,09 ML 0,14 ML 0,06 ML 0,12 ML 0,07 ML 0,02 ML 0,02 ML 0,03 ML 0,03 FR 5,71 FR 9,35 CPR 0,28 COMP 0,32 CPR 0,62 COMP 0,62 COMP 0,39 GOTAS 0,08 GOTAS 0,09 GOTAS 0,10 GOTA 0,08 GOTAS 0,09 GOTAS 0,09 CPR 0,15 ML 0,07 ML 0,05 ML 0,09 ML 0,07 ML 0,06 ML 0,07 ML 0,03

108

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4140 4141 4142 4143 4144 4145 4146 4147 4148 4149 4150 4151 4152 4153 4154 4155 4156 4157 4158 4159 4160 4161 4162 4163 4164 4165 4166 4167 4168 4169 4170 4171 4172 4173 4174 4175 4176 4177

CODIGO BENEFICIO 95121838 CLORIDRATO DE BROMEXINA - GENERICO (Restrito Hosp,) 95083740 CLORIDRATO DE CEFEPIMA - GENERICO 95121846 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121854 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121862 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121870 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121889 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121897 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121900 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121919 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121927 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121935 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,)

APRESENTAÇÃO Laboratorio 1,6 mg/ml, xpe, cx, 50 fr, vd, amb, x 120 ml, c/cp, med, x 10PRATI ml, (hosp,) DONADUZZI 1 g po inj, 10 FA ABL 1 g 1 FA BIOCHIMICO 1 g 50 FA BIOCHIMICO 1 g 50 FA + 50 dil, EUROFARMA 1 g po p/sol, inj, 25 FA vd, AUROBINDO PHARMA 1 g po p/sol, inj, 25 FA vd, + 25 amp, dil, vd, x 3 ml AUROBINDO PHARMA 1 g po p/sol, inj, ct, FA vd, x 17 ml NOVAFARMA 1 g po sol, inj, cx, 10 FA vd, inc, (hosp,) NOVAFARMA 1,0 g sist, fechado cx, 1 FA + bolsa BIOCHIMICO 1,0 g sist, fechado cx, 10 FA + bolsas BIOCHIMICO 1,0 g sist, fechado cx, 50 FA + bolsas BIOCHIMICO

95121943 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121951 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121960 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121978 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121986 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95121994 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95122001 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95122010 CLORIDRATO DE CEFEPIMA - GENERICO (Restrito Hosp,) 95082131 CLORIDRATO DE CICLOBENZAPRINA - GENERICO 95082123 CLORIDRATO DE CICLOBENZAPRINA - GENERICO 95089578 CLORIDRATO DE CICLOBENZAPRINA - GENERICO 95082140 CLORIDRATO DE CICLOBENZAPRINA - GENERICO 95082158 CLORIDRATO DE CICLOBENZAPRINA - GENERICO 95089560 CLORIDRATO DE CICLOBENZAPRINA - GENERICO 95376143 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95081348 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95097023 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95376151 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95081330 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95081356 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95097031 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95097040 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95097058 CLORIDRATO DE CIPROFLOXACINO - GENERICO 95260188 CLORIDRATO DE CLOBUTINOL - GENERICO 95260196 CLORIDRATO DE CLOBUTINOL - GENERICO 95097066 CLORIDRATO DE CLORPROMAZINA - GENERICO

2 g 1 FA 2 g 50 FA 2 g po p/sol, inj, ct, 25 fr, vd, inc, 2 g po p/sol, inj, ct, FA vd, x 17 ml 2 g po sol, inj, cx, 10 FA vd, inc, (hosp,) 2,0 g sist, fechado cx, 1 FA + bolsa 2,0 g sist, fechado cx, 10 FA + bolsas 2,0 g sist, fechado cx, 50 FA + bolsas 10 mg, 15 cprs, rev, 10 mg, 30 cprs, rev, 10 mg, x 30 cprs, rev, 5 mg, 15 cprs, rev, 5 mg, 30 cprs, rev, 5 mg, x 30 cprs, rev, 250 mg, 2 bl, x 7 cprs, 250 mg, 2 bl, x 7 cprs, rev, 500 mg, 14 cprs, 500 mg, 2 bl, x 7 cprs, 500 mg, 2 bl, x 7 cprs, rev, 500 mg, 2 bl, x 7 cprs, rev, 500 mg, bl, 6 cprs, rev, 500 mg, bl, 6 cprs, rev, Sol, 3,5 mg/ml 5 ml 4 mg/ml xpe, 120 ml,+ cp-med, 60 mg/ml sol, oral 20 ml, 5 mg/ml cx, 50 amps, x 5 ml

BIOCHIMICO BIOCHIMICO EUROFARMA NOVAFARMA NOVAFARMA BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOSINTETICA BIOSINTETICA ACHE BIOSINTETICA BIOSINTETICA ACHE EMS GERMED MULTILAB EMS GERMED GEN - LEGRAND BIOSINTETICA MERCK NEO QUIMICA MEDLEY MEDLEY HYPOFARMA

UNIDADE Pco Unt Base A ML 0,04 FA 35,59 FA 35,57 FA 35,58 FA 34,44 FA 32,38 FA 35,25 FA 33,71 FA 33,70 FA 38,92 FA 38,92 FA 38,92 FA FA FA FA FA FA FA FA COMP COMP COMP COMP COMP COMP CPR COMP COMP CPR COMP COMP COMP COMP GOTAS ML GOTAS FA

64,68 64,69 62,61 61,28 61,29 68,00 68,02 68,02 0,55 0,49 0,49 0,49 0,48 0,48 1,51 1,51 2,02 2,27 2,27 2,14 4,65 5,55 0,09 0,05 0,02 0,96

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4178 4179 4180 4181 4182 4183 4184 4185 4186 4187 4188 4189 4190 4191 4192 4193 4194 4195 4196 4197 4198 4199 4200 4201 4202 4203 4204 4205 4206 4207 4208 4209 4210 4211 4212 4213 4214 4215

CODIGO BENEFICIO APRESENTAÇÃO 95140174 CLORIDRATO DE DILTIAZEM - GENERICO 30 mg, cx, 30 cprs, 95097074 CLORIDRATO DE DILTIAZEM - GENERICO 60 mg, 2 bl, x 25 cprs, 95140182 CLORIDRATO DE DILTIAZEM - GENERICO 60 mg, cx, 30 cprs, 95140220 CLORIDRATO DE DILTIAZEM - GENERICO 60 mg, fr, 25 cprs, rev, 95140212 CLORIDRATO DE DILTIAZEM - GENERICO 60 mg, fr, 50 cprs, rev, 95122028 CLORIDRATO DE DOBUTAMINA - GENERICO (Restrito Hosp,)12,5 mg/ml sol, inj, IV amp, vd, x 20 ml 95122036 CLORIDRATO DE DOBUTAMINA - GENERICO (Restrito Hosp,)14,0 mg/ml cx, 10 amps, vd, x 20 ml 95082166 CLORIDRATO DE DONEPEZILA - GENERICO 10 mg, 30 cprs, 95090088 CLORIDRATO DE DOPAMINA - GENERICO 5 mg/ml cx, 50 amps, 95122044 CLORIDRATO DE DOPAMINA - GENERICO (Restrito Hosp,) 5 mg/ml cx, 10 amps, 10 ml (hosp,) 95122052 CLORIDRATO DE DOPAMINA - GENERICO (Restrito Hosp,) 5 mg/ml sol, inj, cx, 50 amps, vd, x 10 ml (hosp,) 95082190 CLORIDRATO DE DORZOLAMIDA - GENERICO 20 mg/ml sol, oft, fr, 15 ml 95082174 CLORIDRATO DE DORZOLAMIDA - GENERICO 20 mg/ml sol, oft, fr, 5 ml 95082182 CLORIDRATO DE DORZOLAMIDA - GENERICO 20 mg/ml sol, oft, fr, 5 ml 95084770 CLORIDRATO DE DORZOLAMIDA + MAL, TIMOLOL 20 mg/ml+ 5 mg/ml sol, oft, fr, got, x 5,0 ml 95083758 CLORIDRATO DE DOXORRUBICINA - GENERICO 50 mg, 10 FA vd, x 50 ml 95540539 CLORIDRATO DE DOXORRUBICINA - GENERICO 50 mg, FA 95122060 CLORIDRATO DE DOXORRUBICINA - GENERICO (Restrito Hosp,) 10 mg, po liof, p/sol, inj, FA vd, 95122079 CLORIDRATO DE DOXORRUBICINA - GENERICO (Restrito Hosp,) 50 mg, po liof, p/sol, inj, FA vd, 95122087 CLORIDRATO DE EPIRRUBICINA - GENERICO (Restrito Hosp,)2 mg/ml sol, inj, IM fr, vd, x 10 ml 95122095 CLORIDRATO DE EPIRRUBICINA - GENERICO (Restrito Hosp,)2 mg/ml sol, inj, IM fr, vd, x 25 ml 95122109 CLORIDRATO DE EPIRRUBICINA - GENERICO (Restrito Hosp,)2 mg/ml sol, inj, IM fr, vd, x 5 ml 95122117 CLORIDRATO DE FLUOXETINA - GENERICO (Restrito Hosp,) 20 mg, 70 cprs, (hosp,) 95122125 CLORIDRATO DE GENCITABINA - GENERICO (Restrito Hosp,)1 g po liof, sol, inj, IV 10 FA vd, x 50 ml 95122133 CLORIDRATO DE GENCITABINA - GENERICO (Restrito Hosp,)1 g po liof, sol, inj, IV FA vd, x 50 ml 95122141 CLORIDRATO DE GENCITABINA - GENERICO (Restrito Hosp,)1000 mg, po liof, inj, FA vd, x 50 ml 95122150 CLORIDRATO DE GENCITABINA - GENERICO (Restrito Hosp,)200 mg, po liof, inj, FA vd, x 10 ml 95122168 CLORIDRATO DE GENCITABINA - GENERICO (Restrito Hosp,)200 mg, po liof, sol, inj, IV 10 FA vd, x 10 ml 95122176 CLORIDRATO DE GENCITABINA - GENERICO (Restrito Hosp,)200 mg, po liof, sol, inj, IV FA vd, x 10 ml 95122184 CLORIDRATO DE GRANISETRONA - GENERICO (Restrito Hosp,) 1 mg/ml sol, inj, IV cx, 50 amps, vd, x 3 ml (hosp,) 95097082 CLORIDRATO DE HIDROXIZINA - GENERICO 2 mg/ml sol, oral fr, 120 ml 95081364 CLORIDRATO DE HIDROXIZINA - GENERICO 2 mg/ml sol, oral fr, plast, amb, x 100 ml+ SD 95097090 CLORIDRATO DE HIDROXIZINA - GENERICO Sol, oral fr, 120 ml 95122192 CLORIDRATO DE IRINOTECANO - GENERICO (Restrito Hosp,)100 mg, sol, inj, cx, 1 FA 5 ml 95122206 CLORIDRATO DE IRINOTECANO - GENERICO (Restrito Hosp,)20 mg/ml sol, inj, FA vd, amb, x 2 ml 95122214 CLORIDRATO DE IRINOTECANO - GENERICO (Restrito Hosp,)20 mg/ml sol, inj, FA vd, amb, x 5 ml 95122222 CLORIDRATO DE IRINOTECANO - GENERICO (Restrito Hosp,)20 mg/ml sol, inj, IV FA vd, x 2 ml 95122230 CLORIDRATO DE IRINOTECANO - GENERICO (Restrito Hosp,)20 mg/ml sol, inj, IV FA vd, x 5 ml

Laboratorio BIOSINTETICA GEN - LEGRAND BIOSINTETICA EMS EMS NOVAFARMA HYPOFARMA RANBAXY UNIAO QUIMICA TEUTO BRAS, TEUTO BRAS, GEN - LEGRAND EMS GERMED TEUTO BRAS, EUROFARMA EUROFARMA GLENMARK GLENMARK ACCORD ACCORD ACCORD TEUTO BRAS, EUROFARMA EUROFARMA ACCORD ACCORD EUROFARMA EUROFARMA NOVAFARMA GEN - LEGRAND BRAINFARMA GERMED EUROFARMA ACCORD ACCORD GLENMARK GLENMARK

UNIDADE Pco Unt Base A CPR 0,18 COMP 0,37 CPR 0,36 CPR 0,38 CPR 0,37 FA 14,80 FA 14,83 COMP 2,71 AP 0,98 FA 0,91 FA 0,83 GOTA 0,10 GOTA 0,30 GOTA 0,31 GOTA 0,42 ML 1,65 FA 87,53 FA 19,08 FA 79,32 FA 71,75 FA 152,55 FA 36,58 COMP 1,46 FA 351,69 FA 351,68 FA 351,71 FA 70,67 FA 70,67 FA 70,67 FA 76,95 ML 0,15 ML 0,13 ML 0,14 FA 736,31 FA 302,58 FA 747,57 FA 227,16 FA 563,41

110

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4216 4217 4218 4219 4220 4221 4222 4223 4224 4225 4226 4227 4228 4229 4230 4231 4232 4233 4234 4235 4236 4237 4238 4239 4240 4241 4242 4243 4244 4245 4246 4247 4248 4249 4250 4251 4252 4253

CODIGO BENEFICIO APRESENTAÇÃO 95780165 CLORIDRATO DE LIDOCAINA - GENERICO 2% gel top, 1 bisn,30 g,+ aplic, 95085564 CLORIDRATO DE LIDOCAINA - GENERICO 20 mg/ml sol, inj, cx, 50 FA vd, x 20 ml (hosp,) 95122249 CLORIDRATO DE LIDOCAINA - GENERICO (Restrito Hosp,) 20 mg/ml sol, inj, 12 FA vd, x 20 ml 95122257 CLORIDRATO DE LIDOCAINA - GENERICO (Restrito Hosp,) 20 mg/ml sol, inj, FA vd, x 20 ml 95097104 CLORIDRATO DE MEMANTINA - GENERICO 10 mg, 30 cprs, rev, 95097112 CLORIDRATO DE MEMANTINA - GENERICO 10 mg, 60 cprs, rev, 95097120 CLORIDRATO DE MEMANTINA - GENERICO 10 mg, bl, 15 cprs, rev, 95097139 CLORIDRATO DE MEMANTINA - GENERICO 10 mg, bl, 30 cprs, rev, 95097147 CLORIDRATO DE MEMANTINA - GENERICO 10 mg, bl, 60 cprs, rev, 95430164 CLORIDRATO DE METFORMINA - GENERICO 500 mg, 30 cprs, 95081380 CLORIDRATO DE METFORMINA - GENERICO 500 mg, bl, 30 cprs, rev, 95097155 CLORIDRATO DE METFORMINA - GENERICO 500 mg, bl, 30 cprs, rev, 95081372 CLORIDRATO DE METFORMINA - GENERICO 500 mg, bl, 60 cprs, rev, 95097163 CLORIDRATO DE METFORMINA - GENERICO 500 mg, com, rev, ct, bl, al, plas, inc, x 30 95430172 CLORIDRATO DE METFORMINA - GENERICO 850 mg, 30 cprs, 95097171 CLORIDRATO DE METFORMINA - GENERICO 850 mg, 30 cprs, ver, 95097180 CLORIDRATO DE METFORMINA - GENERICO 850 mg, bl, 30 cprs, rev, 95097198 CLORIDRATO DE METFORMINA - GENERICO 850 mg, bl, 30 cprs, rev, 95122265 CLORIDRATO DE METFORMINA - GENERICO (Restrito Hosp,)850 mg, bl, 105 cprs, rev, (hosp,) 95122273 CLORIDRATO DE METFORMINA - GENERICO (Restrito Hosp,)850 mg, bl, 210 cprs, rev, (hosp,) 95122281 CLORIDRATO DE METFORMINA - GENERICO (Restrito Hosp,)850 mg, bl, 450 cprs, rev, (hosp,) 95122290 CLORIDRATO DE METFORMINA - GENERICO (Restrito Hosp,)850 mg, bl, 600 cprs, rev, (hosp,) 95320210 CLORIDRATO DE METOCLOPRAMIDA - GENERICO 10 mg, amp, 2 ml, 95097201 CLORIDRATO DE MINOCICLINA - GENERICO 100 mg, 1 bl, x 30 cprs, 95097210 CLORIDRATO DE NARATRIPTANA - GENERICO 2,5 mg, 4 cprs, rev, 95122303 CLORIDRATO DE ONDANSETRONA - GENERICO (Restrito Hosp,) 2 mg/ml cx, 100 amps, vd, 2 ml 95122311 CLORIDRATO DE ONDANSETRONA - GENERICO (Restrito Hosp,) 2 mg/ml cx, 100 ampx, vd, 4 ml 95122320 CLORIDRATO DE ONDANSETRONA - GENERICO (Restrito Hosp,) 2 mg/ml cx, 50 amps, 2 ml 95122338 CLORIDRATO DE ONDANSETRONA - GENERICO (Restrito Hosp,) 2 mg/ml cx, 50 amps, 4 ml 95122346 CLORIDRATO DE ONDANSETRONA - GENERICO (Restrito Hosp,) 2 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml (hosp,) 95097228 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, 3 bl, x 10 cprs, 95097236 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, 3 x 10 cprs, 95082220 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, bl, 10 cprs, rev, 95082212 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, bl, 20 cprs, rev, 95097244 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, bl, 20 cprs, rev, 95082204 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, bl, 30 cprs, rev, 95082239 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, bl, 30 cprs, rev, 95097252 CLORIDRATO DE PAROXETINA - GENERICO 20 mg, bl, 30 cprs, rev,

Laboratorio CRISTALIA TEUTO BRAS, BLAUSIEGEL BLAUSIEGEL EUROFARMA EUROFARMA ARROW ARROW ARROW MERCK SANOFI-AVENTIS BRAINFARMA SANOFI-AVENTIS PRATI DONADUZZI MERCK BUNKER BRAINFARMA SANDOZ ACCORD ACCORD ACCORD ACCORD HALEX ISTAR RANBAXY EMS HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA NOVAFARMA BIOSINTETICA ZYDUS AUROBINDO PHARMA AUROBINDO PHARMA MEDLEY FARMASA AUROBINDO PHARMA MEDLEY

UNIDADE Pco Unt Base A G 0,34 FA 4,28 FA 4,05 FA 4,04 COMP 1,64 COMP 1,62 COMP 1,28 COMP 1,41 COMP 1,39 CPR 0,24 COMP 0,22 COMP 0,24 COMP 0,18 COMP 0,26 CPR 0,32 COMP 0,26 COMP 0,34 COMP 0,33 COMP 0,30 COMP 0,27 COMP 0,27 COMP 0,27 AP 0,53 COMP 1,96 COMP 1,75 AMP 22,24 AMP 44,48 AMP 21,18 AMP 42,37 AMP 23,08 COMP 2,34 COMP 1,93 COMP 3,14 COMP 3,22 COMP 2,49 COMP 2,26 COMP 1,10 COMP 2,57

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4254 4255 4256 4257 4258 4259 4260 4261 4262 4263 4264 4265 4266 4267 4268 4269 4270 4271 4272 4273 4274 4275 4276 4277 4278 4279 4280 4281 4282 4283 4284 4285 4286 4287 4288 4289 4290 4291

CODIGO BENEFICIO APRESENTAÇÃO 95097260 CLORIDRATO DE PAROXETINA - GENERICO 30 mg, 2 bl, x 15 cprs, rev, 95097279 CLORIDRATO DE PAROXETINA - GENERICO 30 mg, 2 bl, x 15 cprs, rev, 95122354 CLORIDRATO DE PROMETAZINA - GENERICO (Restrito Hosp,) 25 mg, com, rev, ct, bl, al, plas, inc, x 500 (hosp,) 95120440 CLORIDRATO DE PROPRANOLOL - GENERICO 40 mg cx, 40 cprs, 95097287 CLORIDRATO DE PROPRANOLOL - GENERICO (Restrito Hosp,) 40 mg, cx, 100 cprs, (hosp,) 95010653 CLORIDRATO DE RANITIDINA - GENERICO 150 mg cx, 2 str, x 10 cprs, 95010548 CLORIDRATO DE RANITIDINA - GENERICO 150 mg, 10 cprs, 95082271 CLORIDRATO DE RANITIDINA - GENERICO 150 mg, 2 bl, x 10 cprs, rev, 95082255 CLORIDRATO DE RANITIDINA - GENERICO 150 mg, cx, 10 cprs, rev, 95082247 CLORIDRATO DE RANITIDINA - GENERICO 150 mg, cx, 20 cprs, rev, 95082263 CLORIDRATO DE RANITIDINA - GENERICO 150 mg, cx, 60 cprs, rev, 95010521 CLORIDRATO DE RANITIDINA - GENERICO 150 mg, fr, 20 cprs, 95122362 CLORIDRATO DE RANITIDINA - GENERICO 25 mg/ml - cx, 100 amps, vd, x 2 ml 95122370 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) 150 mg, cx, 10 envs, x 10 cprs, rev, (hosp,) 95122389 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) 25 mg/ml cx, 100 x 2 ml 95122397 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) 25 mg/ml sol, inj, 2 ml c/120 (hosp,) 95122400 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) 25 mg/ml sol, inj, amp, 50 vd, x 2 ml 95122419 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) 25 mg/ml sol, inj, cx, 100 amps, x 2 ml (hosp,) 95122427 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) 25 mg/ml sol, inj, cx, 50 amps, vd, amb, x 2 ml 95122435 CLORIDRATO DE RANITIDINA - GENERICO (Restrito Hosp,) Sol, inj, 50 amps, 2 ml 95350110 CLORIDRATO DE SELEGILINA - GENERICO 5 mg, 2 bl, al, plast, x 15 cprs, 95097295 CLORIDRATO DE SERTRALINA - GENERICO 100 mg, bl, 14 cprs, rev, 95290435 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, 3 bl, x 10 cprs, 95290397 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, 30 cprs, 95097309 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 10 cprs, rev, 95097317 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 20 cprs, 95097325 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 20 cprs, rev, 95097333 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 20 cprs, rev, 95097341 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 20 cprs, rev, 95097350 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 30 cprs, rev, 95097368 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 30 cprs, rev, 95097376 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, 30 cprs, rev, 95097384 CLORIDRATO DE SERTRALINA - GENERICO 50 mg, bl, al, plas, inc, x 28 cprs, rev, 95110232 CLORIDRATO DE SOTALOL - GENERICO 160 mg 30 cprs, 95390472 CLORIDRATO DE TERBINAFINA - GENERICO 1% cr, bisn, 20 g, 95097392 CLORIDRATO DE TERBINAFINA - GENERICO 10 mg/g creme derm, bisn, 20 g 95390480 CLORIDRATO DE TERBINAFINA - GENERICO 125 mg, 1 bl, x 14 cprs, 95390502 CLORIDRATO DE TERBINAFINA - GENERICO 250 mg, 1 bl, x 14 cprs,

Laboratorio EMS GERMED PRATI DONADUZZI TEUTO BRAS, TEUTO BRAS, ATIVUS MEDLEY GEN - LEGRAND MEDQUIMICA MEDQUIMICA MEDQUIMICA TEUTO BRAS, FARMACE TEUTO BRAS, HYPOFARMA TEUTO BRAS, ASPEN PHARMA TEUTO BRAS, NOVAFARMA UNIAO QUIMICA BIOSINTETICA NEO QUIMICA MEDLEY MEPHA-RATIOPHARM BRAINFARMA RANBAXY BRAINFARMA NEO QUIMICA SANDOZ BRAINFARMA NEO QUIMICA SANDOZ AUROBINDO PHARMA MERCK MEDLEY TEUTO BRAS, MEDLEY MEDLEY

UNIDADE Pco Unt Base A COMP 1,77 COMP 1,87 COMP 0,09 CPR 0,13 COMP 0,11 CPR 0,71 CPR 0,84 COMP 0,73 COMP 1,02 COMP 0,85 COMP 0,68 CPR 0,70 FA 0,82 COMP 0,56 FA 0,54 FA 1,09 FA 0,74 FA 0,76 FA 1,07 FA 0,88 CPR 0,64 COMP 3,83 CPR 2,23 CPR 1,70 COMP 2,04 COMP 1,62 COMP 1,92 COMP 2,02 COMP 1,89 COMP 1,78 COMP 1,84 COMP 1,90 COMP 1,25 CPR 1,37 G 0,74 G 0,46 CPR 1,79 CPR 3,54

112

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4292 4293 4294 4295 4296 4297 4298 4299 4300 4301 4302 4303 4304 4305 4306 4307 4308 4309 4310 4311 4312 4313 4314 4315 4316 4317 4318 4319 4320 4321 4322 4323 4324 4325 4326 4327 4328 4329

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95390464 CLORIDRATO DE TERBINAFINA - GENERICO Creme bisn, 20 g, EUROFARMA 95122443 CLORIDRATO DE TETRAC, + ANFOTER, B - GENERICO (Restrito 25 mg/g Hosp,) + 12,5 mg/g crem, vag, cx, 50 bg, al, x 45 g + 500 aplic, PRATI vag, DONADUZZI (hosp,) 95510036 CLORIDRATO DE TETRAC,+ ANFOTER, B-GEN, 25 mg/g+ 12,5 mg/g cr, vag, bisn, al, 40 g+ 10 aplic, desc ATIVUS 95122451 CLORIDRATO DE TETRACICLINA - GENERICO 500 mg, cap, gel, dura ct, bl, al, plas, inc, x 140 (frac,) PRATI DONADUZZI 95084789 CLORIDRATO DE TICLOPIDINA - GENERICO 250 mg, 3 bl, x 10 cprs, rev, EMS 95097406 CLORIDRATO DE TICLOPIDINA - GENERICO 250 mg, bl, 20 cprs, rev, TEUTO BRAS, 95097414 CLORIDRATO DE TICLOPIDINA - GENERICO 250 mg, bl, 30 cprs, rev, TEUTO BRAS, 95160191 CLORIDRATO DE TICLOPIDINA - GENERICO 250 mg, cx, 30 cprs, BIOSINTETICA 95160205 CLORIDRATO DE TICLOPIDINA - GENERICO 250 mg, fr, 30 cprs, MERCK 95122460 CLORIDRATO DE TRAMADOL - GENERICO (Restrito Hosp,) 50 mg/ml sol, inj, 60 amps, vd, amb, x 1 ml (hosp,) TEUTO BRAS, 95122478 CLORIDRATO DE TRAMADOL - GENERICO (Restrito Hosp,) 50 mg/ml sol, inj, 60 amps, vd, amb, x 2 ml (hosp,) TEUTO BRAS, 95122486 CLORIDRATO DE VANCOMICINA - GENERICO 500 mg, po liof, inj, FA vd, TEUTO BRAS, 95136371 CLORIDRATO DE VANCOMICINA - GENERICO (Restrito Hosp,)500 mg, po inj, cx, 25 FA ABL 95122494 CLORIDRATO DE VANCOMICINA - GENERICO (Restrito Hosp,)500 mg, po liof, inj, 50 FA vd, (hosp,) TEUTO BRAS, 95122508 CLORIDRATO DE VANCOMICINA - GENERICO (Restrito Hosp,)500 mg, po liof, inj, cx, 100 FA vd, inc, ARISTON 95122516 CLORIDRATO DE VANCOMICINA - GENERICO (Restrito Hosp,)500 mg, po liof, inj, cx, 20 FA vd, inc, ARISTON 95122524 CLORIDRATO DE VANCOMICINA - GENERICO (Restrito Hosp,)500 mg, po liof, inj, cx, 20 FA vd, inc, + 20 amps, dil, x 10 mlARISTON 95082298 CLORIDRATO DE VENLAFAXINA - GENERICO 150 mg, 2 bl, x 15 caps, EMS 95082328 CLORIDRATO DE VENLAFAXINA - GENERICO 150 mg, 2 bl, x 15 caps, GEN - LEGRAND 95082280 CLORIDRATO DE VENLAFAXINA - GENERICO 150 mg, bl, 14 caps, EMS 95082301 CLORIDRATO DE VENLAFAXINA - GENERICO 150 mg, bl, 14 caps, GERMED 95082310 CLORIDRATO DE VENLAFAXINA - GENERICO 150 mg, bl, 14 caps, GEN - LEGRAND 95140247 CLORIDRATO DE VERAPAMIL - GENERICO 120 mg AP 2 bl, x 10 cprs, rev, ABBOTT 95140255 CLORIDRATO DE VERAPAMIL - GENERICO 240 mg, 3 bl, x 10 cprs, rev, ABBOTT 95097422 CLORIDRATO DE VERAPAMIL - GENERICO 240 mg, 30 cprs, rev, retard, BIOSINTETICA 95140239 CLORIDRATO DE VERAPAMIL - GENERICO 80 mg 2 bl, x 15 cprs, rev, ABBOTT 95140263 CLORIDRATO DE VERAPAMIL - GENERICO 80 mg cx, 30 cprs, TEUTO BRAS, 95122532 CLORIDRATO DE VERAPAMIL - GENERICO (Restrito Hosp,) 80 mg, com, rev, ct, bl, al, plas, opc, x 300 (hosp,) PRATI DONADUZZI 95122540 CLORIDRATO DE VERAPAMIL - GENERICO (Restrito Hosp,) 80 mg, cx, 150 cprs, (hosp,) TEUTO BRAS, 95016155 CLORIZIN 25 mg, 20 cprs, CIFARMA 95016163 CLORIZIN 50 mg, 20 cprs, CIFARMA 95280120 CLORPROMAZ 100 mg, x 100 cprs, UNIAO QUIMICA 95280138 CLORPROMAZ 25 mg, x 50 amps, 5 ml, UNIAO QUIMICA 95016171 CLORTALIDONA - GENERICO 12,5 mg, 9 bl, x 10 cprs, EMS 95927107 CLORTALIDONA - GENERICO 12,5 mg, cx, 4 bl, x 15 cprs, EMS 95892192 CLORTALIDONA - GENERICO 12,5mg,3bl,x14 cprs, RANBAXY 95927093 CLORTALIDONA - GENERICO 12,5mg,4 bl, x 15 cprs, GERMED 95892206 CLORTALIDONA - GENERICO 25 mg, 3 bl, x 14 cprs, RANBAXY

UNIDADE Pco Unt Base A G 0,43 TB 12,45 G 0,38 CAPS 61,43 COMP 1,28 COMP 1,28 COMP 1,28 CPR 1,20 CPR 1,19 FA 2,84 FA 4,06 FA 14,53 FA 15,28 FA 15,28 FA 14,77 FA 14,77 FA 14,77 CAPS 5,44 CAPS 5,13 CAPS 5,83 CAPS 5,83 CAPS 5,51 CPR 0,78 CPR 1,19 COMP 1,29 CPR 0,42 CPR 0,45 COMP 0,21 COMP 0,36 COMP 0,22 COMP 0,26 CPR 0,18 AP 1,19 COMP 0,12 CPR 0,13 COMP 0,09 CPR 0,09 COMP 0,17

113

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4330 4331 4332 4333 4334 4335 4336 4337 4338 4339 4340 4341 4342 4343 4344 4345 4346 4347 4348 4349 4350 4351 4352 4353 4354 4355 4356 4357 4358 4359 4360 4361 4362 4363 4364 4365 4366 4367

CODIGO BENEFICIO 95927115 CLORTALIDONA - GENERICO 95016201 CLORTALIDONA - GENERICO 95016180 CLORTALIDONA - GENERICO 95927123 CLORTALIDONA - GENERICO 95892214 CLORTALIDONA - GENERICO 95927131 CLORTALIDONA - GENERICO 95016198 CLORTALIDONA - GENERICO 95927140 CLORTALIDONA - GENERICO 95028331 CLORTALIL 95028340 CLORTALIL 95892222 CLORTALIL 95028358 CLORTALIL 95028366 CLORTALIL 95892230 CLORTAMINA 95994963 CLORTIL 95994971 CLORTIL 95054260 CLOSENID 95580727 CLOTASSIO 95927158 CLOTRIMAZOL + ACETATO DE DEXAMETASO 95037063 CLOTRIMAZOL - GENERICO 95037071 CLOTRIMAZOL - GENERICO 95037098 CLOTRIMAZOL - GENERICO 95037080 CLOTRIMAZOL - GENERICO 95082336 CLOTRIMAZOL - GENERICO 95037055 CLOTRIMAZOL - GENERICO 95097430 CLOTRIMAZOL - GENERICO 95892249 CLOTRIMAZOL - GENERICO 95043497 CLOTRIMAZOL - GENERICO 95097449 CLOTRIMAZOL - GENERICO 95054278 CLOTRIMAZOL - GENERICO 95390545 CLOTRIMAZOL - GENERICO 95390570 CLOTRIMAZOL - GENERICO 95082344 CLOTRIMAZOL - GENERICO 95987576 CLOTRIMAZOL - GENERICO 95097457 CLOTRIMAZOL - GENERICO 95097465 CLOTRIMAZOL - GENERICO 95390553 CLOTRIMAZOL - GENERICO 95097473 CLOTRIMAZOL - GENERICO

APRESENTAÇÃO 25 mg, 4 bl, x 15 cprs, 25 mg, 6 bl, x 10 cprs, 25 mg, 9 bl, x 10 cprs, 25 mg, cx, 4 bl, x 15 cprs, 50 mg, 2 bl, x 14 cprs, 50 mg, 3 bl, x 10 cprs, 50 mg, 9 bl, x 10 cprs, 50 mg, cx, 3 bl, x 10 cprs, 25 mg, 4 bl, x 15 cprs, 25 mg, 9 bl, x 10 cprs, 50 mg, 2 bl, x 14 cprs, 50 mg, 3 bl, x 10 cprs, 50 mg, 9 bl, x 10 cprs, 50 mg/ml sol, inj, 5 FA x 10 ml 25 mg, 40 cprs, 50 mg, 30 cprs, 40 mg, cprs,ct, 2 bl, al, plas, amb, x 20 Fr, 100 ml, 10 mg/g+ 0,4 mg/g bisn, 40 g 10 mg/g crem, derm, ct, bg, al, x 20 g 10 mg/g crem, derm, ct, bg, al, x 30 g 10 mg/g crem, derm, cx, 100 bg, al, x 20 g (emb, hosp,) 10 mg/g crem, derm, cx, 100 bg, al, x 30 g (emb, hosp,) 10 mg/g crem, vag, ct, bg, al, x 35 g+ 6 aplic, 10 mg/g creme bisn, 20 g 10 mg/g creme bisn, 20 g 10 mg/g creme derm, 50 g 10 mg/g creme derm, bisn, 20 g 10 mg/g creme vag, bisn, 35 g + 6 aplic, 10 mg/g cremebisn, 20 g 10 mg/ml creme derm, bisn, 20 g 20 mg/g creme vag, bisn, 20 g+ 3 aplic, 20 mg/g creme vag, ct, bg, al, x 20 g+ 3 aplic, Creme 10 mg/g bisn, 20 g Creme 10 mg/g bisn, 35 g + 6 aplic, Creme 20 g Creme derm, 1 bisn, 20 g, Creme vag, 35 g c/6 aplic,

Laboratorio GERMED RANBAXY EMS EMS RANBAXY GERMED EMS EMS SIGMA PHARMA SIGMA PHARMA LEGRAND SIGMA PHARMA SIGMA PHARMA BIOCHIMICO TEUTO BRAS, TEUTO BRAS, DUCTO BUNKER MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GERMED GEN - LEGRAND TEUTO BRAS, UNIAO QUIMICA MEDLEY GEN - LEGRAND EMS MEDLEY PRATI DONADUZZI NEO QUIMICA NEO QUIMICA MULTILAB MEDLEY MULTILAB

UNIDADE Pco Unt Base A CPR 0,15 COMP 0,16 COMP 0,14 CPR 0,23 COMP 0,24 CPR 0,34 COMP 0,31 CPR 0,35 CPR 0,15 CPR 0,12 COMP 0,31 CPR 0,31 CPR 0,24 FA 47,27 COMP 0,16 COMP 0,24 COMP 0,21 ML 0,08 G 0,32 G 0,31 G 0,24 G 0,19 G 0,14 G 0,66 G 0,31 GRAMA 0,31 GRAMA 12,32 G 0,31 GRAMA 0,66 G 0,35 G 0,31 G 1,11 G 1,11 G 0,31 GRAMA 0,66 GRAMA 0,30 G 0,31 GRAMA 0,57

114

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4368 4369 4370 4371 4372 4373 4374 4375 4376 4377 4378 4379 4380 4381 4382 4383 4384 4385 4386 4387 4388 4389 4390 4391 4392 4393 4394 4395 4396 4397 4398 4399 4400 4401 4402 4403 4404 4405

CODIGO BENEFICIO 95892257 CLOTRIMAZOL + ACETATO DE 95892265 CLOTRIMAZOL + ACETATO DE 95892273 CLOTRIMAZOL + ACETATO DE 95927182 CLOVIR 95927190 CLOVIR (*) 95041770 CLOXAZOLAM - GENERICO 95987584 CLOXAZOLAM - GENERICO 95041788 CLOXAZOLAM - GENERICO 95987592 CLOXAZOLAM - GENERICO 95041796 CLOXAZOLAM - GENERICO 95987606 CLOXAZOLAM - GENERICO 95054294 CLOZAL 95054286 CLOZAL 95611045 CLUSIVOL 95611061 COBACTIN 95611053 COBACTIN 95611070 COBAGLOBAL 95611088 COBAGLOBAL 95611100 COBAVITAL 95611096 COBAVITAL 95071571 COCICHIMIL 95927220 CODATEN 95927239 CODATEN 95331174 CODEIN 95331140 CODEIN 95331166 CODEIN 95331158 CODEIN 95054308 CODERGINE 95331190 CODEX 95331182 CODEX 95132201 CO-ENAPROTEC 95132210 CO-ENAPROTEC 95640223 COLCHIS 95054324 COLCHIS 95640231 COLCHIS 95054316 COLCHIS 95016236 COLESTASE 95016244 COLESTASE

DEXAMETAS DEXAMETAS DEXAMETAS

APRESENTAÇÃO 10+ 0,4 mg/g creme bisn, 40 g Creme bisn, 40 g Creme bisn, 40 g 0,050 g/g creme bisn, 10 g 200 mg, cx, 25 cprs, 1 mg, 20 cp, 1 mg, 20 cprs, 2 mg, 20 cp, 2 mg, 20 cprs, 4 mg, 20 cp, 4 mg, 20 cprs, 1 mg, cx, 20 cprs, 2 mg, cx, 20 cprs, Composto fr, 240 ml 4 mg/1 mg, comp, 4 st x 4 Xpe, fr, vd, x 120 ml, (cereja e morango) 1 x 16 cprs, Sol, 1 x 100 ml Cx, 16 micro-cprs, Xpe, vd, 100 ml, 0,5 mg, cx, 20 cprs, 50 mg 20 ce 50 mg, 10 ce 3 mg/ml fr, 120 ml 30 mg, 3 bl, x 10 cprs, 30 mg/ml cx, 25 amps, 2 ml 60 mg, 3 bl, x 10 cprs, 6 mg, bl, 14 caps, 30 mg 12 cprs, 7,5 mg 12 cprs, 10/25 mg 30 cprs, 20/12,5 mg 30 cprs, 0,5 mg, cx, 20 cprs, 0,5 mg, cx, 30 cprs, 1 mg 20 cprs, 1 mg, 30 cprs, Cx, 12 cprs, Susp, vd, 60 ml

Laboratorio EMS GERMED GEN - LEGRAND CAZI CAZI NOVARTIS EUROFARMA NOVARTIS EUROFARMA NOVARTIS EUROFARMA DAIICHI SANKYO DAIICHI SANKYO WYETH CONSUMER ZAMBON ZAMBON LEGRAND LEGRAND SOLVAY FARMA SOLVAY FARMA MILIAN NOVARTIS NOVARTIS CRISTALIA CRISTALIA CRISTALIA CRISTALIA NEO QUIMICA UNIAO QUIMICA UNIAO QUIMICA HEXAL HEXAL APSEN APSEN APSEN APSEN SANOFI-AVENTIS SANOFI-AVENTIS

UNIDADE Pco Unt Base A GRAMA 10,86 G 0,32 G 0,32 G 1,56 CPR 2,15 COMP 0,45 COMP 0,45 COMP 0,70 COMP 0,70 COMP 1,06 COMP 1,06 COMP 0,50 COMP 0,81 ML 0,15 CPR 0,62 ML 0,11 CPR 0,98 ML 0,16 CPR 0,59 ML 0,13 COMP 0,55 CPR 2,42 CPR 2,42 ML 0,26 CPR 0,90 AP 5,11 CPR 1,49 CAPS 3,26 CPR 1,26 CPR 0,91 CPR 0,64 CPR 1,22 CPR 0,89 COMP 1,12 CPR 0,98 COMP 1,30 COMP 0,26 ML 0,05

115

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4406 4407 4408 4409 4410 4411 4412 4413 4414 4415 4416 4417 4418 4419 4420 4421 4422 4423 4424 4425 4426 4427 4428 4429 4430 4431 4432 4433 4434 4435 4436 4437 4438 4439 4440 4441 4442 4443

CODIGO BENEFICIO 95690026 COLIRIO BLUMEN 95927247 COLIRIO LAVOLHO 95690042 COLIRIO MOURA BRASIL 95690050 COLIRIO TEUTO 95987614 COLIS-TEK 95122559 COLIS-TEK (Restrito Hosp,) 95510060 COLPIST MT 95510087 COLPIST MT 95510095 COLPISTAR 95510109 COLPISTATIN 95136649 COLPOTROFINE 95136657 COLPOTROFINE 95650075 COLTRAX 95650067 COLTRAX 95927263 COLZURIC 95054332 COMBIGAN 95570250 COMBIRON 95570268 COMBIRON 95054340 COMBIRON FOLICO 95200720 COMBIVENT 95043500 COMPAZ 95044698 COMPAZ 95043519 COMPAZ 95611126 COMPLEVITAN

APRESENTAÇÃO 20 ml, Fr, 15 ml 20 ml, Fr, 20 ml 150 mg, po liof, cx, fr, amp, vd, inc, 150 mg, po liof, ct, FA vd, inc, 10 aplic, vag, pre-envasados desc, Bisn, 40 g+ 10 aplic, Tb, 40 g,+ 10 aplic, Creme vag, bg, 40 g,+ 10 aplic, 10 mg, bl, 20 caps, gel mole 10 mg/g creme vag, bisn, 30 g + aplic, 4 mg, 2 bl, x 10 cprs, Inj, cx, 3 amps, 0,5 mg, cx, 20 cprs, Fr, 10 ml Susp, oral fr, 120 ml+ cp, med, x 10 ml Susp, oral gts, fr, 30 ml+ cgt, Bl, 45 cprs, rev, Fr, aeros, 10 ml,+ aerocamera 10 mg, 20 bl, 10 cps, 10 mg, 50 amps, 2 ml 5 mg, 20 bl, 10 cps, Fr, 30 drags,

Laboratorio LUPER REGIUS SANOFI-AVENTIS TEUTO BRAS, OPEM OPEM ATIVUS ATIVUS FARMOQUIMICA ACHE TEVA TEVA SANOFI-AVENTIS SANOFI-AVENTIS ROYTON ALLERGAN ACHE ACHE ACHE BOEHRINGER INGELHEIM CRISTALIA CRISTALIA CRISTALIA BUNKER

95611118 COMPLEVITAN 95611134 COMPLEVITAN 95611142 COMPLEXO B 95611150 COMPLEXO B 95611169 COMPLEXO B 95611177 COMPLEXO B 95590447 COMPLEXO B 2 ML

Gts, fr, 30 ml, Liq, fr, 100 ml, 1 x 100 drags, 1 x 20 drags, Gts, 1 x 20 ml Xpe, 1 x 120 ml AM

BUNKER BUNKER EMS EMS EMS EMS

95350136 COMTAN 95054359 CONAZOL 95097481 CONCARIO 95097490 CONCARIO 95097503 CONCARIO 95097511 CONCARIO 95580751 CONCENTRADO ACIDO PARA HEMODIALISE

200 mg, 30 cprs, Creme bisn, 20 g 1,25 mg, 2 bl, x 15 cprs, rev, 10 mg, 2 bl, x 15 cprs, rev, 2,5 mg, 2 bl, x 15 cprs, rev, 5 mg, 2 bl, x 15 cprs, rev, F3 sol, fr, 5 lts,

NOVARTIS BRASTERAPICA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA FARMARIN

UNIDADE Pco Unt Base A GOTAS 0,02 GOTAS 0,03 GOTAS 0,02 GOTAS 0,02 F,A, 37,97 FA 37,97 UND 3,62 G 0,40 G 0,72 G 0,47 CAPS 2,15 GR 1,66 CPR 1,52 CPR 2,81 CPR 0,52 GOTA 0,49 ML 0,08 GOTAS 0,02 COMP 0,46 DOSE 0,13 CP 0,91 AMP 0,86 CP 0,75 CPR 0,24 GOTAS ML CPR CPR GOTAS ML AP CPR G COMP COMP COMP COMP Lt

0,01 0,06 0,15 0,59 0,02 0,10 0,56 4,39 0,63 0,95 1,52 1,09 1,27 1,55

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4444 4445 4446 4447 4448 4449 4450 4451 4452 4453 4454 4455 4456 4457 4458 4459 4460 4461 4462 4463 4464 4465 4466 4467 4468 4469 4471 4472 4473 4474 4476 4477 4478 4479 4480 4481 4482 4483

CODIGO BENEFICIO 95580786 CONCENTRADO BASICO PARA HEMODIALISE 95987649 CONCEPNOR 95892311 CONCERTA 95927298 CONCERTA 95120467 CONCOR 95028404 CONCOR 95028412 CONCOR 95097520 CONCOR 95028420 CONCOR 95097538 CONCOR 95028439 CONCOR 95097546 CONCOR 95028447 CONDROFLEX 95927301 CONIDRIN 95750398 CONIDRIN 95927310 CONIDRIN 95054367 CONMEL 95927336 CONMEL 95016295 CONSTANTE 95016287 CONSTANTE 95016309 CONSTANTE 95065156 CONSTRICTION 95037101 CONTIABE 95892320 CONTIFLO OD 95892338 CONTIFLO OD 95520139 CONTRACEP 95089772 CONTRASTE IODADO HIDROSSOLUVEL - IONICO 95089764 CONTRASTE IODADO HIDROSSOLUVEL - NÃO IONICO 95094636 CONTRASTE MEIO BARITADO 95089780 CONTRASTE PARA RESSONANCIA MAGNÉTICA 95892346 COPAXONE 95132228 CO-PRESSOTEC 95132236 CO-PRESSOTEC 95054383 COR MIO 95110259 COR MIO 95690069 CORCICLEN 95132260 CORDAREX 95132279 CORDAREX

APRESENTAÇÃO F3 sol, fr, 5 lts, Cx, 21 cprs, Bl, 30 cprs, 54 mg, Cart, 1 fr, 30 cprs, 18 mg, 1,25 mg, 14 cprs, 1,25 mg, 2 bl, x 14 cprs, rev, 10 mg, 2 bl, x 14 cprs, rev, 10 mg, bl, 14 cprs, rev, 2,5 mg, 2 bl, x 14 cprs, rev, 2,5 mg, bl, 14 cprs, rev, 5 mg, 2 bl, x 14 cprs, rev, 5 mg, bl, 14 cprs, rev, 500 mg,+ 400 mg, 2 bl, x 10 caps, gel, dura Ad, vd, 30 ml, Lact, vd, 10 ml, Ped, vd, 20 ml, 500 mg, cx, 25 x 4 cprs, 500 mg, cx, 25 x 8 cprs, 0,25mg,2 bl, x 10 cprs, 0,5mg,2 bl, x 10 cprs, 1,0mg,2 bl, x 10 cprs, Inj, 5 mg/ml cx, 50 amps, x 10 ml (hosp,) Inj, cx, 2 amps, x 2 ml 0,4 mg, bl, 20 caps, 0,4 mg, bl, 30 caps, Susp, inj, FA 1 ml, Sol, Injetável - Conc, entre 292 a 370mg/ml - CADA 1 ML Sol, Injetável - Conc, entre 300 a 370mg/ml - CADA 1 ML SOL, ORAL - CADA 1 ML Sol, Injetável - CADA 1 ML 20 mg/ml sol, inj, 28 ser, preenchida x 1 ml 10 mg/25 mg, 30 cprs, 20 mg/12,5 mg, 30 cprs, 200 mg, bl, 30 cprs, 200 mg, cx, 20 cprs, Bisn, 3,5 g, 10 mg, 2 bl, x 10 cprs, 2,5 mg, cx, 20 cprs,

Laboratorio ASTRAZENECA NEO QUIMICA JANSSEN - CILAG JANSSEN - CILAG MERCK MERCK MERCK MERCK MERCK MERCK MERCK MERCK ZODIAC ARROW ARROW ARROW FARMASA FARMASA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA NEO QUIMICA CAZI RANBAXY RANBAXY SIGMA PHARMA

TEVA TEUTO BRAS, TEUTO BRAS, HEXAL HEXAL ALLERGAN BIOSINTETICA BIOSINTETICA

UNIDADE Pco Unt Base A Lt 1,55 CPR 0,20 COMP 10,28 CPR 7,57 CPR 1,63 CPR 1,72 CPR 2,75 COMP 2,60 CPR 1,98 COMP 1,98 CPR 2,41 COMP 2,41 CPR 1,63 GOTAS 0,02 GOTAS 0,03 GOTAS 0,02 COMP 0,51 CPR 0,57 COMP 0,17 COMP 0,33 COMP 0,58 AMP 1,31 AMP 7,38 CAPS 3,39 CAPS 3,27 AP 13,24 ML 0,36 ML 0,91 ML 0,07 ML 4,27 UNID 125,96 CPR 0,71 CPR 1,11 COMP 0,60 CPR 0,81 G 1,77 CPR 0,73 CPR 0,54

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4484 4485 4486 4487 4488 4489 4490 4491 4492 4493 4494 4495 4496 4497 4498 4499 4500 4501 4502 4503 4505 4506 4507 4508 4509 4513 4514 4515 4516 4517 4518 4519 4520 4521 4522 4523 4524 4525

CODIGO BENEFICIO 95132252 CORDAREX 95892354 CORDIL 95892362 CORDIL 95054391 CORDILAT 95927387 CORDIRON 95927395 CORDIRON 95120513 COREG 95120521 COREG 95120491 COREG 95120505 COREG 95132317 CO-RENITEC 95132309 CO-RENITEC 95120548 CORGARD 95120530 CORGARD 95331298 CORISTINA 95140352 CORONAR 95140310 CORONAR 95016333 CORONARIL 95016341 CORONARIL 95016350 CORONARIL 95028455 CORTICOIDEX 95640258 CORTICORTEN 95074732 CORTICORTEN 95640240 CORTICORTEN 95074740 CORTICORTEN 95054405 CORTIFUNGIN 95054413 CORTIFUNGIN 95028463 CORTISON 95074759 CORTISON 95028471 CORTISON 95074767 CORTISON 95927409 CORTISONAL 95450262 CORTISONAL 95450254 CORTISONAL 95083782 CORTISONAL (*) 95083790 CORTISONAL (*) 95892389 CORTISTON 95892397 CORTISTON

APRESENTAÇÃO

Laboratorio

5 mg, 2 bl, x 10 cprs, 60 mg, cx, 50 cprs, 90 mg, cx, 20 caps, 80 mg, 20 bl, 10 cps, 10 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 12,5 mg, 14 cprs, 25 mg, fr, plast, 14 cprs, 3,125 mg, 14 cprs, 6,25 mg, 14 cprs, 10/25 mg, c/30 cp, 20/12,5 mg, c/30 cp, 40 mg, cx, c/ 2 bl x 15 80 mg, cx, c/ 2 bl x 10 D blist 4 cprs 10 mg/ml inj, cx,50 amps, 1 ml, 20 mg, cx, 30 cprs, 120 mg, 2 bl, x 10 cprs, rev, 240 mg, 3 bl, x 10 cprs, rev, 80 mg, 3 bl, x 10 cprs, rev, 4 mg/ml sol, inj, 50 amps, vd, x 2,5 ml 20 mg cx, 2 bl, x10 cprs, 20 mg, cx, bl, 500 cprs, (hosp,) 5 mg cx, 1 bl, x 20 cprs, 5 mg, cx, bl, 500 cprs, (hosp,) 20 mg/g+0,5 mg/gcrem,derm,bisn,x30g 20 mg/g+0,5 mg/gpom,derm,bisn,x30g 100 mg, po inj, cx, 50 FA vd,+ 50 amps, dil, x 2 ml 100 mg, po liof, sol, inj, cx, 50 FA vd, (hosp,) 500 mg, po inj, cx, 50 FA vd,+ 50 amps, dil, x 2 ml 500 mg, po liof, sol, inj, cx, 50 FA vd, (hosp,) 10 mg/g creme derm, bisn, 20 g 100 mg, 1 FA+ dil, 500 mg, 1 FA+ dil, 100 mg, po inj, ct, 50 FA vd, inc, 500 mg, po inj, ct, 50 FA vd, inc, 100 mg, cx, 50 FA+ 50 dil, 500 mg, cx, 50 FA+ 50 dil,

BIOSINTETICA TEUTO BRAS, TEUTO BRAS, CRISTALIA DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS ROCHE ROCHE ROCHE ROCHE MERCK SHARP & DOHME MERCK SHARP & DOHME B-MS B-MS MANTECORP BIOLAB SANUS BIOLAB SANUS SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA NOVAFARMA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA SIGMA PHARMA SIGMA PHARMA NOVAFARMA NOVAFARMA NOVAFARMA NOVAFARMA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA ARISTON ARISTON

UNIDADE Pco Unt Base A CPR COMP COMP COMP CPR CPR CPR CPR CPR CPR CPR CPR CPR CPR CPR AP CPR COMP COMP COMP AMP CPR COMP CPR COMP G G FA FA FA FA G AP AP FA FA FA FA

0,39 0,46 1,18 0,19 0,35 0,67 2,81 3,15 2,25 2,52 0,84 1,27 0,67 1,18 1,13 1,71 0,31 0,63 1,05 0,38 5,64 0,64 0,56 0,37 0,32 0,34 0,34 2,19 2,19 5,56 5,56 0,61 5,02 10,76 3,40 7,81 4,06 9,81

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4526 4527 4528 4529 4530 4531 4532 4533 4534 4535 4536 4537 4538 4539 4540 4541 4542 4543 4544 4545 4546 4547 4548 4549 4550 4551 4552 4553 4554 4555 4556 4557 4558 4559 4560 4561 4562 4563

CODIGO BENEFICIO 95132341 CORUS 95132325 CORUS 95037152 CORUS H 95037144 CORUS H 95097554 COSARTAN 95097562 COSARTAN 95097570 COSARTAN 95376356 COSMEGEN 95720138 COSOPT 95927417 COUMADIN 95927425 COUMADIN 95927433 COUMADIN 95132384 COVERSYL 95028480 COVERSYL 95132376 COVERSYL 95016392 COVERSYL 95016384 COVERSYL 95028498 COVERSYL PLUS 95028501 COVERSYL PLUS 95132422 COZAAR 95995269 COZAAR 95995250 COZAAR 95540555 C-PLATIN-CISPLATINA 95540547 C-PLATIN-CISPLATINA 95840699 CREMEDERME 95927441 CREMEDERME 95995277 CREON 95995285 CREON 95995293 CREON 95927468 CRESTOR 95927450 CRESTOR 95927476 CRESTOR 95927484 CRESTOR 95084797 CRINONE 95927492 CRINONE 95054421 CRISDAZOL 95054430 CRISTACILINA 95054456 CRISTACILINA

APRESENTAÇÃO 25 mg, cx, 28 cprs, 50 mg, cx, 28 cprs, 100/25 mg, cx, 28 cprs, 50/12,5 mg, cx, 28 cprs, 160 mg, 3 bl, x 10 cprs, rev, 320 mg, 3 bl, x 10 cprs, rev, 80 mg, 3 bl, x 10 cprs, rev, 0,5 mg, inj, FA+ dil, Cx, fr, 5 ml 1 mg, cart, fr, 30 cprs, 2,5 mg, cart, fr, 30 cprs, 5 mg, cart, fr, 30 cprs, 4 mg, 14 cprs, 4 mg, 15 cprs, 4 mg, 30 cprs, 8 mg, 15 cprs, 8 mg, 30 cprs, 15 cprs, 30 cprs, 100 mg cx, 2 bl, x 15 cp, 50 mg, cx, 2 bl, x 15 cp, 50mg,cx,1bl,x15cp, Sol, inj, 0,5 mg/ml FA 100 ml 50 mg, Sol, inj, 0,5 mg/ml FA 20 ml 10 mg, Creme tb, 20 g, Pom, tb 20 g 10,000 fr, 100 caps, 10,000 fr, 30 caps, 25,000 fr, 30 caps, 10 mg,cx,10cprs, 10mg,cx,30cprs, 20 mg,cx,10cprs, 20 mg,cx,30cprs, 80 mg, gel vag, cx, 15 aplic, 80 mg, gel vag, cx, 7 aplic, 20 mg/ml50frs,30ml 1,000,000 UI po p/sol, inj, cx, 50 FA vd, 10,000,000 UI po p/sol, inj, cx, 25 FA vd,

Laboratorio BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA GERMED PHARMA GERMED PHARMA GERMED PHARMA MERCK SHARP & DOHME MERCK SHARP & DOHME B-MS B-MS B-MS SERVIER SERVIER SERVIER SERVIER SERVIER SERVIER SERVIER MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME BLAUSIEGEL BLAUSIEGEL BUNKER BUNKER SOLVAY FARMA SOLVAY FARMA SOLVAY FARMA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA MERCK SERONO CRISTALIA NOVAFARMA NOVAFARMA

UNIDADE Pco Unt Base A CPR 0,59 CPR 0,25 CP 1,85 CP 0,88 COMP 0,67 COMP 0,67 COMP 0,67 AP 17,91 GOTAS 0,76 CPR 0,18 CPR 0,46 CPR 0,91 CPR 2,14 CPR 2,63 CPR 2,57 COMP 3,65 COMP 3,86 CPR 2,59 CPR 2,59 CPR 1,27 COMP 0,86 COMP 1,03 FA 167,96 FA 40,58 G 1,08 G 1,10 CAPS 1,18 CAPS 1,28 CAPS 2,57 CPR 3,56 CPR 3,31 CPR 5,17 CPR 5,81 UNID 27,64 UND 29,02 ML 0,35 FA 3,61 FA 13,14

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4564 4565 4566 4567 4568 4569 4570 4572 4573 4574 4575 4576 4577 4578 4580 4581 4582 4583 4584 4585 4586 4587 4588 4589 4590 4591 4592 4593 4594 4595 4596 4597 4598 4599 4600 4601 4602 4603

CODIGO BENEFICIO 95054448 CRISTACILINA 95376364 CRISTALPEN 95400427 CRIXIVAN (ICMS 0%) 95230556 CROMOCATO 95037160 CROMOGLICATO DISSODICO - GENERICO 95230564 CROMOGLICATO DISSODICO - GENERICO 95097589 CROMOGLICATO DISSODICO - GENERICO 95740040 CROMOLERG 95740058 CROMOLERG 95611290 CRONOBE 95350144 CRONOMET 95097597 CRONOPLEX 95083804 CUBICIN 95122567 CUBICIN (Restrito Hosp,) 95089586 CUPRIMINE 95630031 CUPRIMINE 95983058 CUROSURF 95983066 CUROSURF 95995323 CUTENOX 95995331 CUTENOX 95995340 CUTENOX 95995358 CUTENOX 95840710 CUTISANOL 95840702 CUTISANOL 95892400 CUTISONE 95892419 CUTISONE 95520147 CYCLOFEMINA 95054499 CYFENOL 95054472 CYFENOL 95054480 CYFENOL 95700013 CYLOCORT 95016449 CYMBALTA 95400435 CYMEVENE 95085572 CYMEVIR (GANCICLOVIR) SOLUFLEX - SIST, F 95085580 CYMEVIR (GANCICLOVIR) SOLUFLEX - SIST, F 95085599 CYMEVIR (GANCICLOVIR) SOLUFLEX - SIST, F 95085602 CYMEVIR (GANCICLOVIR) SOLUFLEX - SIST, F 95530096 CYSTEX

APRESENTAÇÃO 5,000,000 UI po p/sol, inj, cx, 50 FA vd, 5,000,000 UI cx, 50 FA+ dil, 400 mg, caps, gel, dura ct, fr, plas, OPC x 180 caps, Sol, nasal 40 mg fr, plast, 13 ml Sol, 40 mg/ml fr, 13 ml 4% fr, 5 ml Sol, oft, 40 mg/ml fr, 5 ml 2% oculum fr, 5 ml, 4% oculum fr, 5 ml, 5000 mcg, cx, 2 amps, Cx, 2 x 10 cprs Gotas sol, fr, 20 ml 500 mg, 1 FA 500 mg, 5 FA 250 mg, 100 caps, gel, dura 250 mg, fr, 50 caps, FR AMP 1,5 ML FR AMP 3,0 ML 20 mg/0,2 ml c/10 ser, 40 mg/0,4 ml c/10 ser, 60 mg/0,6 ml c/2 ser, 80 mg/0,87 ml c/2 ser, Gel tb, 100 g, Tb, po 150 g, 1% creme bisn, 20 g 1% pom, bisn, 20 g Cx, 1 amp, 0,5 ml, 200 mg/ml sol, oral fr, plast, got, 15 ml 750 mg, bl, 20 cprs, 750 mg, bl, 200 cprs, Col, 5 ml, 30 mg, 14 caps, 500 mg, 25 FA x 10 ml 1 mg/ml+ pre, dil, clor, sodio bolsa 250 ml 1 mg/ml+ pre, dil, clor, sodio bolsa 500 ml 1 mg/ml+ pre, dil, glicose bolsa 250 ml 1 mg/ml+ pre, dil, glicose bolsa 500 ml 1 x 24 drags,

Laboratorio NOVAFARMA BIOLAB SANUS MERCK SHARP & DOHME NEO QUIMICA NEO QUIMICA ALCON NEO QUIMICA ALLERGAN ALLERGAN BIOLAB SANUS MERCK SHARP & DOHME DELTA NOVARTIS NOVARTIS MEIZLER MERCK SHARP & DOHME CHIESI CHIESI BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO MILLET-ROUX MILLET-ROUX RANBAXY RANBAXY MILLET-ROUX CIFARMA CIFARMA CIFARMA UNIAO QUIMICA ELI LILLY ROCHE HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR EMS

UNIDADE Pco Unt Base A FA 8,69 AP 5,04 CPR 3,15 DOSE 0,10 GOTA 0,07 GOTAS 0,05 GOTAS 0,06 GOTAS 0,07 GOTAS 0,09 AP 9,64 CPR 2,06 GOTAS 0,02 FA 243,37 FA 243,37 CAPS 2,51 CPR 2,36 FA 891,55 FA 1206,39 UNID 16,14 UNID 31,36 UNID 48,09 UNID 64,03 G 0,26 G 0,13 GRAMA 0,99 GRAMA 19,82 AP 19,45 GOTA 0,03 COMP 0,60 COMP 0,49 GOTAS 0,18 COMP 4,52 FA 100,99 UNID 67,54 UNID 129,83 UNID 56,78 UNID 109,20 CPR 0,49

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Orde Geral 4604 4605 4606 4607 4608 4609 4610 4611 4612 4613 4614 4615 4616 4617 4618 4619 4620 4621 4622 4623 4624 4625 4626 4627 4628 4629 4630 4631 4632 4633 4634 4635 4636 4637 4638 4639 4640 4641

CODIGO BENEFICIO 95041800 CYSTISTAT 95540601 D,T,I, 95540610 D,T,I, 95122575 DABAZ (Restrito Hosp,) 95540628 DACARB 95122583 DACARB (Restrito Hosp,) 95065210 DACARZIN 95065229 DACARZIN 95122591 DACOGEN (Restrito Hosp,) 95500014 DACTIL-OB 95995471 DAFLON 95995480 DAFLON 95927506 DAFLON 95152890 DAFLON 95290516 DAFORIN 95290508 DAFORIN 95054502 DAFORIN 95290524 DAFORIN 95892427 DAIVOBET 95800018 DAIVONEX 95390588 DAKTARIN 95390600 DAKTARIN (*) 95390618 DAKTAZOL 95028510 DALACIN T 95376410 DALACIN-C 95376402 DALACIN-C 95892435 DALAP 95270388 DALMADORM 95054510 DALSY 95054553 DALSY 95054529 DALSY 95054537 DALSY 95892451 DALZOSTON 95892443 DALZOSTON 95097600 DAMATER 95927549 DANTALIN 95065237 DANTROLEN 95430180 DAONIL

APRESENTAÇÃO 40 mg/50 ml sol, inj, fr, 50 ml 100 mg, FA 200 mg, FA 1 mg/ml sol, inj, FA vd, x 2 ml 200 mg, liof, 1 fr, 200 mg, po liof, sol, inj, 10 FA vd, amb, 100 mg, po liof, inj, cx, FA x 10 ml 200 mg, po liof, inj, cx, FA x 20 ml 1 FA po liof, 50 mg, Cx, 30 drags, 500 15 cprs, rev, 500 30 cprs, rev, 500 60 cprs, rev, 900 + 100 mg. or. ct. bl. al. plas. trans. x 30 cprs. rev. 10 mg, 2 bl, x 10 caps, 20 mg cx, 20 caps, 20 mg, 2 bl, x 15 cprs, rev, 20 mg, bl, 30 caps pom.derm.bisn.30 g Pom, bisn, 30 g, Locao fr, 30 ml, Gel oral bisn, 40 g, Locao a 2% cx, 1 fr, 30 ml 30 ml, 300 mg, 1 amp 2 ml 300 mg, cx, 16 caps, 1 mg/g gel, derm, bisn, 30 g 30 mg, 3 bl, al, x 10 cprs, rev, 20 mg/ml susp, oral ct, fr, vd, amb, x 100 ml+ ser, dos, 200 mg, ct, 2 bl, al, pvc/pvdc x 6 cprs, rev, 400 mg, rev, ct, bl, al, pvc/pdvc x 10 cprs, 600 mg,cprs,rev,x10 500 mg, fr, vd, 100 ml 500mg,fr,plast,100 ml 30 caps, 100 mg, cx, 25 cprs, IV 20 cx 12 frs Cx, 30 cprs,

Laboratorio SIGMA PHARMA MEIZLER MEIZLER ACCORD EUROFARMA EUROFARMA LIBRA LIBRA JANSSEN - CILAG SANOFI-AVENTIS SERVIER SERVIER SERVIER SERVIER SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ROCHE ROCHE JANSSEN - CILAG JANSSEN - CILAG NEO QUIMICA PFIZER PFIZER PFIZER BIOSINTETICA VALEANT ABBOTT ABBOTT ABBOTT ABBOTT ARISTON ARISTON SCHERING-PLOUGH CAZI CRISTALIA SANOFI-AVENTIS

UNIDADE Pco Unt Base A FA 332,72 X FA 46,82 FA 87,02 FA 28,12 FA 85,64 FA 85,65 FA 28,85 FA 40,22 FA 3464,63 CPR 0,39 COMP 1,78 COMP 1,75 CPR 1,68 CPRS 3,36 CPR 0,88 CPR 1,25 COMP 1,20 CPR 1,13 GRAMA 72,92 G 1,92 ML 0,42 G 0,51 ML 0,25 GOTA 0,07 AP 8,10 CPR 4,68 GRAMA 47,47 CPR 0,51 ML 0,12 COMP 0,65 COMP 1,15 COMP 1,60 ML 0,07 ML 0,07 CAPS 1,03 CPR 0,19 FA 119,61 X CPR 0,34

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4642 4643 4644 4645 4646 4647 4648 4649 4650 4651 4652 4653 4654 4655 4656 4657 4658 4659 4660 4661 4662 4663 4664 4665 4666 4667 4668 4669 4670 4671 4672 4673 4674 4675 4676 4677 4678 4679

CODIGO BENEFICIO 95410058 DARAPRIM 95540660 DARBIN 95540679 DARBIN 95122605 DARBIN (Restrito Hosp,) 95122613 DARBIN (Restrito Hosp,) 95080163 DASC 95540687 DAUNOBLASTINA 95540695 DAUNOCIN 95995528 DAUNOXONE 95995536 DAUNOXONE 95097619 DAXAS 95470093 DDAVP 95470123 DDAVP 95470107 DDAVP 95470085 DDAVP 95470115 DDAVP 95122621 DDAVP (Restrito Hosp,) 95480293 DECADRON (*) 95480307 DECADRON (*) 95480315 DECADRON (*) 95927565 DECADRON (*) 95054561 DECADRON COLIRIO 95065245 DECADRON SOLUCAO INJETAVEL 95065253 DECADRON SOLUCAO INJETAVEL 95054570 DECADRON SOLUCAO NASAL 95927573 DECADRONAL 95097627 DECA-DURABOLIN 95490140 DECA-DURABOLIN 95097635 DECA-DURABOLIN 95490159 DECA-DURABOLIN 95016457 DECAN HALOPER 95927581 DECAZOL 95927590 DEFATIG 95984666 DEFLAIMMUN 95984674 DEFLAIMMUN 95984682 DEFLAIMMUN 95450289 DEFLANIL 95450270 DEFLANIL

APRESENTAÇÃO Cx, 100 cprs, Sol, inj, 100 mg cx, 10 amps, Sol, inj, 500 mg cx, 2 amps, Sol, inj, 20 mg/ml 10 FA vd, Sol, inj, 50 mg/ml FA vd, 1 x 20 drags Fr, amp, 20 mg, FA 20 mg+ amp, dil, 4 ml, 50 mg, inj, cx, 4 FA Fracao de venda - 1 FA 500 mcg bl, pvc/pvdc/al x 30 cprs, rev, 0,1 mg, fr, 30 cprs, 0,1 mg/ml spray nasal fr, 2,5 ml 0,2 mg, fr, 30 cprs, 4 mcg/ml cart, 10 amps, 1 ml Sol, nasal fr, 2,5 ml, c/ 2 aplic, 15 mcg/ml cart, 10 amps, 1 ml 0,50 mg, vd, 20 cprs, 0,75 mg, 20 cprs, 4 mg, vd, 10 cprs, Elixir fr, 120 ml Fr, 5 ml 2 mg, 2 FA x 1 ml 4 mg, 1 FA x 2,5 ml Fr, 20 ml FA 2 ml 25 mg, cx, 1 amp, 25 mg, cx, 1 amp, 50 mg, 1 amp, 50 mg, 1 amp, Sol, inj,3 amps,x1 ml Creme 10 g Cx, 20 drags, 30 mg, 1 bl, x 10 cprs, 6 mg, 2 bl, x 10 cprs, 7,5 mg,2 bl,x10cprs, 30 mg, cx, 10 cprs, 7,5 mg, x 20 cprs,

Laboratorio FARMOQUIMICA DARROW DARROW DARROW DARROW EMS PFIZER MEIZLER UNITED MEDICAL UNITED MEDICAL NYCOMED PHARMA FERRING FERRING FERRING FERRING FERRING FERRING ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE SCHERING-PLOUGH ORGANON SCHERING-PLOUGH ORGANON UNIAO QUIMICA BRASTERAPICA FARMASA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA LIBBS LIBBS

UNIDADE Pco Unt Base A CPR 0,06 AP 11,10 AP 56,16 FA 10,22 FA 103,42 CPR 0,67 FA 56,57 AP 68,99 F,A, 1219,19 UND 1219,19 COMP 4,64 CPR 4,12 DOSE 3,39 CPR 4,12 AP 15,91 DOSE 3,39 AMP 59,64 CPR 0,17 cx 0,31 CPR 0,10 ML 0,08 GOTA 0,08 ML 2,91 FA 7,21 GOTA 0,05 FA 9,48 AMP 7,00 AP 6,74 AMP 13,37 AP 12,89 AMP 13,16 G 0,55 CPR 0,30 COMP 5,50 COMP 1,18 COMP 1,43 CPR 8,66 CPR 2,17

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Orde Geral 4680 4681 4682 4683 4684 4685 4686 4687 4688 4689 4690 4691 4692 4693 4694 4695 4696 4697 4698 4699 4700 4701 4702 4703 4704 4705 4706 4707 4708 4709 4710 4711 4712 4713 4714 4715 4716 4717

CODIGO BENEFICIO 95450297 DEFLANIL 95450300 DEFLANIL 95054596 DEFLAZACORTE 95028536 DEFLAZACORTE 95892460 DEFLAZACORTE 95892478 DEFLAZACORTE 95892486 DEFLAZACORTE 95892494 DEFLAZACORTE 95892508 DEFLAZACORTE 95892516 DEFLAZACORTE 95054588 DEFLAZACORTE 95028544 DEFLAZACORTE 95028552 DEFLOGEN 95987681 DEKATIN 95132490 DELAKETE 95132503 DELAKETE 95830030 DELTACID 95830049 DELTACID 95097643 DELTAFLAN 95995579 DELTAMETRIL 95995587 DELTAMETRIL 95850104 DELTAMITREN 95850112 DELTAMITREN 95830146 DELTAPIO 95830154 DELTAPIO 95097651 DELTAREN 95097660 DELTAREN 95097678 DELTAREN 95016473 DELTRACIN 95016465 DELTRACIN 95143165 DEMEDROX 95143173 DEMEDROX 95450351 DENACEN 95450343 DENACEN 95850139 DEOTRIN 95850120 DEOTRIN 95094415 DEPACON 95340173 DEPAKENE

GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO

APRESENTAÇÃO Gts, fr, 13 ml, Gts, fr, 6,5 ml, 30 mg, 10 cprs, 30 mg, 9 bl, x 10 cprs, 30 mg, bl, 10 cprs, 30 mg, bl, 10 cprs, 30 mg, bl, 10 cprs, 6 mg, 2 bl, x 10 cprs, 6 mg, 2 bl, x 10 cprs, 6 mg, 2 bl, x 10 cprs, 6 mg, 20 cprs, 6 mg, 9 bl, x 10 cprs, 100 mg, cx, 12 cprs, Cx, 30 cprs, rev, 15 mg, fr, 30 cprs, 30 mg, fr, 30 cprs, Locao 100 ml, Shampoo 100 ml, Bisn, 40 g Locao vd, 100 ml Shampoo vd, 100 ml Locao 100 ml Shampoo 100 ml Locao 100 ml Shampoo 100 ml Cx, 20 drags, 50 mg, Gel bisn, 60 g Gotas sol, fr, 10 ml Locao fr, 100 ml Shampoo fr, 100 ml 150 mg/ml susp. inj. 1 amp. 150 mg/ml susp. inj. seringa preenchida x 1 ml 30 mg, cx, 10 cprs, 6 mg, cx, 20 cprs, Locao fr, 100 ml, Shampoo fr, 100 ml, 100 mcg/ml sol, inj, FA x 5 ml 250 mg, fr, 25 caps,

Laboratorio LIBBS LIBBS MEPHA-RATIOPHARM EMS EMS GERMED EUROGENUS - LEGRAND EMS GERMED GEN - LEGRAND MEPHA-RATIOPHARM EMS UNIAO QUIMICA ATIVUS CHIESI CHIESI SOLVAY FARMA SOLVAY FARMA DELTA MEDQUIMICA MEDQUIMICA TEUTO BRAS, TEUTO BRAS, LUPER LUPER DELTA DELTA DELTA MEDIC MEDIC UNIAO QUIMICA UNIAO QUIMICA MARJAN MARJAN BUNKER BUNKER ABBOTT ABBOTT

UNIDADE Pco Unt Base A GOTAS 0,25 GOTAS 0,20 COMP 5,46 CPR 5,92 COMP 5,93 COMP 4,99 COMP 4,13 COMP 1,24 COMP 1,04 COMP 1,24 COMP 1,21 CPR 1,24 CPR 0,79 CPR 0,74 CPR 1,03 CPR 2,02 ML 0,10 ML 0,10 GRAMA 0,40 ML 0,11 ML 0,10 ML 0,09 ML 0,09 ML 0,09 ML 0,09 COMP 0,38 GRAMA 0,21 GOTAS 0,03 ML 0,08 ML 0,08 AMP 20,60 AMP 20,96 CPR 9,88 CPR 1,86 ML 0,13 ML 0,13 FA 94,80 CPR 0,47

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Orde Geral 4718 4719 4720 4721 4722 4723 4724 4725 4726 4727 4728 4729 4730 4731 4732 4733 4734 4735 4736 4737 4738 4739 4740 4741 4742 4743 4744 4745 4746 4747 4748 4749 4750 4751 4752 4753 4754 4755

CODIGO BENEFICIO 95340181 DEPAKENE 95340190 DEPAKENE 95054600 DEPAKENE 95037179 DEPAKOTE 95037187 DEPAKOTE 95016481 DEPAKOTE 95037195 DEPAKOTE 95097694 DEPAKOTE 95054618 DEPAXAN 95054626 DEPAXAN 95450360 DEPO-MEDROL 95892524 DEPRAMINA 95290532 DEPRAX 95927603 DEPRESS 95927611 DEPRESS 95350152 DEPRILAN 95310061 DEPROZOL 95310070 DEPROZOL 95097708 DERIVA MICRO 95850171 DERMACERIUM 95054634 DERMACERIUM 95054642 DERMACERIUM 95037209 DERMACERIUM 95037217 DERMACERIUM 95016511 DERMACERIUM 2,2 95016538 DERMACERIUM 2,2 95016490 DERMACERIUM 2,2 95016520 DERMACERIUM 2,2 95016503 DERMACERIUM 2,2 95097716 DERMAFREE 95071601 DERMALINA 95071580 DERMALINA 95071598 DERMALINA 95892532 DERMAMON-FREE CREME PROTETOR 95892567 DERMAMON-FREE CREME PROTETOR 95927620 DERMATISAN 95054650 DERMAZINE 95054669 DERMAZINE

APRESENTAÇÃO 300 mg, fr, 25 cprs,rev, 500 mg, fr, 50 cprs, rev, Xpe, 250 mg/5 ml fr, 100 ml 250 mg, 30 cprs, 500 mg, 30 cprs, ER 500 mg, 20 cprs, ER 500 mg, 30 cprs, Sprinkle 10 caps, 20 mg, bl, 20 cprs, bl, al, 20 mg, bl, 30 cprs, bl, al, 40 mg, fr, 2 ml 25 mg, 20 cprs, rev, 20 mg, caps, gel, bl, x 28 20 mg, 14 caps, 20 mg, 28 caps, 5 mg, 20 cprs, 1000 mg, 2 cprs, rev, 1000 mg, 4 cprs, rev, 1 mg, gel, derm, bisn, 30 g 1%+ 0,4% crem, cx, bisn, plast, x 120 g 1%+ 0,4% crem, cx, bisn, plast, x 30 g 1%+ 0,4% crem, cx, bisn, plast, x 50 g 10 g 5g 120 g 15 g 30 g 400 g 50 g Fr, 15 ml 20 mg/g creme derm, bisn, al, x 28 g 20 mg/g locao top, fr, vd, amb, x 30 g 20 mg/g po top, fr, plast, opc x 30 g Bisnaga tampa flip-top 100 g - 12 un, (IPI incl,) Bisnaga tampa flip-top 60 g - 12 un, (IPI incl,) Creme bisn, 20 g 1% crem, derm, cart, bisn, plast, opaca x 30 g 1% crem, derm, cart, bisn, plast, opaca x 50 g

Laboratorio ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT BIOSINTETICA BIOSINTETICA PFIZER TEUTO BRAS, ACHE UNIAO QUIMICA UNIAO QUIMICA BIOSINTETICA ACHE ACHE GLENMARK SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE DELTA COSMED COSMED COSMED DBS DBS EMS SILVESTRE SILVESTRE

UNIDADE Pco Unt Base A CPR 0,64 CPR 0,80 ML 0,10 CP 1,05 CP 1,95 COMP 1,64 CP 1,95 CAPS 0,61 COMP 1,84 COMP 1,70 AP 11,00 COMP 0,17 CPR 2,14 CPR 1,08 CPR 1,08 CPR 1,44 CPR 10,41 CPR 9,86 GRAMA 1,56 G 0,62 G 0,90 G 0,75 G 0,52 G 0,52 GRAMA 1,04 GRAMA 1,04 GRAMA 1,04 GRAMA 0,86 GRAMA 1,04 ML 1,06 G 0,37 G 0,27 FR 16,99 UND 4,38 UND 3,75 G 1,13 G 0,57 G 0,46

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Orde Geral 4756 4757 4758 4759 4760 4761 4762 4763 4764 4765 4766 4767 4768 4769 4770 4771 4772 4773 4774 4775 4776 4777 4778 4779 4780 4781 4782 4783 4784 4785 4786 4787 4788 4789 4790 4791 4792 4793

CODIGO BENEFICIO 95054677 DERMAZINE 95054685 DERMAZINE 95016546 DERMAZINE 95016554 DERMAZINE 95016562 DERMAZINE 95016570 DERMAZINE 95840745 DERMAZINE 95840761 DERMAZINE 95840770 DERMAZINE 95840753 DERMAZINE 95071610 DERMIL 95071628 DERMIL 95071636 DERMIL 95927638 DERMOBAN 95840800 DERMOBENE 95840818 DERMOBENE 95892575 DERMOCORTE 95892583 DERMOCORTE 95840826 DERMODEX 95927646 DERMOMAX 95927654 DERMOMAX 95016597 DERMOTIL 95780173 DERMOXIN 95850180 DERMS 95016619 DERSANI 95016600 DERSANI 95016635 DERSANI 95016627 DERSANI 95016643 DERSANI MIRIM 95054693 DESAGREG 95054707 DESAGREG 95892591 DESALEX 95927689 DESALEX 95927697 DESALEX 95097724 DESARCOR 95097732 DESARCOR 95082352 DESCON 95097740 DESCON

APRESENTAÇÃO 1% crem, derm, pote plast, x 100 g 1% crem, derm, pote plast, x 400 g 30 g cx, 24 bisn, 30 g cx, 60 bisn, 50 g cx, 24 bisn, 50 g cx, 60 bisn, Tb com 100 g Tb com 30 g Tb com 400 g Tb com 50 g 500 UI+ 900 UI+ 150 mg/g pom, derm, bisn, plast, x 20 g 500 UI+ 900 UI+ 150 mg/g pom, derm, bisn, plast, x 45 g 500 UI+ 900 UI+ 150 mg/g pom, derm, bisn, plast, x 90 g 2% creme bisn, 15 g Creme 20 g, Sol, 20 ml Creme bisn, 30 g Pom, bisn, 30 g Tb, 60 g, 40 mg/g creme dermat, ct, 1 bisn, al x 30 40 mg/g creme dermat, ct, 1 bisn, al, x 5 g 1 mg/g pom, derm, ct, bg, al, x 20 g Pom, tb, 10 g, Tb, 30 g, pom, Oleo Dersani 100 ml (IPI incluso) Oleo Dersani 20 ml (IPI incluso) Oleo Dersani 200 ml (IPI incluso) Oleo Dersani 500 ml (IPI incluso) Oleo Infantil Dersani Mirim 50 ml (IPI incluso) 250 mg, bl, 20 cprs, rev, 250 mg, bl, 30 cprs, rev, 0,5 mg/ml xpe, fr, vd, 100 ml+ dosador 0,5 mg/mlxpe,fr,60 ml 5 mg,bl,plas,x10cprs, 16 mg, bl, 30 cprs, 8 mg, bl, 30 cprs, Gts, fr, 20 ml Vd, 20 caps, gel, dura

Laboratorio UNIDADE Pco Unt Base A SILVESTRE G 0,30 SILVESTRE G 0,17 SILVESTRE GRAMA 0,20 SILVESTRE GRAMA 0,20 SILVESTRE GRAMA 0,20 SILVESTRE GRAMA 0,20 SILVESTRE G 0,21 SILVESTRE G 0,50 SILVESTRE G 0,12 SILVESTRE G 0,41 COSMED G 0,15 COSMED G 0,17 COSMED G 0,13 CAZI G 1,70 LEGRAND G 0,44 LEGRAND ML 0,91 EMS GRAMA 0,54 EMS G 0,54 B-MS G 0,52 BIOSINTETICA G 1,75 BIOSINTETICA G 2,24 GLENMARK GRAMA 1,08 BUNKER G 1,16 UNIAO QUIMICA G 0,69 ADVANCED PRODUCTS DIVISAO SANIPLAN ML 0,36 ADVANCED PRODUCTS DIVISAO SANIPLAN ML 0,49 ADVANCED PRODUCTS DIVISAO SANIPLAN ML 0,30 ADVANCED PRODUCTS DIVISAO SANIPLAN ML 0,26 ADVANCED PRODUCTS DIVISAO SANIPLAN ML 0,53 EUROFARMA COMP 1,05 EUROFARMA COMP 1,03 MANTECORP ML 0,50 MANTECORP ML 0,50 MANTECORP CPR 3,75 SANDOZ COMP 1,06 SANDOZ COMP 0,98 FARMASA GOTA 0,06 FARMASA CAPS 0,95

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Orde Geral 4794 4795 4796 4797 4798 4799 4800 4801 4802 4803 4804 4805 4806 4807 4808 4809 4810 4811 4812 4813 4814 4815 4816 4817 4818 4819 4820 4821 4822 4823 4824 4825 4826 4827 4828 4829 4830 4831

CODIGO BENEFICIO 95100156 DESFRIN 95100148 DESFRIN 95995714 DESINFLEX 95995722 DESINFLEX 95927743 DESINFLEX 95065261 DESLANOL 95097759 DESLORANA 95097767 DESLORANA 95097775 DESLORANA 95094423 DESLORATADINA - GENERICO 95097783 DESLORATADINA - GENERICO 95097791 DESLORATADINA - GENERICO 95097805 DESLORATADINA - GENERICO 95097813 DESLORATADINA - GENERICO 95097821 DESLORATADINA - GENERICO 95084800 DESLORATADINA - GENERICO 95097830 DESLORATADINA - GENERICO 95097848 DESLORATADINA - GENERICO 95084819 DESLORATADINA - GENERICO 95084827 DESLORATADINA - GENERICO 95927751 DESOBESI M 95892605 DESONIDA - GENERICO 95028579 DESONIDA - GENERICO 95892613 DESONIDA - GENERICO 95028587 DESONIDA - GENERICO 95892621 DESONIDA - GENERICO 95892630 DESONIDA - GENERICO 95892648 DESONIDA - GENERICO 95892656 DESONIDA - GENERICO 95892664 DESONIDA - GENERICO 95892672 DESONIDA - GENERICO 95376445 DESPACILINA 400,000 UI 95560130 DESTILBENOL 95090444 DETIMEDAC 95995838 DETRUSITOL LA 95995846 DETRUSITOL LA 95082360 DETRUSITOL LA 95089594 DEXA CIANOTRAT

APRESENTAÇÃO Ped, fr, 10 ml Sol, nasal spray 10 ml 50 mg, cx, 20 cprs, 75 mg, inj, 5 amps, Retard 100 mg, 20 caps, 0,2 mg/ml sol, inj, 50 amps, vd, x 2 ml 0,5 mg/ml xpe, fr, 100 ml 0,5 mg/ml xpe, fr, 60 ml 5 mg, bl, 10 cprs, rev, 0,5 mg/ml xpe ct, fr, plast, opc, x 60 ml+ ser, dos, 0,5 mg/ml xpe, ct, fr, vd, amb, x 60 ml + ser, dos, 0,5 mg/ml xpe, fr, 100 ml 0,5 mg/ml xpe, fr, 100 ml 0,5 mg/ml xpe, fr, 60 ml 0,5 mg/ml xpe, fr, 60 ml 5 mg, bl, 10 cprs, rev, 5 mg, bl, 10 cprs, rev, 5 mg, bl, 10 cprs, rev, Xpe, 0,5 mg/ml fr, 100 ml Xpe, 0,5 mg/ml fr, 60 ml Cx, 30 caps, 0,5 mg/g creme bisn, 30 g 0,5 mg/g creme derm, bisn, x 30 g 0,5 mg/g locao cremosa fr, 60 g 0,5 mg/g locao derm, fr, plast, 60 g 0,5 mg/g locao top, fr, 60 g Locao capilar 1 mg/ml fr, 30 g Locao capilar fr, 30 g Locao capilar fr, 30 g Locao cremosa fr, 60 g Locao cremosa fr, 60 g Cx, 100 FA c/dil, 1 mg, 50 cprs, rev, 200 mg, po liof, inj, ct, FA vd, amb, x 10 4 mg, 14 caps, 4 mg, 28 caps, 4 mg, 30 caps, Sol, inj, cx, 6 amps, 1 ml+ 6 amps, 2 ml

Laboratorio UNIAO QUIMICA UNIAO QUIMICA DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS UNIAO QUIMICA LEGRAND LEGRAND LEGRAND PRATI DONADUZZI PRATI DONADUZZI GEN - LEGRAND GERMED GEN - LEGRAND GERMED EMS GEN - LEGRAND GERMED EMS EMS ACHE GERMED PRATI DONADUZZI EMS PRATI DONADUZZI MEDLEY EMS GERMED GEN - LEGRAND GERMED GEN - LEGRAND B-MS APSEN OPEM PFIZER PFIZER PFIZER DELTA

UNIDADE Pco Unt Base A GOTAS 0,04 DOSE 0,04 CPR 0,45 AMP 0,81 CPR 0,92 AMP 1,07 ML 0,32 ML 0,32 COMP 2,43 ML 0,27 ML 0,30 ML 0,30 ML 0,30 ML 0,30 ML 0,30 COMP 2,25 COMP 2,12 COMP 2,25 ML 0,30 ML 0,30 CAPS 0,42 GRAMA 0,50 FR 9,70 GRAMA 0,77 FR 16,58 GRAMA 0,48 GRAMA 0,46 GRAMA 0,46 GRAMA 0,46 GRAMA 0,40 GRAMA 0,40 AP 5,40 CPR 0,44 FA 28,23 CAPS 7,79 CAPS 7,79 CAPs 8,72 AMP 6,60

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4832 4833 4834 4835 4836 4837 4838 4839 4840 4841 4842 4843 4844 4845 4846 4847 4848 4849 4850 4851 4852 4853 4854 4855 4856 4857 4858 4859 4860 4861 4862 4863 4864 4865 4866 4867 4868 4869

CODIGO BENEFICIO 95660941 DEXA-CITONEURIN 95660950 DEXA-CITONEURIN (*) 95660968 DEXACOBAL 95016660 DEXADEN 95016651 DEXADEN 95016678 DEXADEN 95790292 DEXADERME 95790306 DEXADERME 95927760 DEXADERMIL 95790322 DEXADOR 95790357 DEXADOZE 95790365 DEXADOZE 95700030 DEXAFENICOL 95700021 DEXAFENICOL 95790373 DEXAGIL 95790381 DEXAGIL 95097856 DEXALGEN 95790390 DEXALGEN 95054715 DEXAMESON 95097864 DEXAMETASONA - GENERICO 95892699 DEXAMETASONA - GENERICO 95037250 DEXAMETASONA - GENERICO 95995854 DEXAMETASONA - GENERICO 95995889 DEXAMETASONA - GENERICO 95987690 DEXAMETASONA - GENERICO 95987703 DEXAMETASONA - GENERICO 95995919 DEXAMETASONA - GENERICO 95995927 DEXAMETASONA - GENERICO 95995935 DEXAMETASONA - GENERICO 95927778 DEXAMETASONA - GENERICO 95097872 DEXAMETASONA - GENERICO 95097880 DEXAMETASONA - GENERICO 95097899 DEXAMETASONA - GENERICO 95028625 DEXAMETASONA - GENERICO 95081399 DEXAMETASONA - GENERICO 95450459 DEXAMETASONA - GENERICO 95892710 DEXAMETASONA - GENERICO 95016694 DEXAMETASONA - GENERICO

APRESENTAÇÃO Emb, c/20 cprs, Est, 3 amps, 1 ml, e 3 amps, 2 ml, Cx, 3 amps,x 2 ml+ 3 amps,x 1 ml, 0,5 mg, 20 cprs, Creme 10 g Elixir 100 ml Creme bisn, 10 g Pom, bisn, 10 g Creme bisn,10 g 5,000 mcg, 20 cprs, rev, 1000 3 amps 1 e 2 ml 5000 3 amps 1 e 2 ml Bisn, 3,5 g, Fr, 5 ml, Cx, 20 cprs, Inj, 3 amps, 1 ml, B x 2 ml, A Amp, 1 x 1 ml Amps, 3 x 1 ml, 50 bisn, 10 g 0,1 mg/ml elixir fr, 120 ml 0,1 mg/ml elixir fr, vd, x 120 ml 0,1 mg/ml, elx, ct, fr, plas, opc, x 120 ml, 0,5 mg, 2 bl, x 10 cprs, 0,75 mg, 2 bl, x 10 cprs, 2mg,1mlcx,50amps, 4 mg 2,5 ml, cx, 50 amps, 4 mg, 1 bl, x 10 cprs, 4,0 mg, 1 bl, x 10 cprs, 4,0 mg, 1 bl, x 10 cprs, Elixir 0,1 mg/ml (vd c/120 ml) Elixir 0,1 mg/ml 100 ml (hosp,) - cx, c/60 frs, Elixir 0,1 mg/ml 120 ml (hosp,) - cx, c/60 frs, Elixir 0,1 mg/ml CT 100 ml - frasco Elixir 0,1 mg/ml cx, vd, 120 ml+ copo med, Elixir 0,1 mg/ml fr, pet, 100 ml+ cp, med, Elixir 0,1 mg/ml, fr, 100 ml Elixir cx, 1 fr, 120 ml Elixir fr, 120 ml

Laboratorio MERCK MERCK UNIAO QUIMICA CIFARMA CIFARMA CIFARMA MEDIC MEDIC LEGRAND ATIVUS TEUTO BRAS, TEUTO BRAS, ALLERGAN ALLERGAN MARJAN MARJAN EUROFARMA EUROFARMA CRISTALIA CRISTALIA PRATI DONADUZZI PRATI DONADUZZI EMS EMS HYPOFARMA HYPOFARMA GEN - LEGRAND EMS GERMED NEO QUIMICA FARMACE FARMACE FARMACE DUCTO TEUTO BRAS, TEUTO BRAS, CRISTALIA GEN - LEGRAND

UNIDADE Pco Unt Base A CPR 1,59 AP 6,70 AP 7,09 COMP 0,19 GRAMA 0,94 ML 0,09 G 0,74 G 0,74 G 1,09 CPR 1,60 AP 4,29 AP 6,21 G 1,66 GOTAS 0,06 CPR 1,45 AP 5,65 AMP 8,52 AP 8,90 G 0,72 ML 0,07 ML 0,05 ML 0,07 COMP 0,13 COMP 0,16 AMP 0,95 AMP 1,38 COMP 0,63 COMP 0,63 COMP 0,53 ML 0,06 ML 0,06 ML 0,05 ML 0,06 GOTA 0,00 ML 0,06 ML 0,06 ML 0,05 ML 0,05

127

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4870 4871 4872 4873 4874 4875 4876 4877 4878 4879 4880 4881 4882 4883 4884 4885 4886 4887 4888 4889 4890 4891 4892 4893 4894 4895 4896 4897 4898 4899 4900 4901 4902 4903 4904 4905 4906 4907

CODIGO BENEFICIO 95892729 DEXAMETASONA - GENERICO 95892737 DEXAMETASONA - GENERICO 95122630 DEXAMETASONA - GENERICO (Restrito Hosp,) 95097902 DEXAMETONAL 95700048 DEXAMINOR 95700056 DEXAMINOR 95790403 DEXANEURIN 95450521 DEXANIL 95450548 DEXANIL (*) 95450530 DEXANIL (*) 95122648 DEXANIL (Restrito Hosp,) 95122656 DEXANIL (Restrito Hosp,) 95450599 DEXASON 95450602 DEXASON 95054723 DEXASON 95450610 DEXASON 95450572 DEXASON 95450629 DEXASON 95680012 DEXAVISON 95661000 DEXAZONA 95660976 DEXAZONA 95660984 DEXAZONA 95892745 DEXAZONA 95892753 DEXCLORFENIRAMINA - GENERICO 95927794 DEXCLORFLEX 95927808 DEXLERG 95016716 DEXTAMINE 95016708 DEXTAMINE 95611347 DEXTROVITASE 95892770 DFLAM 95430229 DIABINESE 95037284 DIACQUA 95037268 DIACQUA 95037276 DIACQUA 95430237 DIAFORMIN 95927816 DIAFURAN 95582185 DIÁLISE PERITONEAL 1,5% 95582193 DIÁLISE PERITONEAL 7%

APRESENTAÇÃO Elixir fr, 120 ml+ cp, med, x 10 ml Elixir fr, vd, 100 ml 50 frs, 0,1 mg/ml elx, cx, 50 fr, plast, opc, x 120 ml (hosp,) Creme derm, 10 g Col, fr, 5 ml, Pom, fr, 3,5 g, Cx, amp, 2 ml,+ amp, 1 ml, Creme 0,1% bisn, 15 g, 2 mg/ml cx, 2 amps, 1 ml 4 mg/ml cx, 1 FA 2,5 ml, Sol, inj, 2 mg/ml 50 FA x 1 ml Sol, inj, 4 mg/ml 50 FA x 2,5 ml 0,50 mg, bl, 20 cprs, 0,75 mg, bl, 20 cprs, 1,0 mg/ml creme derm, 50 bisn, x 10 g (hosp,) 4 mg, bl, 10 cprs, 4 mg, FA 2,5 ml Creme tb, 10 g Colirio fr, 5 ml 2 mg, inj, cx, 2 amps, 1 ml, Cx, 10 cprs, Elixir fr, 100 ml, Sol, fr, got, x 5 ml Xpe, 2 mg/ml fr, 100 ml 2 mg, 1 bl, x 20 2 mg, cx, 20 cprs, 2,00 / 0,25 mg, 15 cprs, Xpe, 120 ml Inj, cx, 1 x 20 cc 25 mg/ml sol, inj, cx, 10 amps, vd, x 3 ml Cx, 30 cprs, 250 mg, 100 mg, bl, 16cprs, 25 mg, bl, 30 cprs, 50 mg, bl, 30cprs, 850 mg cx, 30 cprs, rev, 2 mg, cx, 12 cprs, Fr com 1000 ml Fr com 1000 ml

Laboratorio MEDLEY PRATI DONADUZZI PRATI DONADUZZI HEXAL ALLERGAN ALLERGAN UNIAO QUIMICA DUCTO DUCTO DUCTO NEO QUIMICA NEO QUIMICA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BUNKER BUNKER BUNKER BUNKER TEUTO BRAS, BRASTERAPICA CAZI CIFARMA CIFARMA ACHE CLARIS PFIZER EUROFARMA EUROFARMA EUROFARMA UNIAO QUIMICA CAZI JP JP

UNIDADE Pco Unt Base A UND 8,48 ML 1,92 ML 0,87 GRAMA 7,23 GOTAS 0,04 G 1,15 AP 8,48 G 0,62 AP 3,60 AP 7,40 AMP 3,12 AMP 3,21 CPR 0,16 CPR 0,20 G 0,67 CPR 0,92 AP 6,30 G 0,81 GOTAS 0,05 AP 4,22 CPR 0,50 ML 0,10 GOTA 0,07 ML 0,04 CPR 0,28 CPR 0,40 COMP 0,61 ML 0,16 AP 7,37 AMP 0,71 CPR 0,33 CP 0,91 CP 0,42 CP 0,67 CPR 0,53 CPR 0,55 FR 5,18 FR 7,25

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4908 4909 4910 4911 4912 4913 4914 4915 4916 4917 4918 4919 4920 4921 4922 4923 4924 4925 4926 4927 4928 4929 4930 4931 4932 4933 4934 4935 4936 4937 4938 4939 4940 4941 4942 4943 4944 4945

CODIGO BENEFICIO 95016759 DIAMELLITIS 95016740 DIAMELLITIS 95016732 DIAMELLITIS 95430288 DIAMICRON 95430270 DIAMICRON 95927824 DIAMICRON 95136380 DIAMIN (Restrito Hosp,) 95995978 DIAMOX 95040080 DIASEC 95037292 DIASEC 95892788 DIATYL 95097910 DIAZEPAM - GENERICO 95054774 DIAZEPAM - GENERICO 95097929 DIAZEPAM - GENERICO 95082387 DIAZEPAM - GENERICO 95892796 DIAZEPAM - GENERICO 95892800 DIAZEPAM - GENERICO 95097937 DIAZEPAM - GENERICO 95097945 DIAZEPAM - GENERICO 95270434 DIAZEPAM - GENERICO 95054766 DIAZEPAM - GENERICO 95097953 DIAZEPAM - GENERICO 95927883 DIAZEPAM - GENERICO 95082379 DIAZEPAM - GENERICO 95892818 DIAZEPAM - GENERICO 95892826 DIAZEPAM - GENERICO 95097961 DIAZEPAM - GENERICO 95097970 DIAZEPAM - GENERICO 95048383 DIAZEPAM - GENERICO 95995994 DIAZEPAM - GENERICO 95996001 DIAZEPAM - GENERICO 95097988 DIAZEPAM - GENERICO 95122664 DIAZEPAM - GENERICO (Restrito Hosp,) 95984780 DIAZEPAM N,Q, 95984798 DIAZEPAM N,Q, 95984801 DIAZEPAM N,Q, 95270442 DIAZEPAN N,Q, 95270450 DIAZEPAN N,Q,

APRESENTAÇÃO 1 mg, 30 cprs, 2 mg, 30 cprs, 4 mg, 30 cprs, MR 30 mg 15 cprs, MR 30 mg 30 cprs, MR 30 mg 60 cprs, 200 mg/ml sol, inj, cx, FA vd, inc, x 50 ml Ct, 1 fr, x 25 cprs, Cx, 12 cprs, Fracao de venda 4 bl, x 4 caps, (B1) 5 mg, 2 bl, x 10 cprs, 10 mg, 2 bl, x 10 cprs, 10 mg, 2 bl, x 10 cprs, 10 mg, 3 bl, x 10 cprs, 10 mg, 3 bl, x 10 cprs, 10 mg, bl, 20 cprs, 10 mg, cx, 20 cprs, 10 mg, cx, 30 cprs, 10 mg, inj, 2 ml, 5 amps, 5 mg, 2 bl, x 10 cprs, 5 mg, 2 bl, x 10 cprs, 5 mg, 2 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, bl, 20 cprs, 5 mg, cx, 20 cprs, 5 mg, cx, 30 cprs, 5 mg/ml sol, inj, ct, amp, vd, 72 amps, x 2 ml (hosp,) 5 mg/ml sol, inj, cx, 10 amps, x 2 ml 5 mg/ml sol, inj, cx, 50 amps, x 2 ml NQ 10 mg, 2 bl, x 10 cprs, 5 mg/ml sol, inj, cx, 100 amps, vd, amb, x 2 ml 10 mg, cx, 1 amp, 10 mg, cx, 20 cprs, 5 mg, vd, 20 cprs, 10 mg, cx, 20 cprs, 5 mg, vd, 20 cprs,

Laboratorio CIFARMA CIFARMA CIFARMA SERVIER SERVIER SERVIER CLARIS UNIAO QUIMICA HEXAL HEXAL PROCTER & GAMBLE SIGMA PHARMA GEN - LEGRAND EMS EMS GERMED RANBAXY NEO QUIMICA NEO QUIMICA GERMED GEN - LEGRAND EMS GERMED EMS GERMED RANBAXY NEO QUIMICA NEO QUIMICA TEUTO BRAS, UNIAO QUIMICA UNIAO QUIMICA SIGMA PHARMA SANTISA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA

UNIDADE Pco Unt Base A COMP 0,36 COMP 0,72 COMP 1,15 CPR 0,70 CPR 0,70 CPR 0,70 FA 174,74 COMP 0,40 CPR 0,65 CP 1,17 CAPS 0,61 COMP 0,36 COMP 0,24 COMP 0,25 COMP 0,25 COMP 0,25 COMP 0,24 COMP 0,26 COMP 0,26 AP 0,58 COMP 0,17 COMP 0,19 CPR 0,19 COMP 0,18 COMP 0,18 COMP 0,17 COMP 0,19 COMP 0,19 AMP 0,46 AMP 0,41 AMP 0,43 COMP 0,47 COMP 0,40 AMP 1,46 COMP 0,45 COMP 0,31 CPR 0,37 CPR 0,30

129

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 4946 4947 4948 4949 4950 4951 4952 4953 4954 4955 4956 4957 4958 4959 4960 4961 4962 4963 4964 4965 4966 4967 4968 4969 4970 4971 4972 4973 4974 4975 4976 4977 4978 4979 4980 4981 4982 4983

CODIGO BENEFICIO 95376453 DIAZOL 95376461 DIAZOL 95020357 DICETEL 95020349 DICETEL 95016767 DICINONE 95927891 DICLAC 95661018 DICLAC 95927905 DICLIN 95028641 DICLIN 95661034 DICLO P 95892842 DICLOFARMA 95016783 DICLOFARMA 95984810 DICLOFEN (*) 95927913 DICLOFENACO 95927921 DICLOFENACO 95927930 DICLOFENACO 95927948 DICLOFENACO 95927964 DICLOFENACO 95927972 DICLOFENACO 95927980 DICLOFENACO 95927999 DICLOFENACO 95928006 DICLOFENACO 95996036 DICLOFENACO 95928014 DICLOFENACO 95996044 DICLOFENACO 95996052 DICLOFENACO 95996060 DICLOFENACO 95996079 DICLOFENACO 95996087 DICLOFENACO 95996095 DICLOFENACO 95996109 DICLOFENACO 95928030 DICLOFENACO 95928049 DICLOFENACO 95928057 DICLOFENACO 95928065 DICLOFENACO 95928073 DICLOFENACO 95996133 DICLOFENACO 95996141 DICLOFENACO

POTASSICO - GENERICO POTASSICO - GENERICO POTASSICO - GENERICO POTASSICO - GENERICO POTASSICO - GENERICO POTASSICO - GENERICO POTASSICO - GENERICO POTASSICO - GENERICO DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE COLESTIRAMINA - GENERIC DE SODIO - GENERICO DIETILAMONIO - GENERICO DIETILAMONIO - GENERICO DIETILAMONIO - GENERICO DIETILAMONIO - GENERICO POTASSICO - GENERICO RESINATO - GENERICO

APRESENTAÇÃO 12 cprs, Fr, 60 ml 100 mg, cx, 20 cprs, rev, 50 mg, cx, 20 cprs, rev, Cx, 20 cprs, 50 mg, cx, 20 cprs, SR 75 mg 20 cprs, 2 mg,+ 0,035 mg est, cal, 21 cprs, rev, 2 mg,+ 0,035 mg est, cal, 63 cprs, rev, 50 mg, 20 cprs, rev, 25 mg/ml amp, 3 ml 75 mg/3 ml amp, 3 ml 50 mg, 20 drags, 50 mg, 1 str, x 10 drags, 50 mg, 10 cprs, 50 mg, 2 str, x 10 drags, 50 mg, 20 cprs, 50 mg, bl, 20 cprs, 50 mg, bl, 20 cprs, rev, 50 mg, cx, 20 cprs, 50 mg, fr, plat, 20 cprs, 70 mg, 1 bl, x 14 caps, 70 mg, 14 cs, 70 mg, 2 bl, x 10 caps, 70 mg, 2 bl, x 10 caps, 70 mg, 2 bl, x 10 caps, 70 mg, 2 bl, x 10 caps, 70 mg, 2 bl, x 7 caps, 70 mg, 2 bl, x 7 caps, 70 mg, 2 bl, x 7 caps, 70 mg, 20 cs, Inj, 75 mg, cx, 50 amps, 3 ml 10 mg / g gel bisn, 60 g Gel derm, 10 mg/gbisn, 60 g Gel, 10 mg/g bisn, 60 g Gel, 10 mg/g cx, 1 bisn, 60 g 50 mg, 20 dg, 15 mg/ml gts, fr, 20 ml

Laboratorio EMS EMS NYCOMED PHARMA NYCOMED PHARMA SANOFI-AVENTIS HEXAL HEXAL MERCK MERCK UNIAO QUIMICA FARMACE FARMACE PHARMACIA/PFIZER BRAINFARMA RATIOPHARM BRAINFARMA RATIOPHARM RANBAXY BIOSINTETICA EMS APOTEX MEDLEY NOVARTIS MEDLEY EMS GERMED GEN - LEGRAND EMS GERMED GEN - LEGRAND NOVARTIS DUCTO CRISTALIA TEUTO BRAS, EMS NEO QUIMICA NOVARTIS EMS

UNIDADE Pco Unt Base A CPR 1,29 ML 0,21 CPR 2,68 CPR 1,79 COMP 0,79 CPR 0,33 CPR 0,85 CPR 0,46 CPR 0,37 CPR 0,52 AMP 66,78 AMP 0,18 DRAG 0,43 CPR 0,52 CPR 0,43 CPR 0,49 CPR 0,43 CPR 0,31 CPR 0,45 CPR 0,50 CPR 0,36 CPR 0,92 CAPS 0,81 CPR 0,87 CAPS 0,87 CAPS 0,88 CAPS 0,83 CAPS 0,92 CAPS 0,91 CAPS 0,84 CAPS 0,82 AP 0,69 G 0,11 G 0,12 G 0,15 G 0,11 DRAG 0,60 GOTA 0,02

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Orde Geral 4984 4985 4986 4987 4988 4989 4990 4991 4992 4993 4994 4995 4996 4997 4998 4999 5000 5001 5002 5003 5004 5005 5006 5007 5008 5009 5010 5011 5012 5013 5014 5015 5016 5017 5018 5019 5020 5021

CODIGO BENEFICIO 95996150 DICLOFENACO RESINATO - GENERICO 95996168 DICLOFENACO RESINATO - GENERICO 95996176 DICLOFENACO SODICO - GENERICO 95028650 DICLOFENACO DE COLESTIRAMINA - GENERICO 95892850 DICLOFENACO DE COLESTIRAMINA - GENERICO 95028668 DICLOFENACO DE COLESTIRAMINA - GENERICO 95661115 DICLOFENACO DE SODIO - GENERICO 95661123 DICLOFENACO DE SODIO - GENERICO 95892877 DICLOFENACO DIETILAMONIO GENER 95892885 DICLOFENACO DIETILAMONIO GENER 95892893 DICLOFENACO DIETILAMONIO GENER 95061975 DICLOFENACO DIETILAMONIO GENERICO 95094601 DICLOFENACO DIETILAMONIO - GENERICO 95083812 DICLOFENACO POTASSICO - GENERICO 95892907 DICLOFENACO POTASSICO - GENERICO 95016791 DICLOFENACO POTASSICO - GENERICO 95661255 DICLOFENACO POTASSICO - GENERICO 95661220 DICLOFENACO POTASSICO - GENERICO 95045422 DICLOFENACO POTASSICO - GENERICO 95122672 DICLOFENACO POTASSICO - GENERICO (Restrito Hosp,) 95122680 DICLOFENACO POTASSICO - GENERICO (Restrito Hosp,) 95661263 DICLOFENACO RESINATO - GENERICO 95054812 DICLOFENACO RESINATO - GENERICO 95661271 DICLOFENACO RESINATO - GENERICO 95661280 DICLOFENACO RESINATO - GENERICO 95071644 DICLOFENACO SODICO - GENERICO 95892923 DICLOFENACO SODICO - GENERICO 95892931 DICLOFENACO SODICO - GENERICO 95928081 DICLOFENACO SODICO - GENERICO 95028676 DICLOFENACO SODICO - GENERICO 95928090 DICLOFENACO SODICO - GENERICO 95097996 DICLOFENACO SODICO - GENERICO 95028684 DICLOFENACO SODICO - GENERICO 95028692 DICLOFENACO SODICO - GENERICO 95043527 DICLOFENACO SODICO - GENERICO 95928103 DICLOFENACO SODICO - GENERICO 95928120 DICLOFENACO SODICO - GENERICO 95098003 DICLOFENACO SODICO - GENERICO

APRESENTAÇÃO 15 mg/ml gts, fr, 20 ml Gts, 15 mg/ml fr, 20 ml 50 mg, 20 ce 70 mg, 1 bl, x 10 caps, 70 mg, 1 bl, x 10 caps, 70 mg, 11 bl, x 6 caps, Inj, 75 mg cx, 5 amps,3 ml Inj, 75 mg, cx, 5 amps, 3 ml Gel bisn, 60 g Gel creme bisn, 60 g Gel creme cx, 50 bisn, 60 g 11,6 mg, gel x 60 g 10 mg/g gel creme bisn, 60 g 25 mg/ml 100 x 3 ml sol, inj, cx, amp, vd, inc, (hosp,) 50 mg, 10 cprs, rev, 50 mg, 6 bl, x 10 cprs, rev, 50 mg, bl, 20 cprs, 50 mg, cx, 20 cprs, 50 mg, cx,20 cprs,disp, 50 mg, bl, 1000 cprs, rev, (hosp,) 50 mg, bl, 240 cprs, rev, (hosp,) 15 mg/ml susp, fr, plast, gts, 20 ml, 15 mg/mlsusp,oral20ml Gts, 15 mg/ml fr, 20 ml, Gts, fr, 20 ml, 1 mg/ml sol, oft, fr, plast, got, x 5 ml 10 mg/g gel bisn, 60 g 100 mg, bl, 10 caps, gel, microg, 100mg,1bl,x10cprs, 25 mg/ml 3 ml cx, 100 amps, 25 mg/ml cx, 50 amps, x 3 ml 25 mg/ml sol, inj, 5 amps, vd, x 3 ml, 25 mg/ml sol, inj, IM cx, 50 amps, vd, x 3 ml 50 mg 20 cprs, rev, ent, 50 mg bl, 20 cprs, rev, 50 mg, 1 bl, x 10 cprs, rev, 50 mg, 2 bl, x 10 cprs, rev, 50 mg, 20 cprs,

Laboratorio GEN - LEGRAND GERMED NOVARTIS EMS GERMED EMS NEO QUIMICA DUCTO RANBAXY PRATI DONADUZZI PRATI DONADUZZI UNIAO QUIMICA BIOSINTETICA TEUTO BRAS, EMS EMS RANBAXY EMS TEUTO BRAS, ACCORD ACCORD BIOSINTETICA MEPHA-RATIOPHARM TEUTO BRAS, MEDLEY NEO QUIMICA EMS MERCK RANBAXY HYPOFARMA UNIAO QUIMICA TEUTO BRAS, NOVAFARMA SANDOZ ABBOTT BRAINFARMA BRAINFARMA MULTILAB

UNIDADE Pco Unt Base A GOTA 0,02 GOTA 0,02 COMP 0,63 CPR 0,84 CAPS 0,83 CPR 0,84 AP 0,92 AP 0,83 G 0,12 GRAMA 0,17 UND 4,50 G 0,15 GRAMA 0,13 Amp 0,99 COMP 0,63 COMP 0,42 CPR 0,31 CPR 0,50 COMP 0,27 COMP 0,55 COMP 0,55 GOTAS 0,02 GOTA 0,02 GOTAS 0,02 GOTAS 0,02 GOTA 0,09 GRAMA 0,16 CAPS 0,81 CPR 0,76 AMP 0,67 AP 0,78 AMP 1,10 AMP 0,91 CPR 0,40 CP 0,44 CPR 0,55 CPR 0,52 COMP 0,32

131

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5022 5023 5024 5025 5026 5027 5028 5029 5030 5031 5032 5033 5034 5035 5036 5037 5038 5039 5040 5041 5042 5043 5044 5045 5046 5047 5048 5049 5050 5051 5052 5053 5054 5055 5056 5057 5058 5059

CODIGO BENEFICIO 95661433 DICLOFENACO SODICO - GENERICO 95661310 DICLOFENACO SODICO - GENERICO 95098011 DICLOFENACO SODICO - GENERICO 95071660 DICLOFENACO SODICO - GENERICO 95094431 DICLOFENACO SODICO - GENERICO 95071652 DICLOFENACO SODICO - GENERICO 95892940 DICLOFENACO SODICO - GENERICO 95098020 DICLOFENACO SODICO - GENERICO 95928162 DICLOFENACO SODICO - GENERICO 95892958 DICLOFENACO SODICO - GENERICO 95048375 DICLOFENACO SODICO - GENERICO 95016805 DICLOFENACO SODICO - GENERICO 95016813 DICLOFENACO SODICO - GENERICO 95082425 DICLOFENACO SODICO - GENERICO (*) 95082417 DICLOFENACO SODICO - GENERICO (*) 95082433 DICLOFENACO SODICO - GENERICO (*) 95082409 DICLOFENACO SODICO - GENERICO (*) 95082395 DICLOFENACO SODICO - GENERICO (*) 95098038 DICLOFENACO SODICO - GENERICO (Restrito Hosp,) 95122699 DICLOFENACO SODICO - GENERICO (Restrito Hosp,) 95122702 DICLOFENACO SODICO - GENERICO (Restrito Hosp,) 95996184 DICLOFETAMOL 95700064 DICLOGENOM 95700072 DICLOGENOM 95037322 DICLOKALIUM 95928170 DICLOKALIUM 95037349 DICLOKALIUM (*) 95037330 DICLOKALIUM (*) 95028714 DICLONACO 95661484 DICLONACO 95928189 DICLONATRIUM 95037357 DICLONATRIUM 95037365 DICLORIDRATO DE CETIRIZINA - GENERIC 95028722 DICLORIDRATO DE CETIRIZINA - GENERIC 95928197 DICLORIDRATO DE CETIRIZINA - GENERIC 95028730 DICLORIDRATO DE CETIRIZINA - GENERIC 95928200 DICLORIDRATO DE CETIRIZINA - GENERIC 95996192 DICLORIDRATO DE CETIRIZINA - GENERIC

APRESENTAÇÃO 50 mg, bl, 20 cprs, 50 mg, bl, 20 cprs, rev, 50 mg, bl, x 20 cprs, rev, 50 mg, com, rev, ct, bl, al, plas, inc, x 20 50 mg, com, rev, ct, bl, al, plas, inc, x 400 (frac,) 50 mg, com, rev, ct, bl, al, plas, inc, x 500 (emb, hosp,) 60 g gel bisn, 60 g 75 mg, cx, 5 amps, 3 ml, 75 mg, cx,5amps,3ml, Gel, bisn, 60 g Sol, inj, 25 mg/ml cx, 100 amps, x 3 ml Sol, inj, 5 amps, x 3 ml SR 100 mg, 10 cprs, 100 mg, 2 bl, x 10 cprs, rev, 100 mg, bl, x 10 cprs, rev, 100 mg, bl, x 10 cprs, rev, 100 mg, des, lenta 2 bl, x 10 cprs, rev, 100 mg, des, lenta bl, 10 cprs, rev, 25 mg/ml cx, 50 amps, x 3 ml 25 mg/ml sol, inj, cx, 5 amps, vd, inc, x 3 ml (hosp,) 25 mg/ml sol, inj, cx, 50 amps, vd, inc, x 3 ml (hosp,) Cx, 25 bl, x 4 cprs, Colirio 5 ml Pom, 3,5 g 10 mg/g gel, crem, ct, bg, al, x 60 g 50 mg 500 cprs, 50 mg, com, rev, ct, bl, al, plas, inc, x 200 50 mg, com, rev, ct, bl, al, plas, inc, x 500 (emb, hosp,) 50mg,cx, 1 bl, 20 cprs, Inj, 75 mg,cx, 5 amps, 3 ml, 50 mg 500 cprs, 50 mg, com, rev, ct, 25 bl, al, plas, inc, x 20 (emb, hosp,) 1 mg/ml, sol, or, ct, fr, vd, amb, x 120 ml, 10 mg c/14 10 mg c/14 10 mg c/7 10 mg c/7 10 mg, 1 bl, x 6 cprs, rev,

Laboratorio RANBAXY BIOSINTETICA COSMED PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GEN - LEGRAND MEDLEY MEDLEY GERMED TEUTO BRAS, UNIAO QUIMICA MEPHA-RATIOPHARM GEN - LEGRAND GERMED GEN - LEGRAND EMS EMS UNIAO QUIMICA ARISTON ARISTON DUCTO UNIAO QUIMICA UNIAO QUIMICA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI DUCTO DUCTO PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI SANDOZ HEXAL SANDOZ HEXAL IPCA DO BRASIL

UNIDADE Pco Unt Base A CPR 0,43 CPR 0,45 COMP 0,44 COMP 0,50 COMP 0,38 COMP 0,20 GRAMA 9,00 AMP 0,87 AP 0,74 GRAMA 0,15 AMP 0,85 AMP 0,76 COMP 1,23 COMP 0,95 COMP 1,23 COMP 1,23 COMP 1,21 COMP 1,23 AMP 0,76 AMP 0,92 AMP 0,82 COMP 0,62 GOTAS 0,19 G 5,21 G 0,19 CPR 0,05 CP 0,05 CP 0,05 CPR 0,26 AP 1,66 CPR 0,04 CP 0,05 ML 0,15 UND 1,11 CPR 1,17 UND 1,11 CPR 1,17 COMP 1,01

132

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5060 5061 5062 5063 5064 5065 5066 5067 5068 5069 5070 5071 5072 5073 5074 5075 5076 5077 5078 5079 5080 5081 5082 5083 5084 5085 5086 5087 5088 5089 5090 5091 5092 5093 5094 5095 5096 5097

CODIGO BENEFICIO 95996206 DICLORIDRATO DE CETIRIZINA - GENERIC 95996214 DICLORIDRATO DE CETIRIZINA - GENERIC 95996222 DICLORIDRATO DE CETIRIZINA - GENERIC 95928219 DICLORIDRATO DE CETIRIZINA - GENERIC 95928227 DICLORIDRATO DE CETIRIZINA - GENERIC 95071679 DICLORIDRATO DE LEVOCETIRIZINA - GENERICO 95230580 DICLORIDRATO DE CETIRIZINA - GENERICO 95230599 DICLORIDRATO DE CETIRIZINA - GENERICO 95081410 DICLORIDRATO DE CETIRIZINA - GENERICO 95098046 DICLORIDRATO DE CETIRIZINA - GENERICO 95098054 DICLORIDRATO DE CETIRIZINA - GENERICO 95081402 DICLORIDRATO DE CETIRIZINA - GENERICO 95137998 DICLORIDRATO DE HIDROXIZINA - GENERICO 95037373 DICLOSTIR 95037381 DICLOSTIR 95037390 DICLOSTIR 95071687 DICLOTON 95110283 DICORANTIL 95054820 DIELOFT 95098062 DIELOFT 95054839 DIELOFT 95016821 DIENPAX 95016830 DIENPAX 95016872 DIENTRIN 95016864 DIENTRIN 95016856 DIENTRIN DIETA ESPECIAL PARA PACIENTE EM PROCESSO 95590919 CICATRICIAL 95590668 DIETA HIPERCALORICA 95982710 DIETA OLIGOMERICA 95042865 DIETA PADRAO 95042873 DIETA PADRAO COM FIBRAS 95590480 DIETA PARA PACIENTES COM INSUFICIENCIA HEPATICA 95007873 DIETA PARA PACIENTES COM INSUFICIENCIA RENAL 95590463 DIETA PARA PACIENTES DIABETICOS 95042814 DIETA PARA PACIENTES EM SITUACOES CRITICAS 95590773 DIETA PARA PNEUMOPATAS 95590633 DIETA PEDIATRICA 95054855 DIFEBRIL

APRESENTAÇÃO 10 mg, 2 bl, x 6 cprs, rev, 10 mg, bl, 12 cprs, rev, 10 mg, bl, 6 cprs, rev, 120 ml 80 ml 5 mg, bl, 10 cprs, rev, 1 mg/ml sol, oral fr, 120 ml,+cp, med, 10 mg bl, 6 cprs, rev, 10 mg, 2 bl, al, plas, inc, x 7 cprs, rev, 10 mg, bl, al, plas, inc, x 12 cprs, rev, 10 mg, bl, al, plas, inc, x 6 cprs, rev, 10 mg, bl, al, plas, inc, x 7 cprs, rev, 80 frs. 100 ml 70 mg, 2 bl, x 10 caps, 70 mg, 2 bl, x 7 caps, 70 mg, bl, 10 caps, Cx, 10 drags, F 250 mg, 16 cprs, 100 mg, bl, 20 cprs, rev, 50 mg, bl, 30 cprs, rev, 50mg,bl,20cprs, rev, 10 mg, 20 cprs, 5 mg, blister 20 cprs, Cart, 12 cprs, Cx, 30 x 4 cprs, Susp, 60 cc

Laboratorio IPCA DO BRASIL BIOSINTETICA BIOSINTETICA PRATI DONADUZZI PRATI DONADUZZI EUROFARMA MEDLEY MEDLEY SANDOZ SANDOZ SANDOZ SANDOZ MEDQUIMICA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ROYTON SANOFI-AVENTIS MEDLEY MEDLEY MEDLEY SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS

500 mg, str, 100 cprs,

CIFARMA

UNIDADE Pco Unt Base A COMP 2,07 COMP 1,64 COMP 1,69 ML 0,10 ML 0,15 COMP 1,66 ML 0,14 CPR 1,78 COMP 1,37 COMP 1,54 COMP 1,55 COMP 1,38 COMP 0,14 CP 0,64 CP 0,68 CP 0,64 DRAG 0,33 CPR 1,09 COMP 4,08 COMP 1,46 COMP 2,09 COMP 0,32 COMP 0,20 COMP 0,46 COMP 0,46 ML 0,06 ML 0,06 ML 0,03 ML 0,08 ML 0,02 ML 0,02 ML 0,21 ML 0,06 ML 0,05 ML 0,13 ML 0,13 ML 0,11 COMP 0,36

133

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5098 5099 5100 5101 5102 5103 5104 5105 5106 5107 5108 5109 5110 5111 5112 5113 5114 5115 5116 5117 5118 5119 5120 5121 5122 5123 5124 5125 5126 5127 5128 5129 5130 5131 5132 5133 5134 5135

CODIGO BENEFICIO 95054847 DIFEBRIL 95054863 DIFEBRIL 95700080 DIFEN 95661514 DIFENAN 95661549 DIFENAN 95065300 DIFENIDRIN 95320326 DIGECAP 95016910 DIGEDRAT 95016929 DIGEDRAT 95996230 DIGEDRAT 95016937 DIGESAN 95016945 DIGESAN 95016988 DIGESAN 95016953 DIGESAN

APRESENTAÇÃO 500 mg/ml sol, oral fr, plast, got, 10 ml 500 mg/ml sol, oral fr, plast, got, 20 ml 0,1% col, fr, 5 ml, 50 mg, cx, 20 cprs, 75 mg, cx, 5 amps, 3ml, 50 mg/ml25amps,1ml Zimatico 20 caps, 200 mg, 30 caps, gel 200 mg, 60 caps, gel 200 mg, bl, 20 caps, gel, mole Cx, 20 caps, Gts, ped, 20 ml, Inj, cx, 6 amps, 2 ml Retard 20 caps,

Laboratorio CIFARMA CIFARMA ALLERGAN ROYTON ROYTON CRISTALIA SIGMA PHARMA MEDLEY MEDLEY MEDLEY SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS

95016970 DIGESAN 95016961 DIGESAN 95320440 DIGESPRID 95071709 DIGESPRID 95071695 DIGESPRID 95320458 DIGESPRID 95098070 DIGESTIL 95098089 DIGESTIL 95320466 DIGESTINA 95320482 DIGESTINA 95320474 DIGESTINA 95996273 DIGOXIL 95090150 DIGOXINA 95090142 DIGOXINA 95037403 DIGOXINA - GENERICO 95054880 DIGOXINA - GENERICO 95084835 DIGOXINA - GENERICO 95054871 DIGOXINA - GENERICO 95996281 DIGOXINA - GENERICO 95140360 DILACOR 95140417 DILACORON 95140387 DILACORON 95140409 DILACORON 95132554 DILAFLUX

Sol, inj, cx, 50 amps, x 2 ml, Sol, oral fr, 120 ml 10 mg cx, 2 bl, x 10 caps, 10 mg, 50 bl, x 10 caps, gel dura (hosp,) 4 mg/ml sol, oral cx, 50 fr, plast, opc, got, x 10 ml (hosp,) Gts, 4 mg/ml fr, plast, 20 ml 10 mg, 20 cprs, Sol, oral 20 ml 10 mg, x 20 cprs, 5 mg/ml 6 amps, 2 ml Gts, 4 mg, x 20 ml, 0,25 mg, 20 cprs, Cx, 25 cprs, 0,25 mg, Sol, 60 ml 0,05 mg/ml, elx, ct, fr, vd, amb, x 60 ml, c/ cgt 0,25 mg, cx, 100 cprs, 0,25 mg, cx, 25 cprs, 0,25 mg, cx, 30 cprs, Elixir 60 ml 80 mg, cx, 30 cprs, rev, 120 mg, ret, 2 bl, x 10 cprs, rev, 240 mg, retard cprs, rev, 3 bl, inc, x 10 80 mg, cprs, rev, 2 bl, x 15 10 mg, C sublingual 3 bl, x 10

SANOFI-AVENTIS SANOFI-AVENTIS NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA TEUTO BRAS, TEUTO BRAS, UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA LEGRAND GLAXOSMITHKLINE GLAXOSMITHKLINE PRATI DONADUZZI TEUTO BRAS, NEO QUIMICA TEUTO BRAS, PRATI DONADUZZI TEUTO BRAS, ABBOTT ABBOTT ABBOTT MEDLEY

UNIDADE Pco Unt Base A GOTA 0,02 GOTA 0,01 GOTAS 0,07 CPR 0,26 AP 3,32 AMP 10,25 CPR 0,97 COMP 1,95 COMP 1,76 CAPS 1,95 CAPS 1,08 GOTA 0,05 AMP 4,22 COMP 1,06 AMP ML CPR CAPS GOTA GOTAS COMP GOTAS CPR AP GOTAS COMP CPR ML ML COMP COMP COMP ML CPR CPR CPR CPR CPR

3,45 0,18 0,71 0,64 0,06 0,03 0,70 0,03 0,97 3,57 0,04 0,31 0,43 0,35 0,21 0,16 0,26 0,26 0,14 0,37 1,63 2,55 0,86 0,18

134

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5136 5137 5138 5139 5140 5141 5142 5143 5144 5145 5146 5147 5148 5149 5150 5151 5152 5153 5154 5155 5156 5157 5158 5159 5160 5161 5162 5163 5164 5165 5166 5167 5168 5169 5170 5171 5172 5173

CODIGO BENEFICIO 95132562 DILAFLUX 95996290 DILCOR 95996303 DILCOR 95996311 DILCOR 95054901 DILTIPRESS 95054898 DILTIPRESS 95140522 DILTIZEM 95140506 DILTIZEM 95140492 DILTIZEM 95928260 DILTOR CD 95928278 DILTOR CD 95996320 DIMEFOR 95430296 DIMEFOR 95120602 DIMERCAPROL 95928286 DIMETAPP COMPRIMIDOS 95290559 DIMETAPP ELIXIR 95928294 DIMETAPP GELCAPS 95037411 DIMETICONA - GENERICO 95928316 DIMETICONA - GENERICO 95017054 DIMETICONA - GENERICO 95996354 DIMETICONA - GENERICO 95996370 DIMETICONA - GENERICO 95892974 DIMETICONA - GENERICO 95892982 DIMETICONA - GENERICO 95996389 DIMETICONA - GENERICO 95043535 DIMETICONA - GENERICO 95054910 DIMETICONA - GENERICO 95098097 DIMETICONA - GENERICO 95037420 DIMETICONA - GENERICO 95893008 DIMETICONA - GENERICO 95017020 DIMETICONA - GENERICO 95017038 DIMETICONA - GENERICO 95037454 DIMETICONA - GENERICO 95996397 DIMETICONA - GENERICO 95043543 DIMETICONA - GENERICO 95071725 DIMETICONA - GENERICO 95043560 DIMETICONA - GENERICO 95017011 DIMETICONA - GENERICO

APRESENTAÇÃO Laboratorio Retard 20 mg, cprs, rev, 2 bl, x 10 MEDLEY 180 mg, cx, 2 bl, x 10 caps, GROSS 300 mg, cx, 2 bl, x 10 caps, GROSS 90 mg, cx, 2 bl, x 10 caps, GROSS 30 mg, 2 bl, x 25 cprs, SIGMA PHARMA 60 mg, 2 bl, x 25 cprs, SIGMA PHARMA 120 mg, 20 cprs PFIZER AP 240 mg, 10 cprs PFIZER AP 90 mg, 20 cprs PFIZER 180 mg, cx, 20 caps, TORRENT 240 mg, cx, 20 caps, TORRENT 500 mg, 30cprs, FARMOQUIMICA 850 mg, 30 drags, FARMOQUIMICA Cx, 5 amps, SANOFI-AVENTIS Cx, 28 cprs, WHITEHALL Fr, c/120 ml, WYETH CONSUMER Cx, 20 cprs, WYETH CONSUMER 125 mg, 30 bl, x 3 caps, gel, mole MEDLEY 125 mg, cap, gel mole ct, bl, plas, inc, x 10 MEDLEY 125mg,1 bl, x10 caps, GEN - LEGRAND 125mg,1 bl, x10 caps, GERMED 125mg,10 caps,gelmole EMS 40 mg, 2 bl, x 10 cprs, MEDLEY 40 mg, 2 bl, x 10 cprs, GEN - LEGRAND 40 mg, 2 bl, x 10 cprs, EMS 40 mg, 20 cprs, BIOSINTETICA 40 mg, 20 cprs, MEPHA-RATIOPHARM 40 mg, 20 cprs, CIFARMA 40 mg, 50 bl, x 4 cprs, MEDLEY 40 mg, bl, 20 cprs, FARMASA 40 mg, bl, 200 cprs, PRATI DONADUZZI 40 mg, bl, 600 cprs, (hosp,) PRATI DONADUZZI 40 mg, com, ct, bl, al, plas, inc, x 20 PRATI DONADUZZI 75 mg, gts, fr, 15 ml EMS 75 mg, sol, fr, gts, 15 ml BIOSINTETICA 75 mg/ml emu, or cx, 200 frs, plas, opc, got, x 10 ml (hosp,)HIPOLABOR 75 mg/ml emul, oral 200 fr, x 10 ml TEUTO BRAS, 75 mg/ml emul, oral cx, 200 fr, plast, got, x 15 ml (hosp,) PRATI DONADUZZI

UNIDADE Pco Unt Base A CPR 0,42 CAPS 1,64 CAPS 2,26 CAPS 1,00 COMP 0,18 COMP 0,39 CPR 1,29 CPR 2,57 CPR 1,09 CPR 0,98 CPR 1,20 COMP 0,34 CPR 0,58 AP 9,42 CPR 0,35 ML 0,08 CPR 0,96 CP 0,93 CPR 0,99 CAPS 0,81 CAPS 0,78 CAPS 1,12 COMP 0,28 COMP 0,40 COMP 0,32 CP 0,23 COMP 0,29 COMP 0,34 CP 0,20 COMP 0,34 COMP 0,28 COMP 0,15 CP 0,30 GOTA 0,03 GOTA 0,01 GOTA 0,01 GOTA 0,02 GOTA 0,01

135

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5174 5175 5176 5177 5178 5179 5180 5181 5182 5183 5184 5185 5186 5187 5188 5189 5190 5191 5192 5193 5194 5195 5196 5197 5198 5199 5200 5201 5202 5203 5204 5205 5206 5207 5208 5209 5210 5211

CODIGO BENEFICIO 95043551 DIMETICONA - GENERICO 95017003 DIMETICONA - GENERICO 95071717 DIMETICONA - GENERICO 95017046 DIMETICONA - GENERICO 95054928 DIMETICONA - GENERICO 95893016 DIMETICONA - GENERICO 95996400 DIMETICONA - GENERICO 95037446 DIMETICONA - GENERICO 95037438 DIMETICONA - GENERICO 95996419 DIMETICONA - GENERICO 95017062 DIMETICONA - GENERICO (*) 95893024 DIMETICONA + METILBR, HOMATROPINA - GENE 95996427 DIMETICONA + METILBR, HOMATROPINA - GENE 95893032 DIMETICONA + METILBR, HOMATROPINA - GENE 95893040 DIMETICONA + METILBR, HOMATROPINA - GENE 95082441 DIMETICONA + METILBR, HOMATROPINA - GENERICO 95098100 DIMETICONA + METILBR, HOMATROPINA - GENERICO 95020390 DIMETILIV 95020403 DIMETILIV 95020411 DIMETILIV 95490167 DIMETROSE 95928340 DIMEZIN 95071733 DIMEZIN 95054936 DIMEZIN 95054944 DIMEZIN (*) 95065334 DIMORF 95331409 DIMORF 95083820 DIMORF 95083839 DIMORF 95928359 DIMORF 95122710 DIMORF 95331379 DIMORF 95065318 DIMORF 95331360 DIMORF 95122729 DIMORF (Restrito Hosp,) 95122737 DIMORF (Restrito Hosp,) 95331425 DIMORF LC 95331433 DIMORF LC

APRESENTAÇÃO 75 mg/ml emul, oral fr, 15 ml 75 mg/ml emul, oral fr, plast, got, x 15 ml 75 mg/ml emul, oral fr, plast, got, x 15 ml 75 mg/ml emuls, or,cx, 200 fr, plast, got, x 10 ml (hosp,) 75 mg/ml emulsao oral 15 ml 75 mg/ml gts, fr, 15 ml 75 mg/ml gts, fr, 15 ml Fracao de venda (30 x 3) Fracao de venda (50 x 4) Gts, 75 mg, fr, 15 ml 150 mg, tb, plast, x 12 cprs, 80 mg/ml+ 2,5 mg/ml fr, 20 ml 80+2,5mg/mlfr,20 ml Gts, fr, 20 ml Gts, fr, 20 ml Gts, fr, 20 ml, Gts, fr, 20 ml, 40 mg bl, 20 cprs, 75 mg gts, 15 ml Max 125 mg bl, 10 caps, gel, Blister 8 caps, 40 mg, cx, 20 cprs, Emuls, oral 10 ml Emuls, oral 50 fr, plast, got, x 10 ml (hosp,) 40 mg, cx, 20 cprs, 0,1 mg/ml sol, inj, cx, 50 est, amps, vd, amb, x 1 ml 0,2 mg/ml cx, 50 est, c/1 amp, x 1 ml (SP) 0,2 mg/ml sol, inj, 50 amps, x 1 ml 1 mg/ml sol, inj, 50 amps, x 2 ml 10 mg,5bl,10cprs, 10 mg/ml 5 amps, x 1 ml 10 mg/ml sol, oral fr, 60 ml 10 mg/ml50amps,1ml 30 mg, cx, 1 fr, 50 cprs, 0,1 mg/ml sol, inj, cx, 50 est, x 1 amp, vd, amb, x 1 ml 10 mg/ml 50 amps, 1 ml 100 mg, cx, 60 caps, 30 mg, cx, 60 caps,

Laboratorio TEUTO BRAS, PRATI DONADUZZI NEO QUIMICA PRATI DONADUZZI MEPHA-RATIOPHARM EUROFARMA MERCK MEDLEY MEDLEY GEN - LEGRAND FARMASA MEDLEY EMS GERMED EUROGENUS - LEGRAND GEN - LEGRAND GERMED EMS EMS EMS SANOFI-AVENTIS TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA

UNIDADE Pco Unt Base A GOTA 0,02 GOTA 0,03 GOTA 0,03 GOTA 0,01 GOTA 0,02 GOTA 0,02 GOTA 0,02 CP 0,23 CP 0,20 GOTA 0,02 COMP 0,55 GOTA 0,02 GOTA 0,02 GOTAS 0,01 GOTAS 0,01 Gota 0,02 GOTAS 0,02 CPR 0,44 GOTAS 0,03 CPR 1,22 CPR 17,19 CPR 0,40 GOTA 0,03 ML 0,50 COMP 0,40 AMP 3,53 AP 3,17 amp 3,17 amp 3,53 CPR 0,46 AMP 2,72 ML 0,40 AMP 2,33 CPR 1,23 AMP 1,54 AMP 2,33 CPR 2,80 CPR 1,58

136

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5212 5213 5214 5215 5216 5217 5218 5219 5220 5221 5222 5223 5224 5225 5226 5227 5228 5229 5230 5231 5232 5233 5234 5235 5236 5237 5238 5239 5240 5241 5242 5243 5244 5245 5246 5247 5248 5249

CODIGO BENEFICIO 95331441 DIMORF LC 95071741 DIN 95071750 DIN 95071776 DIN 95071792 DIN 95071768 DIN 95071784 DIN 95071814 DIN 95071830 DIN 95071806 DIN 95071822 DIN 95928375 DINATON - FITOTERAPICO 95750401 DINILL 95928383 DINITRATO ISOSSORBIDA - GENERICO 95928391 DINITRATO ISOSSORBIDA - GENERICO 95928405 DIOSMIN 95928413 DIOSMIN 95098119 DIOVAN 95996451 DIOVAN 95893067 DIOVAN 95893059 DIOVAN 95928448 DIOVAN AMLO 95928456 DIOVAN AMLO 95037497 DIOVAN AMLO FIX 95098127 DIOVAN AMLO FIX 95037470 DIOVAN AMLO FIX 95037500 DIOVAN AMLO FIX 95098135 DIOVAN AMLO FIX 95037489 DIOVAN AMLO FIX 95037462 DIOVAN AMLO FIX 95132686 DIOVAN HCT 95928464 DIOVAN HCT 95928472 DIOVAN HCT 95132651 DIOVAN HCT 95098143 DIOVAN TRIPLO 95098151 DIOVAN TRIPLO 95082468 DIOVAN TRIPLO 95082450 DIOVAN TRIPLO

APRESENTAÇÃO 60 mg, cx, 60 caps, 200 mg/ml sol, oral fr, plast, opc, got, x 15 ml 200 mg/ml sol, oral fr, plast, opc, got, x 20 ml 500 mg, bl, x 4 cprs, 500 mg, bl, x 6 cprs, 500 mg, disp, 25 bl, x 4 cprs, 500 mg, disp, 25 bl, x 6 cprs, 750 mg, bl, x 4 cprs, 750 mg, bl, x 6 cprs, 750 mg, disp, 25 bl, x 4 cprs, 750 mg, disp, 25 bl, x 6 cprs, 80 mg, 2 bl, x 10 cprs, 10 ml, 10 mg, 2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 500 mg, 30 cprs, rev, 500 mg, 60 cprs, rev, 320 mg, 14 ce, 320 mg, 28 ce 40 mg, 14 ce, div, 40mg,28cediv, 160 mg/5 mg, 28+ 28 cp 80 mg/5 mg, 28+ 28 cp 160 mg/10 mg, 28 cp, 160 mg/5 mg, 14 cp, 160 mg/5 mg, 28 cp, 320 mg/10 mg, 28 cp, 320 mg/5 mg, 14 cp, 320 mg/5 mg, 28 cp, 80 mg/5 mg, 28 cp, 160 mg/12,5 mg, 28 cprs, 160/25 mg, 14 cprs, 160/25 mg, 28 cprs, 80 mg/12,5 mg, 14 cprs, 160 + 12,5 + 10 mg, 14 + 14 cp, 160 + 12,5 + 5 mg, 14 + 14 cp, 160+ 12,5+ 10 mg, 28+ 28 cp, 160+ 12,5+ 5 mg, 28+ 28 cp,

Laboratorio CRISTALIA COSMED COSMED COSMED COSMED COSMED COSMED COSMED COSMED COSMED COSMED ACHE ALLERGAN GERMED GERMED ACHE ACHE NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS

UNIDADE Pco Unt Base A CPR 2,25 GOTA 0,03 GOTA 0,04 COMP 0,40 COMP 0,54 COMP 0,40 COMP 0,54 COMP 0,79 COMP 1,15 COMP 0,79 COMP 1,15 CPR 1,52 GOTAS 0,03 CPR 0,12 CPR 0,06 CPR 1,38 CPR 1,29 COMP 2,85 COMP 2,85 COMP 2,97 COMP 2,85 CPR 1,51 CPR 1,51 CP 3,55 COMP 3,01 CP 3,01 CP 3,55 COMP 3,01 CP 3,01 CP 3,01 CPR 3,01 CPR 3,03 CPR 3,46 CPR 3,13 COMP 4,01 COMP 3,40 COMP 4,01 COMP 3,40

137

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5250 5251 5252 5253 5254 5255 5256 5257 5258 5259 5260 5261 5262 5263 5264 5265 5266 5267 5268 5269 5270 5271 5272 5273 5274 5275 5276 5277 5278 5279 5280 5281 5282 5283 5284 5285 5286 5287

CODIGO BENEFICIO

APRESENTAÇÃO

Laboratorio

95082484 DIOVAN TRIPLO 160+ 25+ 10 mg, 28+ 28 cp, NOVARTIS 95082476 DIOVAN TRIPLO 160+ 25+ 5 mg, 28+ 28 cp, NOVARTIS 95661565 DIOXAFLEX 75 mg bl, 15 cprs, rev, BAGO 95590196 DIPEPTIVEN 100 ml 1 x 100 ml FRESENIUS KABI 95590188 DIPEPTIVEN 50 ml 1 x 50 ml FRESENIUS KABI 95893075 DIPIFARMA 500 mg/ml amp, 2 ml FARMACE 95122745 DIPIFARMA 500 mg/ml cx, 100 amps, vd, x 2 ml FARMACE 95996460 DIPIMED 500 mg, cx, 100 cprs, MEDQUIMICA 95996478 DIPIMED 500 mg, cx, 200 cprs, MEDQUIMICA 95984860 DIPIMED Gts, fr, 10 ml MEDQUIMICA 95996486 DIPIMED Gts, fr, 20 ml MEDQUIMICA 95017089 DIPINAL 10 mg, 30 cprs, CIFARMA 95071849 DIPIRAL 500 mg, cx, 200 cprs, MILIAN 95071873 DIPIRAL 500 mg, cx,100 cprs, MILIAN 95071865 DIPIRAL 500 mg, fr, 10 ml MILIAN 95071857 DIPIRAL 500 mg, fr, 20 ml MILIAN 95928537 DIPIRONA - GENERICO 500 mg, 25 bl, x 4 cprs, NEO QUIMICA 95122753 DIPIRONA - GENERICO 500 mg/ml 10 ml (hosp,) - cx, c/100 frs, FARMACE 95928553 DIPIRONA - GENERICO 500 mg/ml fr, 20 ml, TEUTO BRAS, 95331484 DIPIRONA - GENERICO 500 mg/ml sol, oral fr, 20 ml ABBOTT 95331522 DIPIRONA - GENERICO Gts, 500 mg/ml fr, 10 ml, TEUTO BRAS, 95331514 DIPIRONA - GENERICO Gts, 500 mg/ml fr, plas, 10 ml NEO QUIMICA 95037519 DIPIRONA - GENERICO Gts, 500 mg/ml fr, plast, 20 ml NEO QUIMICA 95928561 DIPIRONA - GENERICO Gts, 500mg/mlfr,10ml, DUCTO 95928570 DIPIRONA - GENERICO Inj, 500 mg/ml cx, 50 amps, 2 ml, NEO QUIMICA 95098267 DIPIRONA SOD+CLORIDRATO ADIFENINA+CLORIDATO PROMETAZINA-GENERICO 500 mg/1,5 ml + 10 mg/1,5 ml + 5 mg/1,5 ml sol, or, ct, fr, plas, PRATI opc,DONADUZZI got, x 15 ml 95098160 DIPIRONA SODICA - GENERICO 1 g bl, 10 cprs, NEO QUIMICA 95098178 DIPIRONA SODICA - GENERICO 1 g bl, 100 cprs, NEO QUIMICA 95037535 DIPIRONA SODICA - GENERICO 24 bl, x 10 cprs, GERMED 95017097 DIPIRONA SODICA - GENERICO 50 mg/ml fr, 100 ml EMS 95893091 DIPIRONA SODICA - GENERICO 50 mg/ml gts, fr, 20 ml LUPER 95043578 DIPIRONA SODICA - GENERICO 50 mg/ml sol, or, ct, fr, vd, amb, x 100 ml+ cp, med, SANOFI-AVENTIS 95043616 DIPIRONA SODICA - GENERICO 50 mg/ml sol, or, ct, fr, vd, amb, x 100 ml+ cp, med, PRATI DONADUZZI 95043624 DIPIRONA SODICA - GENERICO 50 mg/ml sol, or, cx, 50 fr, vd, amb, x 100 ml+ cp, med, (e PRATI DONADUZZI 95996494 DIPIRONA SODICA - GENERICO 50 mg/ml sol, or, fr, vd, x 100 ml+ cp, med, BIOSINTETICA 95017160 DIPIRONA SODICA - GENERICO 50 mg/ml sol, oral fr, 100 ml GERMED 95017208 DIPIRONA SODICA - GENERICO 50 mg/ml sol, oral fr, 100 ml GEN - LEGRAND 95331689 DIPIRONA SODICA - GENERICO 50 mg/ml sol, oral fr, 100 ml, MEDLEY

UNIDADE Pco Unt Base A COMP COMP CPR ML ML AMP AMP COMP COMP GOTA GOTA COMP COMP COMP GOTA GOTA CPR ML GOTAS GOTAS GOTAS GOTAS GOTA GOTAS AP GOTAS COMP COMP CP ML GOTA ML ML ML ML ML ML ML

4,01 3,40 0,77 3,78 4,28 0,55 0,68 0,32 0,28 2,78 0,01 0,21 0,32 0,43 0,02 0,02 0,18 0,18 0,01 0,01 0,01 0,01 0,01 0,01 0,77 0,03 0,73 0,73 0,24 0,07 5,50 0,06 0,08 0,03 0,07 0,07 0,07 0,11

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5288 5289 5290 5291 5292 5293 5294 5295 5296 5297 5298 5299 5300 5301 5302 5303 5304 5305 5306 5307 5308 5309 5310 5311 5312 5313 5314 5315 5316 5317 5318 5319 5320 5321 5322 5323 5324 5325

CODIGO BENEFICIO 95098186 DIPIRONA SODICA - GENERICO 95928588 DIPIRONA SODICA - GENERICO 95928596 DIPIRONA SODICA - GENERICO 95037543 DIPIRONA SODICA - GENERICO 95055037 DIPIRONA SODICA - GENERICO 95928600 DIPIRONA SODICA - GENERICO 95928618 DIPIRONA SODICA - GENERICO 95098194 DIPIRONA SODICA - GENERICO 95928626 DIPIRONA SODICA - GENERICO 95017143 DIPIRONA SODICA - GENERICO 95071903 DIPIRONA SODICA - GENERICO 95054987 DIPIRONA SODICA - GENERICO 95054995 DIPIRONA SODICA - GENERICO 95094440 DIPIRONA SODICA - GENERICO 95043608 DIPIRONA SODICA - GENERICO 95331638 DIPIRONA SODICA - GENERICO 95893105 DIPIRONA SODICA - GENERICO 95331646 DIPIRONA SODICA - GENERICO 95017100 DIPIRONA SODICA - GENERICO 95017119 DIPIRONA SODICA - GENERICO 95045392 DIPIRONA SODICA - GENERICO 95071881 DIPIRONA SODICA - GENERICO 95043586 DIPIRONA SODICA - GENERICO 95043594 DIPIRONA SODICA - GENERICO 95071890 DIPIRONA SODICA - GENERICO 95055088 DIPIRONA SODICA - GENERICO 95055096 DIPIRONA SODICA - GENERICO 95017127 DIPIRONA SODICA - GENERICO 95017135 DIPIRONA SODICA - GENERICO 95055061 DIPIRONA SODICA - GENERICO 95055070 DIPIRONA SODICA - GENERICO 95996508 DIPIRONA SODICA - GENERICO 95996516 DIPIRONA SODICA - GENERICO 95055002 DIPIRONA SODICA - GENERICO 95055010 DIPIRONA SODICA - GENERICO 95055029 DIPIRONA SODICA - GENERICO 95055045 DIPIRONA SODICA - GENERICO 95055053 DIPIRONA SODICA - GENERICO

APRESENTAÇÃO Laboratorio 500 mg, 24 bl, al, plast, x 10 cprs, MEDLEY 500 mg, 24 bl, al, plast,x10 cprs, MEDLEY 500 mg, 24 bl, al, plast,x10 cprs, Fracao de Venda MEDLEY 500 mg, 24 bl, x 10 cprs, GEN - LEGRAND 500 mg, 240 cprs, (emb, hosp,) MEPHA-RATIOPHARM 500 mg, 25 bl, al, plast,x4 cprs, MEDLEY 500 mg, 25 bl, al, plast,x4 cprs, Fracao de Venda MEDLEY 500 mg, 25 bl, x 4 cprs, NEO QUIMICA 500 mg, 3 bl, al, plast,x10 cprs, MEDLEY 500 mg, bl, 200 cprs, (emb, mult,) PRATI DONADUZZI 500 mg, bl, 4 cprs, BRAINFARMA 500 mg, com, ct, 25 bl, al, plas, inc, x 4 PRATI DONADUZZI 500 mg, com, ct, 50 bl, al, plas, inc, x 10 (emb, hosp,) PRATI DONADUZZI 500 mg, com, ct, bl, al, plas, inc, x 480 (frac,) PRATI DONADUZZI 500 mg, cprs, ct, bl, al, plas, inc, x 240 (emb, mult,) SANOFI-AVENTIS 500 mg, cx, 24 bl, x 10 cprs, EMS 500 mg/ml cx, 100 amps, 2 ml TEUTO BRAS, 500 mg/ml fr, 10 ml, EMS 500 mg/ml fr, plast, got, 10 ml FARMASA 500 mg/ml fr, plast, got, 20 ml FARMASA 500 mg/ml sol, inj, 120 amps, 2 ml (hosp,) TEUTO BRAS, 500 mg/ml sol, inj, cx, 100 amps, vd, amb, x 2 ml (hosp,) HIPOLABOR 500 mg/ml sol, or, ct, fr, vd, amb, gts, x 10 ml SANOFI-AVENTIS 500 mg/ml sol, or, ct, fr, vd, amb, gts, x 20 ml SANOFI-AVENTIS 500 mg/ml sol, or, cx, 200 frs, plas, opc, got, x 10 ml (hosp,)HIPOLABOR 500 mg/ml sol, or, cx, 96 fr, plast, got, x 10 ml (hosp,) MARIOL 500 mg/ml sol, or, cx, 96 fr, plast, got, x 20 ml (hosp,) MARIOL 500 mg/ml sol, or, fr, plast, got, 10 ml BUNKER 500 mg/ml sol, or, fr, plast, got, 20 ml BUNKER 500 mg/ml sol, or, fr, plast, got, x 10 ml MARIOL 500 mg/ml sol, or, fr, plast, got, x 20 ml MARIOL 500 mg/ml sol, or, fr, vd, got, 10 ml BIOSINTETICA 500 mg/ml sol, or, fr, vd, got, 20 ml BIOSINTETICA 500 mg/ml, sol, or, ct, fr, plas, opc, got, x 10 ml, PRATI DONADUZZI 500 mg/ml, sol, or, ct, fr, plas, opc, got, x 20 ml, PRATI DONADUZZI 500 mg/ml, sol, or, cx, 200 fr, plas, opc, got, x 10 ml, (emb, hosp,) PRATI DONADUZZI 500 mg/mlsol,oral10ml MEPHA-RATIOPHARM 500 mg/mlsol,oral20ml MEPHA-RATIOPHARM

UNIDADE Pco Unt Base A COMP 0,28 CPR 0,24 CPR 0,02 CP 0,28 COMP 0,30 CPR 0,49 CPR 0,02 COMP 0,37 CPR 0,51 COMP 0,12 COMP 0,27 COMP 0,38 COMP 0,14 COMP 0,12 CP 0,26 CPR 0,27 AMP 0,37 GOTAS 0,01 GOTA 0,01 GOTA 0,01 AMP 0,43 AMP 0,70 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTA 0,00 GOTA 0,00 GOTA 0,02 GOTA 0,02 GOTA 0,35 GOTA 0,35 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTA 0,02 GOTA 0,00 GOTA 0,02 GOTA 0,01

139

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5326 5327 5328 5329 5330 5331 5332 5333 5334 5335 5336 5337 5338 5339 5340 5341 5342 5343 5344 5345 5346 5347 5348 5349 5350 5351 5352 5353 5354 5355 5356 5357 5358 5359 5360 5361 5362 5363

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95043632 DIPIRONA SODICA - GENERICO Gts, 20 ml BRAINFARMA 95098208 DIPIRONA SODICA - GENERICO Gts, 500 mg/ml fr, plas, 10 ml NEO QUIMICA 95098216 DIPIRONA SODICA - GENERICO Gts, 500 mg/ml fr, plast, 20 ml NEO QUIMICA 95996524 DIPIRONA SODICA - GENERICO Gts, 500 mg/ml fr, vd, 10 ml EUROFARMA 95996532 DIPIRONA SODICA - GENERICO Gts, 500 mg/ml fr, vd, 20 ml EUROFARMA 95017151 DIPIRONA SODICA - GENERICO Gts, fr, 10 ml GERMED 95017194 DIPIRONA SODICA - GENERICO Gts, fr, 10 ml GEN - LEGRAND 95098224 DIPIRONA SODICA - GENERICO Gts, fr, 10 ml MEDQUIMICA 95017178 DIPIRONA SODICA - GENERICO Gts, fr, 20 ml GERMED 95098232 DIPIRONA SODICA - GENERICO Gts, fr, 20 ml MEDQUIMICA 95098240 DIPIRONA SODICA - GENERICO Gts, fr, 20 ml, GEN - LEGRAND 95017186 DIPIRONA SODICA - GENERICO Gts,fr,20ml, EUROGENUS - LEGRAND 95098259 DIPIRONA SODICA - GENERICO Inj, 500 mg/ml cx, 50 amps, 2 ml NEO QUIMICA 95037527 DIPIRONA SODICA - GENERICO Inj, cx, 200 amps, vd, 2 ml EQUIPLEX 95331662 DIPIRONA SODICA - GENERICO Sol, oral got, fr, 10 ml, MEDLEY 95122761 DIPIRONA SODICA - GENERICO (Restrito Hosp,) 500 mg/ml cx, 100 amps, 2 ml (hosp,) TEUTO BRAS, 95122770 DIPIRONA SODICA - GENERICO (Restrito Hosp,) 500 mg/ml, sol, or, cx, 200 fr, plas, opc, got, x 10 ml, (hosp,)PRATI DONADUZZI 95122788 DIPIRONA SODICA - GENERICO (Restrito Hosp,) Inj, amp 2 ml EQUIPLEX 95122796 DIPIRONA SODICA - GENERICO (Restrito Hosp,) Inj, cx, 200 amps, vd, 2 ml (hosp,) EQUIPLEX 95996540 DIPRIVAN 2% 50 ml cx, 1 FA ASTRAZENECA 95982213 DIPRIVAN 20 ML - CX C/ 5 UNID ASTRAZENECA 95982221 DIPRIVAN 50 ML - CX C/ 1 FA ASTRAZENECA 95996559 DIPRIVAN Cx, 1 FA 100 ml, ASTRAZENECA 95899405 DIPRIVAN PFS 1% 1 ser, vd, 50 ml pronta p/uso ASTRAZENECA 95899413 DIPRIVAN PFS 2% 1 ser, vd, 50 ml pronta p/uso ASTRAZENECA 95098275 DIPRO AS Bisn, 30 g DELTA 95098283 DIPRO AS Fr, 30 ml DELTA 95450661 DIPROBETA Susp, inj, cx, 1 amp, 1 ml, BUNKER 95017216 DIPROCORT 5 mg, susp, inj, cartucho 1 amp, 1 ml e 1 ser, esterilizada CIFARMA 95840850 DIPROGENTA Creme 1 bisn, 30 g, MANTECORP 95840842 DIPROGENTA Pom, 1 bisn, 30 g, MANTECORP 95840869 DIPROP, DE BETAM,+AC, SALIC, - GENERICO Pom, derm, bisn, 30 g MEDLEY 95840877 DIPROP,DE BETAM,+ SULF, GENTAMICINA-GEN, Creme bisn, 30 g MEDLEY 95893172 DIPROPIONATO DE BETAMETASONA - GENER 0,5 mg/g pom, bisn, 30 g EMS 95893180 DIPROPIONATO DE BETAMETASONA - GENER Pom, bisn, 30 g GERMED 95893199 DIPROPIONATO DE BETAMETASONA - GENER Pom, bisn, 30 g GEN - LEGRAND 95081429 DIPROPIONATO DE BETAMETASONA + ACIDO SALICILICOSol, - top, GENERICO fr, 30 ml GERMED 95017224 DIPROPIONATO DE BETAMETASONA + ACIDO SALICILICO - 0,64+ GENERICO 30 mg/g pom, 30 g TEUTO BRAS,

UNIDADE Pco Unt Base A GOTA 0,01 GOTAS 0,02 GOTAS 0,02 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTA 0,01 GOTAS 0,02 GOTA 0,01 GOTAS 0,01 GOTAS 0,01 GOTA 0,01 AMP 0,97 AMP 0,51 GOTAS 0,02 AMP 0,43 GOTAS 0,08 AMP 0,53 AMP 0,60 F,A, 141,58 AMP 24,33 ML 1,43 ML 1,54 FA 116,18 FA 232,37 GRAMA 0,51 GOTAS 0,03 AP 14,58 AMP 13,10 G 0,69 G 0,72 G 0,37 G 0,42 GRAMA 0,37 G 0,37 G 0,37 ML 0,46 GRAMA 0,37

140

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5364 5365 5366 5367 5368 5369 5370 5371 5372 5373 5374 5375 5376 5377 5378 5379 5380 5381 5382 5383 5384 5385 5386 5387 5388 5389 5390 5391 5392 5393 5394 5395 5396 5397 5398 5400 5401 5402

CODIGO BENEFICIO APRESENTAÇÃO 95098291 DIPROPIONATO DE BETAMETASONA + ACIDO SALICILICO - Pom, GENERICO bisn, 30 g 95996605 DIPROPIONATO DE BETAMETASONA + FOSF, DISSODICO BETAMETASONA 5 mg/ml+2 mg/ml1FA+seringa - GENERICO 95037551 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA 0,5 mg/g+ - GENERICO 1 mg/g crem, derm, ct, bg, al, x 30 g 95037560 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA 0,5 mg/g+ - GENERICO 1 mg/g pom, derm, ct, bg, al, x 30 g 95893130 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA 0,5+ 1- GENERICO mg/g creme bisn, x 30 g 95893148 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA 0,5+ 1- GENERICO mg/g pom, bisn, x 30 g 95893156 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA Creme - GENERICO bisn, 30 g 95840885 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA Pom, -bisn, GENERICO 30 g 95893164 DIPROPIONATO DE BETAMETASONA + SULFATO GENTAMICINA Pom, -bisn, GENERICO 30 g 95082492 DIPROPIONATO DE BETAMETASONA+SULFATO GENTAMICINA-GENERICO 0,5 mg/g+ 1,0 mg/g creme 30 g 95800026 DIPROSALIC Pom, 1 bisn, 30 g, 95800034 DIPROSALIC Sol, 1 fr, 30 ml, 95893202 DIPROSEN Susp, inj, 5 mg/2 mg, cx, 1 amp, 1 ml 95790446 DIPROSONE Creme 1 bg, 30 g, 95790454 DIPROSONE Locao 1 fr, 30 ml, 95790438 DIPROSONE Pom, 1 bisn, 30 g, 95450670 DIPROSPAN Inj, 1 amp, 1 ml 95450696 DIPROSPAN HYPAK 1 seringa c/1ml 95280154 DISERIM 10 cprs, rev, 95280146 DISERIM 20 cprs, rev, 95160213 DISGREN 300 mg, c/20 95893210 DISOTRON 5000 UI/ml cx, 25 FA 5 ml 95017240 DISPEPTRIN 40+ 8 mg, susp, oral 60 ml 95017232 DISPEPTRIN 400+ 80 mg, 20 cprs, 95098305 DIUBLOK 100 mg, + 12,5 mg, bl, 10 cprs, 95055100 DIUBLOK 100 mg,+ 25 mg, bl, 30 cprs, 95098313 DIUBLOK 50 mg, + 12,5 mg, bl, 10 cprs, 95055118 DIUBLOK 50 mg,+ 12,5 mg, bl, 30 cprs, 95100164 DIUPRESS 25 mg, 20 cprs, 95987754 DIUREFLUX 100 mg, cx, 28 cprs, 95996680 DIUREFLUX 25 mg, cx, 42 cprs, 95996699 DIUREFLUX 50 mg, cx, 28 cprs, 95071911 DIUREMIL 40 mg, cx, 20 cprs,

Laboratorio GEN - LEGRAND EUROFARMA PRATI DONADUZZI PRATI DONADUZZI GEN - LEGRAND GEN - LEGRAND GERMED MEDLEY GERMED RANBAXY MANTECORP MANTECORP TEUTO BRAS, MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP APSEN APSEN BIOSINTETICA ARISTON CIFARMA CIFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA MEDQUIMICA MEDQUIMICA MEDQUIMICA MILIAN

95100180 DIURETIC 95100199 DIURETIC 95100202 DIURETIL 95928634 DIUREZIN 95928642 DIUREZIN

ROYTON ROYTON DUCTO CAZI CAZI

25 mg cx, 20cprs, 50 mg cx, 20 cprs, Cx, 1 bl, x 20 cprs, 25 mg, cx, 20 cprs, 50 mg, cx, 20 cprs,

UNIDADE Pco Unt Base A GRAMA 0,30 F,A, 10,38 G 0,42 G 0,43 UND 11,96 UND 11,96 GRAMA 0,41 G 0,43 G 0,41 G 0,37 G 0,61 ML 0,76 AMP 11,92 G 0,71 ML 0,70 G 0,74 AP 18,71 AP 21,59 CPR 1,26 CPR 1,26 CPR 1,77 FA 7,71 ML 0,13 COMP 0,85 COMP 0,85 COMP 0,85 COMP 0,52 COMP 0,52 CPR 0,66 COMP 0,38 COMP 0,15 CPR 0,28 COMP 0,15 CPR CPR CPR CPR CPR

0,19 0,20 0,16 0,15 0,19

141

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5403 5404 5405 5406 5407 5408 5409 5410 5411 5412 5413 5414 5415 5416 5417 5418 5419 5420 5421 5422 5423 5424 5425 5426 5427 5428 5429 5430 5431 5432 5433 5434 5435 5436 5437 5438 5439 5440

CODIGO BENEFICIO 95928650 DIUREZIN A 95928669 DIUREZIN C 95928677 DIUREZIN E 95100210 DIURISA 95055126 DIURIX 95071920 DIURIX 95100237 DIURIX 95055134 DIURIX 95071938 DIURIX 95100229 DIURIX 95094458 DIVALPROATO DE SODIO - GENERICO 95094466 DIVALPROATO DE SODIO - GENERICO 95120637 DIVELOL 95120645 DIVELOL 95120629 DIVELOL 95071962 DIVELOL 95071946 DIVELOL 95120653 DIVELOL 95071954 DIVELOL 95120661 DIVIDOL 95037578 DNAREN 95984879 DOBTAN 95083847 DOBUTAL 95074791 DOBUTAMIL 95028757 DOBUTAMIL 95074805 DOBUTARISTON 95090266 DOBUTREX 95899448 DOCELIBBS 95899456 DOCELIBBS 95899464 DOCETAXEL - GENERICO 95017267 DOCETAXEL - GENERICO 95028790 DOCETAXEL - GENERICO 95017275 DOCETAXEL - GENERICO 95037586 DOCETERE 95037594 DOCETERE 95122800 DOCETERE (Restrito Hosp,) 95074813 DOCLAXIN 95074830 DOCLAXIN

APRESENTAÇÃO 5 mg,+ 50 mg, cx, 30 cprs, 50/25 mg, cx, 30 cprs, 20/12,5 mg, cx, 30 cprs, Cx, 20 cprs, 25 mg, 15 bl, x 20 cprs, (hosp,) 25 mg, bl, 30 cprs, 25 mg, cx, 20 cprs, 50 mg, 15 bl, x 20 cprs, (hosp,) 50 mg, bl, 30 cprs, 50 mg, cx, 20 cprs, 250 mg, fr, 20 cprs, rev, 500 mg, fr, 20 cprs, rev, Cx, 14 cprs, 12,5 mg, Cx, 14 cprs, 3,125 mg, Cx, 14 cprs, 6,25 mg, Cx, 28 cprs, 12,5 mg, Cx, 28 cprs, 25 mg, Cx, 28 cprs, 3,125 mg, Cx, 28 cprs, 6,25 mg, 70 mg, caps, gel, dura 3 st, x 4 25 mg/ml inj, cx, 50 amps, x 3 ml 250 mg,cx,1amp,20ml, 250 mg, sol, inj, amp, vd, x 20 ml 12,5 mg/ml sol, inj, cx, 50 amps, vd, x 20 ml (hosp,) 250 mg/20 ml sol, inj, amp, vd, 12,5 mg/ml sol, inj, cx, 20 amps, vd, inc, x 20 ml 250 mg amp, 20 ml 20 mg, 1 FA 80 mg, 1 FA 20 mg, fr, 0,5 ml+ dil, 1,5 ml 20 mg, sol, inj, IV FA vd, x 0,5 ml+ dil, amp, x 1,5 ml 80 mg, fr, 2 ml+ dil, 6 ml 80 mg, sol, inj, IV FA vd, x 2,0 ml+ dil, amp, x 6,0 ml 20 mg/0,5 ml sol, inj, FA vd, x 0,5 ml+ dil, x 1,5 ml 80 mg, sol, inj, FA vd, x 2 ml+ dil, x 6 ml 120 mg, sol, inj, FA vd, x 3,0 ml + dil, x 9,0 ml 1000 mg,+ 200 mg, po liof, cx, 10 FA vd, inc, 1000 mg,+ 200 mg, po liof, cx, 20 FA vd, inc,

Laboratorio UNIDADE Pco Unt Base A CAZI CPR 0,33 CAZI CPR 1,87 CAZI CPR 1,62 EUROFARMA CPR 0,98 TEUTO BRAS, COMP 0,13 TEUTO BRAS, COMP 0,16 TEUTO BRAS, CPR 0,16 TEUTO BRAS, COMP 0,15 TEUTO BRAS, COMP 0,19 TEUTO BRAS, CPR 0,19 ZYDUS COMP 0,64 ZYDUS COMP 1,20 BALDACCI CPR 1,18 BALDACCI CPR 1,02 BALDACCI CPR 1,14 BALDACCI COMP 0,86 BALDACCI COMP 1,47 BALDACCI CPR 0,93 BALDACCI COMP 0,73 ZAMBON CPR 1,90 ARISTON AMP 0,61 UNIAO QUIMICA AMP 24,50 BIOCHIMICO AMP 22,46 NOVAFARMA AMP 19,48 NOVAFARMA AMP 19,47 ARISTON AMP 29,64 ABL AP 24,74 LIBBS FA 686,07 LIBBS FA 2466,80 EUROFARMA FA 473,98 GLENMARK FA 381,20 EUROFARMA FA 1709,15 GLENMARK FA 1374,67 DR, REDDY'S FA 673,24 DR, REDDY'S FA 2427,71 DR, REDDY'S/GLAXOSMITHKLINE FA 3433,52 ARISTON FA 33,31 ARISTON FA 37,48

142

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5441 5442 5443 5446 5447 5448 5449 5450 5451 5452 5453 5454 5455 5456 5457 5458 5459 5460 5461 5462 5463 5464 5465 5466 5467 5468 5469 5470 5471 5472 5473 5474 5475 5476 5477 5478 5479 5480

CODIGO BENEFICIO 95074821 DOCLAXIN 95899502 DOCLAXIN 95899510 DOCLAXIN 95017283 DOGMATIL 95017291 DOGMATIL 95017305 DOGMATIL 95331786 DOLAMIN 95028811 DOLAMIN FLEX 95331816 DOLANTINA 95996745 DOLO MOFF 95984887 DOLO MOFF 95928685 DOLO MOFF 95996753 DOLO MOFF 95928693 DOLO MOFF 95331824 DOLOSAL 95028820 DOLOXENE - A 95037608 DOMPERIDONA - GENERICO 95055142 DOMPERIDONA - GENERICO 95055150 DOMPERIDONA - GENERICO 95928707 DOMPEROL 95928715 DOMPEROL 95996761 DONAREN 95071970 DONAREN 95290583 DONAREN 95071989 DONAREN RETARD 95065377 DOPABANE 95065385 DOPACRIS 95331859 DORALGINA 95331867 DORALGINA 95331840 DORALGINA 95331875 DORAPLAX 95065393 DORCAINA 95017313 DORCIFLEX 95055169 DORCIFLEXIN 95028838 DORFEN 95928731 DORFEN 95928740 DORFEN 95928758 DORFEN

APRESENTAÇÃO 500 mg,+ 100 mg, po liof, cx, 10 FA vd, inc, 500 mg/100 mg, cx, 10 FA+ 10 dil, 500 mg/100 mg, cx, 20 FA+ 20 dil, 200 mg, cx, 20 cprs, 50 mg, cx, 20 caps, Gts, ped, fr, 30 ml, 125 mg, cx, 16 cprs, rev, 125 mg,+ 5,0 mg, bl, 15 cprs, rev, Cx, 25 x 2 ml, 0,2 mg/ml sol, inj, cx, 50 amps, x 1 ml 1 mg/ml sol, inj, cx, 50 amps, x 2 ml 10 mg, 50 cprs, 10 mg, inj, cx, 50 amps, x 1 ml 30 mg, 50 cprs, 100 mg, 25 amps, 2 ml, 77 mg,+ 325 mg, cx, 20 caps, 1 mg/ml susp, oral fr, vd, x 100 ml+ pipet, dosad, 10 mg, est, bl, 3 x 10 cprs, 10 mg, est, bl, 6 x 10 cprs, 1 mg/ml xpe, cx, frs, 100 ml 10 mg, cx, 2 bl, x 10 cprs, 100 mg, cx, 20 cprs, rev, 100 mg, cx, 30 cprs, 50 mg, 60 cprs, rev, 150 mg, cx, 20 cprs, rev, 5 mg/ml inj, 10 amps, x 10 ml 5 mg/ml50amps,10ml Cx, 2 bl, x 10drags, Cx, 25 bl, x 4 drags, Gts, fr, plast, 15 ml 200 mg 50 bl, x 4 cprs, Sol, inj, 5 mg/ml 6 FA 20 ml (hosp,) 144 cprs, 35 mg,+ 300 mg,+ 50 mg, bl, 240 cprs, 160 mg, cx, 12 cprs, mast, 160 mg, cx, 24 cprs, mast, 160 mg/5 ml susp, frac, 60 ml 200 mg, gts, fr, 15 ml

Laboratorio ARISTON ARISTON ARISTON SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS FARMOQUIMICA FARMOQUIMICA SANOFI-AVENTIS UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA CRISTALIA ABL MEDLEY RANBAXY RANBAXY FARMION FARMION APSEN APSEN APSEN APSEN ARISTON CRISTALIA NEO QUIMICA NEO QUIMICA NEO QUIMICA LUPER NEO QUIMICA CIFARMA CIFARMA CAZI CAZI CAZI CAZI

UNIDADE Pco Unt Base A FA 21,08 FA 21,08 FA 23,72 COMP 0,84 CAPS 0,59 GOTA 0,01 CPR 0,90 CPR 1,96 AP 2,21 AMP 2,86 AMP 3,19 CPR 0,34 AMP 1,94 CPR 0,91 AP 2,25 CPR 0,65 ML 0,21 COMP 0,26 COMP 0,23 ML 0,22 CPR 0,33 COMP 0,97 COMP 1,66 CPR 0,83 COMP 2,48 AMP 1,31 AMP 1,62 CPR 0,67 CPR 0,65 GOTAS 0,04 CPR 0,50 ML 0,65 COMP 0,29 COMP 0,35 CPR 1,16 CPR 1,08 ML 0,13 GOTAS 0,03

143

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5481 5482 5483 5484 5485 5486 5487 5488 5489 5490 5491 5492 5493 5494 5495 5496 5497 5498 5499 5500 5501 5502 5503 5504 5505 5506 5507 5508 5509 5510 5511 5512 5513 5514 5515 5516 5517 5518

CODIGO BENEFICIO 95055177 DORFEN 95928766 DORFEN 95055185 DORFEN 95331891 DORFLEX 95893237 DORFLEX 95893245 DORFLEX 95331905 DORFLEX 95081437 DORFLEX P 95928804 DORGEN 95996796 DORIBEL 95017380 DORICO 95017372 DORICO 95017348 DORICO 95017399 DORICO 95017356 DORICO 95017364 DORICO 95017330 DORICO 95332065 DORIDINA 95661646 DORIFLAN 95661638 DORIFLAN 95055215 DORIFLAN SOLUCAO 95332103 DORILAN 95893261 DORILAX 95332111 DORILAX 95893270 DORILAX 95332120 DORILEN 95332138 DORILEN 95017461 DORILESS 95017470 DORILESS 95055223 DORILESS 95082506 DORISAN 95332189 DORLESS 95332154 DORLESS 95332170 DORLESS 95065407 DORMANT 95098321 DORMELOX 95098330 DORMELOX 95270515 DORMIRE

APRESENTAÇÃO 500 mg, 200 cprs, 750 mg, cx, 200 cprs, 80 mg,cx,12cprs,mast, 3 bl, al, plast, x 10 cprs, 35 mg,+ 300 mg,+ 50 mg, 24 bl, al, plast, x 10 cprs, Fracao de venda c/10 cprs, (sem tarja) Sol, oral fr, vd, 20 ml, 35 mg,+ 450 mg,+ 50 mg, bl, plas, lar, x 12 cprs, 50 mg, cx, 20 cprs, 50 bl, x 4 cprs, 200 mg, gts, fr, 10 ml, 200 mg, gts, fr, 15 ml 500 mg, cx, 25 bl, x 4 cprs, 750 mg, cx, 10 cprs, 750 mg, cx, 2 bl, x 10 cprs, 750 mg, cx, 50 bl, x 4 cprs, Fracao 750 mg, 04 cpr Cx, 20 drags, 50 mg 10 drags, 50 mg, cx, 2 bl, x 10 drags, Gts, 20 ml Gts, 20 ml 25 bl, x 4 cprs, Blist, 12 cprs, Fracao de venda Cx, 12 cprs, Gts, fr, 15 ml, 12 cprs, 200 cprs, Sol, oral fr, vd, got, 1,5 ml Cx, 100 drags, 100 mg cx, 6 amps, 2 ml, 50 mg cx, 10 caps, 50 mg, cx, 6 amps, 1 ml, 5 mg/ml sol, inj, cx, 50 amps, vd, x 3 ml (hosp,) Cx, 10 cprs, 15 mg, Cx, 10 cprs, 7,5 mg, 15 mg, cx, 20cprs,

Laboratorio CAZI CAZI CAZI SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS CAZI LUPER SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS BUNKER LUPER LUPER LUPER LUPER ACHE ACHE ACHE LEGRAND LEGRAND CIFARMA CIFARMA CIFARMA SINTERAPICO UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA NEO QUIMICA DELTA DELTA CRISTALIA

UNIDADE Pco Unt Base A COMP 0,31 CPR 0,67 COMP 0,66 CPR 0,31 COMP 7,53 CPR 0,31 GOTAS 0,02 COMP 0,59 CPR 0,61 COMP 0,24 GOTA 0,06 GOTA 0,06 COMP 0,59 COMP 1,44 COMP 1,23 COMP 1,42 COMP 1,23 CPR 0,42 CPR 0,56 CPR 0,55 GOTA 0,35 GOTAS 0,03 COMP 0,69 CPR 0,71 UND 2,66 CPR 0,71 GOTAS 0,05 COMP 0,60 COMP 0,49 GOTA 0,49 DRAG 0,43 AP 8,16 CPR 1,63 AP 5,47 AMP 7,17 COMP 1,81 COMP 1,13 CPR 1,83

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5519 5520 5521 5522 5523 5524 5525 5526 5527 5528 5529 5530 5531 5532 5533 5534 5535 5536 5537 5538 5539 5540 5541 5542 5543 5544 5545 5546 5547 5548 5549 5550 5551 5552 5553

CODIGO BENEFICIO 95074848 DORMIRE 95270540 DORMIRE (*) 95270566 DORMIRE (*) 95270558 DORMIRE (*) 95270531 DORMIRE (*) 95122818 DORMIRE (Restrito Hosp,) 95122826 DORMIRE (Restrito Hosp,) 95122834 DORMIRE (Restrito Hosp,) 95122842 DORMIRE (Restrito Hosp,) 95037632 DORMIUM 95270574 DORMIUM 95270582 DORMIUM 95996869 DORMIUM 95122850 DORMIUM (Restrito Hosp,) 95270604 DORMONID 95270590 DORMONID 95270612 DORMONID 95270620 DORMONID 95065431 DORMONID INJETAVEL 95065440 DORMONID INJETAVEL 95065423 DORMONID INJETAVEL 95996877 DORNOT 95332235 DORONA 95332219 DORONA 95332243 DORONA 95082549 DORSANOL 95082557 DORSANOL 95082522 DORSANOL 95082530 DORSANOL 95082514 DORSANOL 95037640 DORSEDIN 95020454 DORSPAN 95020462 DORSPAN 95996885 DOSAPLATIN 95996893 DOSAPLATIN

5554 95996907 DOSATAXEL 5555 95996915 DOSATAXEL 5556 95996923 DOSATECAN

APRESENTAÇÃO 5 mg, 5 amps, 5 ml 15 mg, cx, 5 amps, 3 ml 2 mg/ml - cx, 12 frs, 10 ml+ dos, 5 mg, cx, 5 amps, 5 ml 50 mg, cx, 5 amps, 10 ml 2 mg/ml - cx, 12 frs, 10 ml + 12 dos, 5 mg, 50 amps, 5 ml 5 mg/ml sol, inj, cx, 50 amps, x 3 ml 50 mg, 50 amps, 10 ml 15 mg, bl, 20 cprs, 15 mg, cx, 5 amps, 3 ml 5 mg, cx, 5 amps, 5 ml 50 mg, cx, 5 amps, x 10 ml 15 mg, bl, 30 cprs, 15 mg, 30 cprs, 2 bl, x 10 cprs, 15 mg, 7,5 mg, 2 bl, x 10 cprs, 7,5 mg, 3 bl, x 10 cprs, 15 mg, 5 amps, 5 mg, 5 amps, 50 mg, 5 amps, 50 mg/ml 25 amps, x 2 ml 500 mg cx, 25 bl, x 4 cp, Gts, 500 mg/ml fr, 10 ml, Gts, 500 mg/ml, fr, 20 ml, 500 mg, 5 bl, x 4 cprs, 500 mg, 50 bl, x 4 cprs, 750 mg, 5 bl, x 4 cprs, 750 mg, 50 bl, x 4 cprs, Gts, 15 ml 2 bl, x 10 cprs, 1 x 20 drags Gts, 1 x 20 ml, 100 mg, po liof, inj, FA vd, 1000 mg, 50 mg, po liof, inj, FA vd, 500 mg,

Laboratorio CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE UNIAO QUIMICA DUCTO DUCTO DUCTO MULTILAB MULTILAB MULTILAB MULTILAB MULTILAB LEGRAND EMS EMS CHEMICALTECH CHEMICALTECH

20 mg, sol, inj, ct, FA amp, vd, inc, x 0,5 ml+ dil, x 1,5 80 mg, sol, inj, ct, FA amp, vd, inc, x 2 ml+ dil, x 6 ml 20 mg/ml sol inj, FA vd, 5 ml

CHEMICALTECH CHEMICALTECH CHEMICALTECH

UNIDADE Pco Unt Base A AMP 4,31 AP 9,32 ML 1,30 AP 4,31 AP 21,82 GOTAS 0,72 AMP 4,68 AMP 8,02 AMP 23,68 CP 1,18 AP 9,57 AP 4,58 AMP 21,70 COMP 0,94 CPR 2,07 CPR 4,15 CPR 1,03 CPR 1,04 AMP 10,41 AMP 4,85 AMP 24,50 AMP 1,82 CPR 0,35 GOTAS 0,02 GOTAS 0,01 COMP 0,31 COMP 0,28 COMP 0,38 COMP 0,32 Gota 0,01 CP 0,46 CPR 0,59 GOTAS 0,03 F,A, 2839,44 F,A, 1419,71 F,A, F,A, F,A,

643,14 2562,03 1068,63

145

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5557 5558 5559 5560 5561 5562 5563 5564 5565 5566 5567 5568 5569 5570 5571 5572 5573 5574 5575 5576 5577 5578 5579 5580 5581 5582 5583 5584 5585 5586 5587 5588 5589 5590 5591 5592 5593 5594

CODIGO BENEFICIO 95996931 DOSATECAN 95490183 DOSTINEX 95490175 DOSTINEX 95611398 DOXAL 95065458 DOXELIB 95065466 DOXELIB 95041869 DOXICICLINA - GENERICO 95041850 DOXICICLINA - GENERICO 95376526 DOXICICLINA MONOHIDRATADA - GENERICO 95376518 DOXICICLINA MONOHIDRATADA - GENERICO 95376534 DOXILEGRAND 95540768 DOXOLEM 95540750 DOXOLEM 95037659 DOXOPEG 95928871 DOXSOL 95055240 DOXURAN 95055231 DOXURAN 95055258 DRAMAVIT 95320520 DRAMAVIT 95320512 DRAMAVIT 95037675 DRAMAVIT B6 95037683 DRAMAVIT B6 95320601 DRAMIN 95081453 DRAMIN B6 95098348 DRAMIN B6 95098356 DRAMIN B6 95055290 DRAMIN B6 95098364 DRAMIN B6 95055266 DRAMIN B6 95098372 DRAMIN B6 DL 95098380 DRAMIN CAPSGEL 95840893 DRAPOLENE 95928880 DRENIDRA 95928898 DRENIDRA 95928901 DRENISON 95055312 DRENISON N 95055320 DRENISON N 95100245 DRENOL

APRESENTAÇÃO 20 mg/ml sol, inj, FA vd, 2 ml 0,5 mg fr, 2 cprs, 0,5 mg, fr, 8 cprs, Fr, 20 drags, 20 mg, sol, inj, FA 0,5 ml+ fr, dil, x 1,5 ml 80 mg, sol, inj, FA 2 ml+ fr, dil, x 6 ml 100 mg, 15 cprs, sol, 100 mg, 20 cprs, sol, 100 mg, 15 cprs, sol, 100 mg, 20 cprs, sol, 100 mg, cx, 15 cprs, 10 mg, po liof,+ dil, 50 mg, po liof, 2 mg/ml susp, inj, FA vd, x 10 ml 2 mg, cx, 10 cprs, 4 mg, bl, 20 cprs, 4 mg, bl, 30 cprs, 100 bl, x 4 cprs, B6 cx, 20 cprs, B6 fr, 20 ml Cx, 20 cprs, Fr, 20 ml Sol, oral 120 ml 50 mg,+ 10 mg, bl, pvc/pvdc, al, x 30 cprs, rev, Fracao de venda inf, amp, Inj, cx, 100 amps, x 1 ml Inj, cx, c/10 amps, x 1 ml Sol, oral ped, 30 ml Sol. Oral Ped. 20 ml inj, cx, 100 amps, x 10 ml 25 mg, bl, 10 caps, gel, mole Bisn, 40 g 25 mg, cx, 42 cprs, 50 mg, cx, 28 cprs, Oclusivo rolo c/200 cm Creme derm, ct, bisn, al, x 30 g Pom, derm, ct, bisn, al, x 30 g Cx, 30 cprs,

Laboratorio CHEMICALTECH PFIZER PFIZER SIGMA PHARMA LIBRA LIBRA SANDOZ SANDOZ HEXAL HEXAL LEGRAND ZODIAC ZODIAC ZODIAC CAZI SANDOZ SANDOZ LUPER LUPER LUPER LUPER LUPER TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA TAKEDA PHARMA FARMOQUIMICA CAZI CAZI BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS PFIZER

UNIDADE Pco Unt Base A F,A, 427,44 CPR 32,28 CPR 27,90 CPR 0,93 FA 371,43 FA 1588,89 COMP 1,48 COMP 1,40 CPR 1,32 CPR 0,97 CPR 0,98 FA 31,38 FA 131,54 FA 1537,98 CPR 3,20 COMP 1,51 COMP 1,51 COMP 0,27 CPR 0,37 GOTAS 0,02 CP 0,45 GOTA 0,02 ML 0,14 COMP 0,37 FA 1,54 FA 1,54 AMP 1,67 GOTAS 0,02 GOTA 0,02 FA 1,87 CAPS 1,60 G 0,33 CPR 0,32 CPR 0,45 DOSE 0,27 G 0,60 G 0,61 CPR 0,21

146

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5595 5596 5597 5598 5599 5600 5601 5602 5603 5604 5605 5606 5607 5608 5609 5610 5611 5612 5613 5614 5615 5616 5617 5618 5619 5620 5621 5622 5623 5624 5625 5626 5627 5628 5629 5630 5631 5632

CODIGO BENEFICIO 95017615 DRIPANINA 95017623 DRIPANINA 95017577 DRIPANINA 95017585 DRIPANINA 95017593 DRIPANINA 95017607 DRIPANINA 95017569 DRIPANINA 95055347 DROFAXIL 95055339 DROFAXIL 95065474 DROPERDAL 95928928 DROPROPIZINA - GENERICO 95260242 DROPROPIZINA - GENERICO 95928944 DROPROPIZINA - GENERICO 95928952 DROPROPIZINA - GENERICO 95260250 DROPROPIZINA - GENERICO 95028854 DROPROPIZINA - GENERICO 95028862 DROPROPIZINA - GENERICO 95017631 DRYLTAC 95017640 DRYLTAC 95017658 DRYLTAC 95310096 DUALID S 95420410 DUCTELMIN 95420428 DUCTELMIN 95017666 DUCTOCILINA 95928979 DUCTOCINA 95928995 DUCTOCINA 95010700 DUCTOGEL 95132708 DUCTOMET 95132716 DUCTOMET 95132724 DUCTOPRIL 95893300 DUCTOPRIL 95929010 DUCTOVIRAX 95050094 DULCOLAX 95740066 DUNASON 95074856 DUO-DECADRON 95929029 DUO-DECADRON 95997083 DUODOPA CR 95997091 DUOFLAM

APRESENTAÇÃO 100 mg/ml sol, inj, 10 ser, vd, x 0,2 ml 100 mg/ml sol, inj, 10 ser, vd, x 0,4 ml 100 mg/ml sol, inj, ser, vd, x 0,2 ml 100 mg/ml sol, inj, ser, vd, x 0,4 ml 100 mg/ml sol, inj, ser, vd, x 0,6 ml 100 mg/ml sol, inj, ser, vd, x 0,8 ml 100 mg/ml sol, inj, ser, vd, x 1 ml 250 mg,susp,fr,80ml 500 mg, cx, 8 caps, 2,5 mg/ml 50 amps, 1 ml 1,5 mg/ml xpe, 120 ml 1,5 mg/ml xpe, 120 ml,+ cp-med, 3 mg/mlxpe,fr,120ml, 3,0 mg/ml xpe, 120 ml 3,0 mg/ml xpe, 120 ml,+ cp-med, Xpe, ad, 3,0 mg/ml fr, 120 ml+ cp, med, Xpe, ped, 1,5 mg/ml fr, 120 ml+ cp, med, 70 mg, 2 bl, x 10 caps, 70 mg, 2 bl, x 7 caps, 70 mg, bl, x 10 caps, 75 mg, fr, 20 caps, 100 mg, cx, 1 bl, x 6 cprs, Susp, 100 mg/5 ml, vd, 30 ml, 500 mg, cx, 2 bl, x 6 caps, 250 mg cx, 1 bl, x 6 cprs, 500 mg cx, 1 bl, 6 cprs, rev, Vd, 150 ml 250 mg, cx, 3 bl, x 10 cprs, rev, 500 mg, cx, 3 bl,x10 cprs, 25 mg, cx, 1 bl, 16 cprs, 25 mg, cx, 2 bl, x 16 cprs, Creme50mg/gcx,bisn,10g 20 drags Fr, 15 ml, 8 mg/ml+ 2 mg/ml susp, inj, FA 1 ml+ ser,dos, Inj, 2 ml sem seringa 50/200 mg, 30 cprs, 6,43 mg+2,63 mg - AP 1 ml+ ser,

Laboratorio ARISTON ARISTON ARISTON ARISTON ARISTON ARISTON ARISTON ROYTON ROYTON CRISTALIA PRATI DONADUZZI MEDLEY UNIAO QUIMICA PRATI DONADUZZI MEDLEY NEO QUIMICA NEO QUIMICA LEGRAND LEGRAND LEGRAND ACHE DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO BOEHRINGER INGELHEIM ALCON ACHE ACHE TORRENT CRISTALIA

UNIDADE Pco Unt Base A UNID 15,76 UNID 30,64 UNID 15,75 UNID 30,64 UNID 47,03 UNID 62,69 UNID 78,45 ML 0,22 CAPS 2,31 AMP 5,70 ML 0,05 ML 0,05 ML 0,07 ML 0,08 ML 0,08 GOTA 0,00 GOTA 0,00 CAPS 0,97 CAPS 0,97 CAPS 0,97 CPR 0,78 CPR 0,34 GOTAS 0,01 CAPS 0,91 CPR 2,26 CPR 2,80 ML 0,07 CPR 0,54 CPR 1,06 CPR 0,41 COMP 0,39 G 1,26 CPR 0,20 GOTAS 0,07 FA 5,85 AP 10,70 COMP 1,30 AMP 12,35

147

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5633 5634 5635 5636 5637 5638 5639 5640 5641 5642 5643 5644 5645 5646 5647 5648 5649 5650 5651 5652 5653 5654 5655 5656 5657 5658 5659 5660 5661 5662 5663 5664 5665 5666 5667 5668 5669 5670

CODIGO BENEFICIO 95098399 DUOMO 95074864 DUOMO 95037691 DUO-TRAVATAN 95200754 DUOVENT 95098402 DUOVENT N 95982264 DUOVISC (PROVISC 0,40 ML + VISCOAT 0,35 ML) 95982272 DUOVISC (PROVISC 0,55 ML + VISCOAT 0,50 ML) 95055355 DUPHALAC 95037705 DUPHALAC 95929053 DUPHASTON 95929061 DUPHASTON 95332332 DUROGESIC 95332308 DUROGESIC 95332316 DUROGESIC 95332324 DUROGESIC 95065520 DUROGESIC D-TRANS 95065482 DUROGESIC D-TRANS 95065490 DUROGESIC D-TRANS 95065504 DUROGESIC D-TRANS 95020497 DUSPATALIN 95037730 DUZIMICIN 95037748 DUZIMICIN 95037721 DUZIMICIN 95893318 DUZIMICIN 95037713 DUZIMICIN 95062289 D-VOID 95094520 DYSPORT 95650091 DYSPORT - TOXINA BOTULINICA TA 95250719 EACA BALSAMICO 95230645 EBASTEL 95230653 EBASTEL 95929070 EBASTEL D 95098410 EBIX 95929088 EBIX 95122869 ECALTA (Restrito Hosp,) 95098429 ECASIL-81 95037756 ECATOR 95997113 ECATOR

APRESENTAÇÃO Laboratorio 2 mg, bl, 10 cprs, EUROFARMA 2 mg, bl, 30 cprs, EUROFARMA 2,5 ml ALCON Aerossol fr, 15 ml, BOEHRINGER INGELHEIM 0,02 mg/50 mcl + 0,05 mg/50 mcl sol aer, ct, tb, aco inox x 10 BOEHRINGER ml + bocal INGELHEIM KIT ALCON KIT ALCON 667 mg/ml xpe, 10 saches x 15 ml SOLVAY FARMA 667 mg/ml xpe, fr, plast, x 200 ml SOLVAY FARMA 10 mg 14 cprs, rev, SOLVAY FARMA 10 mg 28 cprs, rev, SOLVAY FARMA 100 mcg, ct, 5 envs, JANSSEN - CILAG 25 mcg, ct, 5 envs, JANSSEN - CILAG 50 mcg, ct, 5 envs, JANSSEN - CILAG 75 mcg, ct, 5 envs, JANSSEN - CILAG 16,8 mg, 5 adesivos 100 mcg/h JANSSEN - CILAG 2,1 mg, 5 adesivos 12 mcg/h JANSSEN - CILAG 4,2 mg, 5 adesivos 25 mcg/h JANSSEN - CILAG 8,4 mg, 5 adesivos 50 mcg/h JANSSEN - CILAG 200 mg, cx, 30 caps, SOLVAY FARMA 50 mg, po sus, or, ct, fr, plas, amb, x 60 ml, PRATI DONADUZZI 50 mg, po sus, or, ct, fr, vd, amb, x 150 ml, PRATI DONADUZZI 50 mg, po sus, or, cx, 50 fr, vd,amb,x150ml,(emb, PRATI DONADUZZI 50 mg, po susp, 60 ml 50 fr, plast, PRATI DONADUZZI 500 mg, cap gel, dura ct, 25 bl, al, plas, inc, x 12 (emb, h PRATI DONADUZZI 0,1 mg/ml sol, nasal ct, fr, vd, amb, neb, x 2,5 ml SUN 500 U po liof, inj, FA vd, IPSEN 500 U c/ 1 FA BIOSINTETICA Xpe, fr, 100 ml, NIKKHO 10 mg, est, 10 cprs, EUROFARMA Xpe, 60 ml EUROFARMA 5 caps, gel, EUROFARMA 10 mg, 14 cprs, LUNDBECK 10 mg, 28 cprs, LUNDBECK 100 mg, 1 vial + 1 dil, PFIZER 81 mg, bl, 90 cprs, rev, BIOLAB SANUS 10 mg, 30 caps, TORRENT 2,5 mg, 30 caps, TORRENT

UNIDADE Pco Unt Base A COMP 0,58 COMP 0,50 GOTA 1,74 DOSE 0,09 FRS 10,28 CX 214,71 CX 247,60 UNID 2,85 ML 0,13 CPR 1,28 CPR 1,28 UND 113,72 UND 37,22 UND 69,50 UND 92,59 UNID 148,63 UNID 24,60 UNID 45,94 UNID 85,78 CPR 2,97 GOTA 0,00 GOTA 0,01 FR 7,82 ML 2,30 CP 0,36 FR 124,38 FA 1285,34 X FA 1285,34 X ML 0,23 CPR 2,85 ML 0,49 CPR 4,46 COMP 1,74 CPR 1,83 FA 339,16 COMP 0,25 CP 1,08 CAPS 0,86

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5671 5672 5673 5674 5675 5676 5677 5678 5679 5680 5681 5682 5683 5684 5685 5686 5687 5688 5689 5690 5691 5692 5693 5694 5695 5696 5697 5698 5699 5700 5701 5702 5703 5704 5705 5706 5707 5708

CODIGO BENEFICIO 95997121 ECATOR 95037764 ECATOR H 95929096 ECOFILM 95893326 ECOFILM 95260269 ECOS 95376704 ECTRIN (*) 95028870 ECTRIN (*) 95376720 ECTRIN (*) 95340246 EDHANOL 95200762 EFEDRIN 95290664 EFEXOR 95017704 EFEXOR 95290656 EFEXOR 95017712 EFORTIL 95997148 EFORTIL 95150056 EFORTIL 95085610 EFRINALIN (Restrito Hosp,) 95098461 EGIDE 95098470 EGIDE 95098488 EGIDE 95098496 EGIDE 95893334 ELIDEL 95037780 ELIGARD 95046003 ELIGARD 95136401 ELIQUIS TABLET ORAL (Restrito Hosp,) 95136398 ELIQUIS TABLET ORAL (Restrito Hosp,) 95090460 ELODIUS 95090452 ELODIUS 95750053 ELOTIN 95065539 ELOXATIN 95065547 ELOXATIN 95122877 ELSPAR (Restrito Hosp,) 95270671 ELUM 95740074 EMADINE 95893342 EMAMA 95997199 EMEND 95094474 EMET 95929126 EMIDRAT

APRESENTAÇÃO 5 mg, 30 caps, 5/25 mg, cx, 30 cprs, Fr, 15 ml Fr, plast, cgt 5 ml Xpe, fr, 120 ml 1 x 20 cprs, Inj, IV 50 amps, x 5 ml Susp, 1 x 100 ml Cx, 20 cprs, 50 mg/ml cx, 100 amps, 1 ml XR 150 mg, ct, 1 bl, x 14 cprs, XR 37,5 mg, ct, 1 bl, x 7 cprs, XR 75 mg, ct, 1 bl, x 14 cprs, 10 mg/ml sol, inj, 5 amps, x 1 ml 5 mg, bl, 20 cprs, Sol, oral 20 ml, 1 mg, sol, inj, cx, 100 amps, vd, amb, x 1 ml 100 mg, 60 cprs, rev, or, 25 mg, 30 cprs, rev, or, 25 mg, 60 cprs, rev, or, 50 mg, 60 cprs, rev, or, 1% 30 g cr, 22,5 mg, susp, inj, ct, sache c/ser, B+ sache c/ser, A dil, 7,5 mg, susp, inj, sache c/ser, B+ sache c/ser, A dil,+ ag 2,5 mg, cx, 10 x 10 (hosp,) 2,5 mg, cx, 6 x 10 (hosp,) 100 mg/ml sol, oral fr, vd, amb, x 95 ml+ ser, dos, 250 mg, fr, plast, 120 caps, gel, mole Fr, 5 ml 5,0 mg/ml sol, inj, FA vd, x 10 ml 5,0 mg/ml sol, inj, FA vd, x 20 ml 10,000 UI po liof, FA vd, 10 ml 1 mg, 20 cprs, Sol, fr, 5 ml, 400 mg, fr, plast, 30 caps, gel, mole Cx, 1 bl, x 2 caps, 80 mg, e 1 bl, x 1 caps, 125 mg, 25 mg/ml+ 5 mg/ml sol, oral fr, plast, got, x 20 ml Sol, 1 x 500 ml, (sabor guarana e cereja)

Laboratorio TORRENT TORRENT LATINOFARMA LATINOFARMA UNIAO QUIMICA EMS EMS EMS SOLVAY FARMA CRISTALIA WYETH WYETH WYETH BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM ARISTON LIBBS LIBBS LIBBS LIBBS NOVARTIS ZODIAC ZODIAC B-MS B-MS BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM ELOFAR SANOFI-AVENTIS SANOFI-AVENTIS BAGO FARMASA ALCON EUROFARMA MERCK SHARP & DOHME EUROFARMA EMS

UNIDADE Pco Unt Base A CAPS 0,98 CP 1,07 GOTAS 0,10 GOTA 0,10 ML 0,11 CPR 0,57 AMP 1,31 ML 0,10 CPR 0,19 AP 6,63 CPR 9,63 COMP 2,90 CPR 6,79 AMP 0,82 COMP 0,13 GOTAS 0,01 FA 0,42 COMP 2,37 COMP 0,57 COMP 0,57 COMP 1,13 GRAMA 217,91 FA 1492,74 X F,A, 649,79 X COMP 3,53 COMP 3,53 ML 5,52 CAPS 9,40 GOTAS 0,06 FA 1327,49 FA 2655,08 FA 75,97 CPR 0,50 GOTAS 0,25 CAPS 0,59 CAPS 160,60 GOTAS 6,65 ML 0,03

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5709 5710 5711 5712 5714 5715 5716 5717 5718 5719 5720 5721 5722 5723 5724 5725 5726 5727 5728 5729 5730 5731 5732 5733 5734 5735 5736 5737 5738 5739 5740 5741 5742 5743 5744 5745 5746 5747

CODIGO BENEFICIO APRESENTAÇÃO 95893350 EMISTOP 2 mg/ml sol, inj, cx, 5 amps, vd, trans, x 2 ml 95893369 EMISTOP 2 mg/ml sol, inj, cx, 5 amps, vd, trans, x 4 ml 95780190 EMLA 5 bisn, 5 g, 95780203 EMLA Creme 1 bisn, 5 g 95929142 EMPLASTRO SABIA Cx, c/60 envs, 10,5 cm x 16,5 cm - 01 un, 95929150 EMPLASTRO SABIA MINI Cart, c/06 envs, 5,0 cm x 7,5 cm - 24 un, 95098526 EMSEXPECTOR Xpe, fr, 120 ml 95250727 EMS-EXPECTORANTE Fr, 100 ml, 95997237 EMS-MAX 500 mg, cx, 3 cprs, 95997245 EMS-MAX Susp, 600 mg, (po+ dil,) 95122885 EMTAZ (Restrito Hosp,) 1 g po liof, inj, ct, FA vd, x 50 ml 95122893 EMTAZ (Restrito Hosp,) 200 mg, po liof, inj, ct, FA vd, x 10 ml 95065555 EMULSAO LIPIDICA Ivelip - Emulsao lipidica 20% - 100 ml 95065571 EMULSAO LIPIDICA Ivelip - Emulsao lipidica 20% - 1000 ml, 95065563 EMULSAO LIPIDICA Ivelip - Emulsao lipidica 20% - 500 ml, 95929169 EMULSAO SCOTT Laranja200 ml 95929177 EMULSAO SCOTT Laranja400 ml 95929185 EMULSAO SCOTT Morango 200 ml 95929193 EMULSAO SCOTT Morango 400 ml 95929207 EMULSAO SCOTT Reg, 200 ml 95929215 EMULSAO SCOTT Reg, 400 ml 95055371 ENABLEX 15 mg, 14 cp, 95055363 ENABLEX 15 mg, 28 cp, 95055398 ENABLEX 7,5 mg, 14 cp, 95055380 ENABLEX 7,5 mg, 28 cp, 95132740 ENALABAL 10 mg cx, 30 cprs, 95132759 ENALABAL 20 mg cx, 30 cprs, 95132767 ENALABAL 5 mg cx, 30 cprs, 95071997 ENALAP 10 mg, cx, 30 cprs, 95072012 ENALAP 20 mg, cx, 30 cprs, 95072004 ENALAP 5 mg, cx, 30 cprs, 95132791 ENALPRIN 10 mg cx, 30cprs, 95132813 ENALPRIN 20 mg cx, 30cprs, 95132775 ENALPRIN 5 mg cx, 30cprs, 95041877 ENANTATO DE NORETISTERONA + VALERAT 50 mg/ml+ 5 mg/ml sol, inj, ser, preenc, vd, x 1 ml+ ag, d 95098534 ENANTATO DE NORETISTERONA + VALERATO DE ESTRADIOL 50 +- 5 GENERICO mg/ml sol, inj, amp, vd, amb, x 1 ml + ser, 95055410 ENAPROTEC 10 mg, ct, bl, al/al x 30 cprs, 95055428 ENAPROTEC 20 mg, ct, bl, al/al x 30 cprs,

Laboratorio CLARIS CLARIS ASTRAZENECA ASTRAZENECA JOHNSON & JOHNSON JOHNSON & JOHNSON EMS EMS EMS EMS SUN SUN BAXTER BAXTER BAXTER GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE NOVARTIS NOVARTIS NOVARTIS NOVARTIS BALDACCI BALDACCI BALDACCI MILIAN MILIAN MILIAN ROYTON ROYTON ROYTON EUROFARMA CIFARMA HEXAL HEXAL

UNIDADE Pco Unt Base A AMP 34,00 AMP 47,36 G 2,22 G 2,64 ENV 2,21 ENV 0,64 ML 0,10 ML 0,14 COMP 6,76 ML 1,56 FA 596,21 FA 120,15 ML 1,52 ML 0,47 ML 0,55 ML 0,03 ML 0,03 ML 0,03 ML 0,03 ML 0,03 ML 0,03 COMP 5,63 COMP 5,63 COMP 5,63 COMP 5,63 CPR 0,81 CPR 1,53 CPR 0,47 COMP 0,44 COMP 0,60 COMP 0,29 CPR 0,32 CPR 0,48 CPR 0,23 UND 11,31 FA 10,55 COMP 0,57 COMP 0,91

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5748 5749 5750 5751 5752 5753 5754 5755 5756 5757 5758 5759 5760 5761 5762 5763 5764 5765 5766 5767 5768 5769 5770 5771 5772 5773 5774 5775 5776 5777 5778 5779 5780 5781 5782 5783 5784 5785

CODIGO BENEFICIO 95055401 ENAPROTEC 95132864 ENATEC 95132872 ENATEC 95132899 ENATEC 95132880 ENATEC 95132902 ENATEC 95132910 ENATEC 95893377 ENATIL 95893385 ENATIL 95929258 ENAX 95098542 ENBREL PFS 95065628 ENCRISE 95090479 ENDOCRIS 95090487 ENDOCRIS 95090495 ENDOCRIS 95090509 ENDOCRIS 95094482 ENDOFER 95570292 ENDOFOLIN 95570306 ENDOFOLIN 95037799 ENDOFOLIN 95570314 ENDOFOLIN 95570322 ENDOFOLIN 95085629 ENDONIDAZOL - SISTEMA FECHADO 95085637 ENDONITOL 3% - SISTEMA FECHADO 95028943 ENEMAPLEX 130 95611576 ENERGOPLEX 95065636 ENFLURAN 95065644 ENFLURAN 95065652 ENFLURANO - GENERICO 95065660 ENFLURANO - GENERICO 95065679 ENFLURANO - GENERICO 95929274 ENGERIX B 95929290 ENGOV 95082565 ENOXALOW 95098550 ENOXALOW 95082573 ENOXALOW 95098569 ENOXALOW 95082581 ENOXALOW

APRESENTAÇÃO Laboratorio 5 mg, ct, bl, al/al x 30 cprs, HEXAL 10 mg, 30 cprs, HEBRON 20 mg, cx, 10 cprs, HEBRON 20 mg, cx, 30 cprs, HEBRON 5 mg, cx, 30 cprs, HEBRON F 10/25 cx, 2 x 15 cprs, HEBRON F 20/12,5 cx, 30 cprs, HEBRON 10 mg, cx, 30 cprs, BRASTERAPICA 20 mg, cx, 30 cprs, BRASTERAPICA Cx, 30 caps, ATIVUS (50 mg) 4 x 1,0 ml sol, inj, ct, 4 ser, preench, c/ag, + 8 lencos WYETH 20 U/ml sol, inj, 10 amps, x 1 ml BIOLAB SANUS 20 mg/0,2 ml sol, inj, 10 ser, CRISTALIA 40 mg/0,4 ml sol, inj, 10 ser, CRISTALIA 60 mg/0,6 ml sol, inj, 2 ser, CRISTALIA 80 mg/0,8 ml sol, inj, 2 ser, CRISTALIA 50 mg/ml sol, oral, fr, plast, amb, got, x 30 ml BIOLAB SANUS 2 mg, cx, 20 cprs, MARJAN 5 mg, cx, 20 cprs, MARJAN 5 mg, cx, 30 cprs, MARJAN Gts, fr, 30 ml MARJAN Liq, fr, 100 ml MARJAN 1 x 100 ml FRESENIUS KABI 1 x 2000 ml FRESENIUS KABI 1 x 130 ml, s/cartucho (enema fosfatado) FRESENIUS KABI Sol, inj, cx, 5 amps, LIBBS 1 fr, 100 ml CRISTALIA 1 fr, 240 ml CRISTALIA Fr, vd, amb, x 50 ml BIOCHIMICO Fr, vd, amb,x100ml BIOCHIMICO Fr, vd, amb,x240ml BIOCHIMICO 10 mcg, ser, 0,5ml, GLAXOSMITHKLINE Fracao - 1 env, x 6 cprs, COSMED 100 mg, ct, 1 ser, preench, 1,0 ml BLAUSIEGEL 100 mg, ct, 10 ser, preench, 1,0 ml BLAUSIEGEL 20 mg, ct, 1 ser, preench, 0,2 ml BLAUSIEGEL 20 mg, ct, 10 ser, preench, 0,2 ml BLAUSIEGEL 40 mg, ct, 1 ser, preench, 0,4 ml BLAUSIEGEL

UNIDADE Pco Unt Base A COMP 0,38 CPR 0,58 CPR 1,19 CPR 0,73 CPR 0,36 CPR 0,89 CPR 1,22 COMP 0,37 COMP 0,62 CAPS 0,61 UND 6132,93 x AMP 15,31 UNID 15,94 UNID 30,96 UNID 47,46 UNID 63,21 GOTAS 15,28 CPR 0,68 CPR 0,76 CP 0,63 GOTAS 0,01 ML 0,11 FR 7,30 FR 16,71 UND 9,06 AP 2,36 ML 1,90 ML 1,47 ML 1,60 ML 15,99 ML 1,61 AP 31,76 CPR 0,56 UNID 86,39 UNID 86,39 UNID 17,96 UNID 17,96 UNID 34,87

151

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5786 5787 5788 5789 5790 5791 5792 5793 5794 5795 5796 5797 5798 5799 5800 5801 5802 5803 5804 5805 5806 5807 5808 5809 5810 5811 5812 5813 5814 5815 5816 5817 5818 5819 5820 5821 5822 5823

CODIGO BENEFICIO 95098577 ENOXALOW 95082590 ENOXALOW 95098585 ENOXALOW 95082603 ENOXALOW 95098593 ENOXALOW 95098607 ENTACAPONA - GENERICO 95098615 ENTARKIN 95450726 ENTOCORT 95450718 ENTOCORT 95037810 ENURAN 95037829 ENURAN 95074929 ENURAN 95929304 ENXAK 95630074 ENZICOBA 95630082 ENZICOBA 95630066 ENZICOBA 95929347 ENZILOM 95929355 ENZILOM 95340262 EPELIN 95089608 EPEZ 95089624 EPEZ 95089616 EPEZ 95028951 EPHYNAL 95055436 EPICITRIN 95098623 EPIDUO 95065687 EPIFRIN 95997342 EPILENIL 95098631 EPILENIL 95340289 EPILENIL 95997350 EPILEPTIL 95690077 EPITEZAN 95400508 EPIVIR (ICMS 0%) 95400516 EPIVIR (ICMS 0%) 95540849 EPOSIDO-ETOPOSIDO 95570365 EPREX 95570403 EPREX 95570373 EPREX 95570381 EPREX

APRESENTAÇÃO 40 mg, ct, 10 ser, preench, 0,4 ml 60 mg, ct, 1 ser, preench, 0,6 ml 60 mg, ct, 10 ser, preench, 0,6 ml 80 mg, ct, 1 ser, preench, 0,8 ml 80 mg, ct, 10 ser, preench, 0,8 ml 200 mg, 3 bl, x 10 cprs, rev, 200 mg, 3 bl, x 10 cprs, rev, 3 mg, 1 x 45 caps, Enema 7 frs, Fr, vd, 100 ml Fr, vd, 240 ml Fr, vd, 50 ml Cx, 12 cprs, 1 mg, cx, 12 cprs, 1 mg, cx, 40 cprs, 5 mg, cx, 20 cprs, 10 mg, bl, c/20 cprs, 4,0 mg/ml fr, c/10 ml Susp, oral vd, 120 ml, 10 mg, 30 cprs, 5 mg, 10 cprs, 5 mg, 30 cprs, 3 bl,x10 caps,400mg, Pom, cx, 50 bisn, 10 g (hosp,) Gel, bisn, 60 g 0,1% sol, inj, 100 amps, x 1 ml 250 mg,fr,vd,25caps, 500 mg, fr, vd, x 50 cprs, rev, Xpe, fr, 100 ml 2 mg, cx, 20 cprs, Bisn, 3,5 g, 150 mg, 60 cprs Sol, oral fr, 240 ml Sol, inj, 20 mg/ml FA 5 ml, cx, c/10 100 mg, 1,000 UI cx, 6 ser, preench, A,F, 10,000 UI cx, 6 ser, preench, A,F, 2,000 UI cx, 6 ser, preench, A,F, 3,000 UI cx, 6 ser, preench, A,F,

Laboratorio BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL EMS SIGMA PHARMA ASTRAZENECA ASTRAZENECA BIOCHIMICO BIOCHIMICO BIOCHIMICO CAZI FARMASA FARMASA FARMASA OSORIO DE MORAES OSORIO DE MORAES PFIZER TORRENT TORRENT TORRENT BAYER NEO QUIMICA GALDERMA CRISTALIA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS TEUTO BRAS, ALLERGAN GLAXOSMITHKLINE GLAXOSMITHKLINE BLAUSIEGEL JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG

UNIDADE Pco Unt Base A UNID 34,87 UNID 49,19 UNID 49,19 UNID 65,84 UNID 65,83 COMP 2,66 COMP 2,20 CPR 4,41 GOTA 0,09 ML 1,86 ML 1,86 FR 1,86 CPR 0,78 CPR 0,48 CPR 0,43 CPR 2,15 CPR 0,20 GOTAS 0,02 ML 0,05 COMP 2,63 COMP 2,39 COMP 2,39 CPR 0,90 G 0,44 GRAMA 1,40 AMP 0,47 CAPS 0,47 COMP 0,80 ML 0,07 COMP 0,29 G 2,28 CPR 6,45 ML 0,45 FA 48,15 AP 28,37 AP 257,36 AP 46,55 AP 66,02

152

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5824 5825 5826 5827 5828 5829 5830 5831 5832 5833 5834 5835 5836 5837 5838 5839 5840 5841 5842 5843 5844 5845 5846 5847 5848 5849 5850 5851 5852 5853 5854 5855 5856 5857 5858 5859 5860 5861

CODIGO BENEFICIO 95570390 EPREX 95997369 EPREX 95290702 EQUILID 95290699 EQUILID 95017747 ERADACIL 95300112 ERANZ 95300104 ERANZ 95037845 ERBITUX 95122907 ERBITUX 95122915 ERBITUX 95500030 ERGOMETRIN 95500022 ERGOMETRIN 95500049 ERGOTRATE 95500065 ERGOTRATE 95929371 ERIBIOTIC 95929380 ERIBIOTIC 95929401 ERIBIOTIC 95929398 ERIBIOTIC 95929452 ERITAX 95929460 ERITAX 95260285 ERITOS 95260293 ERITOS 95376852 ERITRAX 95376860 ERITRAX 95997458 ERITREX (*) 95997466 ERITREX (*) 95376917 ERITREX (*) 95017755 ERITROKINE 95017801 ERITROKINE 95017771 ERITROKINE 95017780 ERITROKINE 95017798 ERITROKINE 95017763 ERITROKINE 95065695 ERITROMAX 95065709 ERITROMAX 95997512 ERITROMAX - ERITROPOETINA 95997520 ERITROMAX - ERITROPOETINA 95997539 ERITROMAX - ERITROPOETINA

APRESENTAÇÃO 4,000 UI cx, 6 ser, preench, A,F, Cart, c/1 ser, de 40,000 UI de 1 ml 200 mg, 20 cprs, 50 mg, 20 caps, Fr, 2 caps, 10 mg, ct, 2 bl, x 14 cprs, 5 mg, ct, 2 bl, x 14 cprs, 2 mg/ml sol, inj, FA vd, x 50 ml 5 mg/ml sol, inj, FA vd, x 100 ml 5 mg/ml sol, inj, FA vd, x 20 ml 125 mg, 500 drags, 50 amps, 1 ml, 12 cprs, Inj, 100 amps, 250 mg, cx, 12 caps, 500 mg, cx, 10 cprs, Susp, oral 250 mg/5 ml fr, 50 ml Susp,125mg/5 ml60ml 500 mg, c/12 cprs, Susp,250 mg,fr,100ml, Xpe, ad, 150 ml, Xpe, ped, 150 ml, 500 mg, cx, 12 caps, Susp, 250 mg, fr, 100 ml, 25 mg/ml, fr, 105 ml, susp, oral+ cp, med, 10 ml, 50 mg/ml, fr, 105 ml, susp, oral+ cp, med, 10 ml, 500 mg, cotab, cx, 21 cprs, 1000 U/0,5 ml 6 ser, preench, 10000 U/ml 6 ser, preench, 2000 U/0,5 ml 6 ser, preench, 3000 U/0,3 ml 6 ser, preench, 4000 U/0,4 ml 6 ser, preench, 500 U/0,25 ml 6 ser, preench, 40000 UI/ml sol, inj, cx, 1 ser, preench, x 1 ml 40000 UI/ml sol, inj, cx, 12 ser, preench, x 1 ml 2000 UI cx, 12 FA po liof,+ dil, 1 ml 2000 UI cx, FA po liof,+ dil, 1 ml 2000 UI FA 1 ml

Laboratorio JANSSEN - CILAG JANSSEN - CILAG SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS WYETH WYETH MERCK MERCK MERCK UNIAO QUIMICA UNIAO QUIMICA BIOLAB SANUS BIOLAB SANUS TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, LUPER LUPER BIOLAB SANUS BIOLAB SANUS LUPER LUPER ACHE ACHE ACHE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE SILVESTRE BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL

UNIDADE Pco Unt Base A AP 90,91 UNID 941,51 CPR 0,77 CPR 0,41 COMP 11,04 CPR 13,99 CPR 12,59 FA 659,80 X FA 2710,53 X FA 542,12 X CPR 0,23 AP 1,16 CPR 0,44 AP 1,09 CPR 1,36 CPR 1,94 ML 0,28 ML 0,20 CPR 2,39 ML 0,21 ML 0,08 ML 0,05 CPR 2,39 ML 0,21 ML 0,11 ML 0,19 CPR 1,68 UNID 23,26 UNID 157,26 UNID 39,33 UNID 55,77 UNID 76,80 UNID 16,28 FA 931,99 FA 932,00 X F,A, 74,87 F,A, 78,78 F,A, 84,23

153

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5862 5863 5864 5865 5866 5867 5868 5869 5870 5871 5872 5873 5874 5875 5876 5877 5878 5879 5881 5882 5883 5884 5885 5886 5887 5888 5889 5890 5891 5892 5893 5894 5895 5896 5897 5898 5899 5900

CODIGO BENEFICIO 95997555 ERITROMAX - ERITROPOETINA 95997547 ERITROMAX - ERITROPOETINA 95997563 ERITROMAX - ERITROPOETINA 95997571 ERITROMAX - ERITROPOETINA 95570659 ERITROMAX - ERITROPOETINA HUMANA RECOMB, 95570578 ERITROMAX - ERITROPOETINA HUMANA RECOMB, 95997580 ERITROMED 95987851 ERITROMED 95997598 ERITROMED 95997601 ERITROMED 95893393 EROWGLIZ 95893407 EROWGLIZ 95893415 EROWGLIZ 95929479 ERRADIC UG 95830197 ESCABIN 95028960 ESCABIN 95830243 ESCABRON 95830227 ESCABRON 95611630 ESCLEROVITAN 95611649 ESCLEROVITAN 95122923 ESMERON (Restrito Hosp,) 95929495 ESPASMO DIMETILIV 95098640 ESPASMO FLATOL 95020519 ESPASMODID COMPOSTO 95020527 ESPASMODID COMPOSTO 95020535 ESPASMODID COMPOSTO 95065750 ESPECIALIDADES PLAMALYTE 95037853 ESPECTROPRIMA 95041885 ESPECTROPRIMA 95893423 ESPECTROPRIMA 95377042 ESPECTROPRIMA 95122931 ESPECTROPRIMA (Restrito Hosp,) 95122940 ESPECTROPRIMA (Restrito Hosp,) 95929517 ESPIROLONA 95929525 ESPIRONOLACTONA - GENERICO 95098658 ESPIRONOLACTONA - GENERICO 95893466 ESPIRONOLACTONA - GENERICO 95028978 ESPIRONOLACTONA - GENERICO

APRESENTAÇÃO Laboratorio 3000 UI12 FA 1ml BLAUSIEGEL 3000UI FA 1ml BLAUSIEGEL 4000 UI cx, 12 FA po liof,+ dil, 1 ml BLAUSIEGEL 4000 UI cx, FA po liof,+ dil, 1 ml BLAUSIEGEL 4000 UI 1 ser, preench, 1 ml, BLAUSIEGEL 4000 UI 12 FA 1 ml, BLAUSIEGEL 125 mg, vd, 100 ml MEDQUIMICA 250 mg, cx, 12 caps, MEDQUIMICA 250 mg, vd, 50 ml MEDQUIMICA 500 mg, cx, 8 cprs, MEDQUIMICA 80 mg, 20 cprs, ARROW 80 mg, 500 cprs, ARROW 80 mg, 60 cprs, ARROW Ct, 7 bl, Err+ 3 bl, Om, LIBBS Locao vd, 100 ml, COSMED Shampoo fr, 100 ml COSMED Locao fr, 100 ml HEBRON Shampoo fr, 100 ml HEBRON Emb, 30 drags, MERCK Plus, vd, 30 caps, MERCK 10 mg/ml sol, inj, cart, 10 FA vd, inc, x 5 ml SCHERING-PLOUGH Fr, 20 ml EMS Gts, fr, 20 ml, LEGRAND Cx, 20 drags, UNIAO QUIMICA Gts, 10 ml, UNIAO QUIMICA Inj, cx, 50 amps, UNIAO QUIMICA Sol, inj, eletrol, - 500 ml, BAXTER 40 mg/ml,+ 8 mg/ml, sus, or, ct, fr, plas, opc, x 60 ml, PRATI DONADUZZI 40 mg/ml,+ 8 mg/ml, sus, or, cx, 50 fr, plas, opc, x 50 ml, PRATI DONADUZZI 40 mg/ml+ 8 mg/ml susp, oral cx, 50 fr, plast, x 60 ml (hos PRATI DONADUZZI 400 mg+ 80 mg c/300 cprs, PRATI DONADUZZI 40 mg/ml, + 8 mg/ml, sus, or, cx, 50 fr, plas, opc, x 50 ml, (hosp,) PRATI DONADUZZI 40 mg/ml, + 8 mg/ml, sus, or, cx, 50 fr, plas, opc, x 60 ml, (hosp,) PRATI DONADUZZI 100 mg, cx, 20 cprs, CAZI 100 mg, 1 bl, x 15 cprs, EMS 100 mg, 1 bl, x 16 cprs, EMS 100 mg, 2 bl, 15 cprs, GERMED 100 mg, bl, 16 cprs, EUROFARMA

UNIDADE Pco Unt Base A F,A, 94,69 F,A, 94,68 F,A, 132,39 F,A, 132,38 AP 142,59 FA 138,32 ML 0,17 CAPS 1,46 ML 0,32 COMP 2,76 COMP 0,48 COMP 0,48 COMP 0,49 CPR 47,30 ML 0,11 ML 0,11 ML 0,20 ML 0,20 CPR 0,49 CPR 1,06 FA 38,20 GOTAS 0,03 GOTAS 0,03 CPR 0,45 GOTAS 0,04 AP 1,91 ML 0,19 ML 0,02 ML 0,97 ML 0,02 CPR 0,08 ML 0,02 ML 0,02 CPR 1,08 CPR 0,58 COMP 0,74 COMP 0,83 CPR 0,86

154

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5901 5902 5903 5904 5905 5906 5907 5908 5909 5910 5911 5912 5913 5914 5915 5916 5917 5920 5921 5922 5923 5924 5925 5926 5927 5928 5929 5930 5931 5932 5933 5934 5935 5936 5937 5938 5939 5940

CODIGO BENEFICIO 95893458 ESPIRONOLACTONA - GENERICO 95017836 ESPIRONOLACTONA - GENERICO 95997636 ESPIRONOLACTONA - GENERICO 95893431 ESPIRONOLACTONA - GENERICO 95893440 ESPIRONOLACTONA - GENERICO 95929533 ESPIRONOLACTONA - GENERICO 95997644 ESPIRONOLACTONA - GENERICO 95017810 ESPIRONOLACTONA - GENERICO 95028986 ESPIRONOLACTONA - GENERICO 95098666 ESPIRONOLACTONA - GENERICO 95997652 ESPIRONOLACTONA - GENERICO 95017828 ESPIRONOLACTONA - GENERICO 95028994 ESPIRONOLACTONA - GENERICO 95929541 ESPIRONOLACTONA - GENERICO 95929550 ESSEDIN 95929568 ESSEDIN 95020543 ESSEN 95082611 ESTOLATO DE ERITROMICINA - GENERICO 95083880 ESTOLATO DE ERITROMICINA - GENERICO 95122958 ESTOLATO DE ERITROMICINA - GENERICO (Restrito Hosp,) 95030360 ESTOMEPE 95929592 ESTRADOT 95929606 ESTRADOT 95929614 ESTRADOT 95929630 ESTRINOLON 95929622 ESTRINOLON 95084843 ESTRIOL - GENERICO 95069577 ESTRIOPAX 95929649 ESTRIOPAX 95929657 ESTROCUR 95929665 ESTROCUR 95929681 E-TABS 95929690 E-TABS 95190066 ETHAMOLIN 95929703 ETHENEM 95929711 ETHENEM 95929720 ETHENEM 95074945 ETHYOL

APRESENTAÇÃO 100 mg,1 bl,x16 cprs, 100mg, 6bl, x 10 cprs, 100mg,1bl,x15 cprs, 100mg,1bl,x16 cprs, 100mg,1bl,x30 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 2 bl, x 15 cprs, 25 mg, 6 bl, x 10 cprs, 25 mg, bl, 30 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 6 bl, x 10 cprs, 50 mg, bl, 30 cprs, 500 mg, 2 bl, x 15 cprs, 100+ 2+ 2 mg/ml sol, oral fr, 20 ml 200+ 3+ 3 mg/ml xpe, fr, 100 ml Cx, 16 caps, 500 mg, com, ct, bl, al, plas, inc, x 20 500 mg, com, ct, bl, al, plas, inc, x 420 (hosp,) 500 mg, com, ct, bl, al, plas, inc, x 420 (hosp,) 20 mg, cx, 14 caps, 100 mcg 8 sist, 25 mcg 8 sist, 50 mcg 8 sist, 0,625 mg, cx, 21 drags, 0,625 mg,cx, 28 drags, 1 mg/g creme vag, bisn, 50 g+ 50 aplic, 1 mg/g creme vag, cx, 50 bisn, x 50 g (hosp,) Creme vag, 1 mg/g bisn, 50 g+ aplic, 10 mg cx, 30cprs, 20 mg cx, 30 cprs, 1000UIfr,30caps,gel, 400 UI fr, 30 caps, gel, Inj, cx, 6 amps 2 ml 150 mg, cx, 20 cprs, rev, 150 mg, cx, 240 cprs, rev, 300 mg, cx, 16 cprs, rev, 500mg, 3FA10ml

Laboratorio GERMED EMS GERMED EMS EMS EMS GERMED EMS EUROFARMA EMS GERMED EMS EUROFARMA EMS LEGRAND LEGRAND FARMASA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI BUNKER NOVARTIS NOVARTIS NOVARTIS EMS EMS NEO QUIMICA NEO QUIMICA NEO QUIMICA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA FARMOQUIMICA CIBRAN CIBRAN CIBRAN SCHERING-PLOUGH

UNIDADE Pco Unt Base A COMP 0,82 COMP 0,52 COMP 0,59 COMP 0,59 COMP 0,74 CPR 0,39 COMP 0,39 COMP 0,35 CPR 0,40 COMP 0,63 COMP 0,62 COMP 0,47 CPR 0,63 CPR 0,45 GOTAS 0,03 ML 0,13 CPR 0,98 COMP 0,96 COMP 0,58 COMP 0,58 CPR 2,82 UND 10,00 UND 6,35 UND 7,46 CPR 0,75 CPR 0,75 UNID 0,42 TB 22,72 G 0,52 CPR 0,64 CPR 1,17 CPR 1,32 CPR 0,57 AP 3,97 CPR 0,51 CPR 0,52 CPR 1,17 FA 737,74 X

155

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5941 5942 5943 5944 5945 5946 5947 5948 5949 5950 5951 5952 5953 5954 5955 5956 5957 5958 5959 5960 5961 5962 5963 5964 5965 5966 5967 5968 5969 5970 5971 5972 5973 5974 5975 5976 5977 5978

CODIGO BENEFICIO 95098674 ETILDOPANAN 95132937 ETILDOPANAN 95132929 ETILDOPANAN 95997660 ETILEFRIL 95082620 ETNA 95082638 ETNA 95017852 ETOMERASE 95044701 ETOMIDATO (GENERICO) 95017860 ETOPOSIDEO - GENERICO 95072047 ETOXIN 95017887 ETRANE 95017895 ETRANE 95929738 EUCIL 95929754 EUCIL 95320687 EUCIL 95929827 EUFOR 95300120 EUGERIAL 95098682 EULEXIN 95540911 EUNADES (ETOPOSIDO) 95017909 EUPEPT 95017933 EUPEPT 95017925 EUPEPT 95037888 EUPEPT 95017917 EUPEPT 95132945 EUPRESSIN 95132970 EUPRESSIN 95132961 EUPRESSIN 95132953 EUPRESSIN 95041893 EUPROSTATIN 95041907 EUPROSTATIN 95982329 EUSOL - SOLUÇÃO PARA CONSERVAÇÃO DE CORNEA 95055479 EUTHYROX 95082654 EUTHYROX 95055487 EUTHYROX 95098690 EUTHYROX 95055495 EUTHYROX 95055509 EUTHYROX 95055517 EUTHYROX

APRESENTAÇÃO 250 mg cx, 2 bl, x 10 cprs, 250 mg cx, 3 bl, x 10 cprs, 500 mg cx, 2 bl, x 10 cprs, 10 mg/ml sol, inj, 6 amps, x 1 ml Cx, 2 bl, x 10 caps, Sol, inj, cx, 3 frs, vd,+ 3 amps, vd, 100 mg, sol, inj, FA x 5 ml 2 mg/ml - 25 amp, - 10 ml, 20 mg/ml sol, inj, IV amp, vd, x 5 ml Xpe, 50mg/mlfr,120ml Fr, 100 ml Fr, 240 ml 10 mg, cx, 20 cprs, Ad, gts, fr, 10 ml Sol, oral ped, vd, 10 ml, 20 mg, cx,28 cprs, 30 mg 30 cprs, 250 mg, est, 20 cprs, 100 mg, sol, inj, cx, 10 FA 10 mg, 14 caps, 10 mg, 7 caps, 20 mg, 14 caps, 20 mg, 28 caps, 20 mg, 7 caps, 10 mg, cx, 30 cprs, 2,5 mg, str, x 30 cprs, 20 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 2 mg, 2 bl, x 15 cprs, 2 mg, 9 bl, x 10 cprs, FRASCO 100 mcg, cart, bl, al, al, x 50 cprs, 112 mcg cart, bl, al, al, x 50 cprs, 125 mcg, cart, bl, al, al, x 50 cprs, 137 mcg cart, bl, al, al, 50 cprs, 150 mcg, cart, bl, al, al, x 50 cprs, 175 mcg, cart, bl, al, al, x 50 cprs, 200 mcg, cart, bl, al, al, x 50 cprs,

Laboratorio NEO QUIMICA NEO QUIMICA NEO QUIMICA UNIAO QUIMICA GROSS GROSS BIOCHIMICO CRISTALIA GLENMARK APSEN ABBOTT ABBOTT FARMASA FARMASA FARMASA FARMASA BAGO MANTECORP PFIZER CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA SIGMA PHARMA SIGMA PHARMA VISTATEK MERCK MERCK MERCK MERCK MERCK MERCK MERCK

UNIDADE Pco Unt Base A COMP 1,83 CPR 0,96 CPR 1,94 AMP 0,81 CAPS 1,33 AMP 14,10 FA 45,80 AMP 12,43 FA 31,15 ML 0,29 ML 2,64 ML 2,66 CPR 0,19 GOTAS 0,02 GOTAS 0,02 CPR 3,43 CPR 1,14 COMP 6,72 FA 25,87 CAPS 0,79 CAPS 0,87 CAPS 1,60 CP 0,78 CAPS 1,71 CPR 0,74 CPR 0,53 CPR 1,42 CPR 0,53 COMP 0,64 COMP 0,44 UND 131,25 COMP 0,43 COMP 0,48 COMP 0,48 COMP 0,51 COMP 0,51 COMP 0,58 COMP 0,64

156

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 5979 5980 5981 5982 5983 5984 5985 5986 5987 5988 5989 5990 5991 5992 5993 5994 5995 5996 5997 5998 5999 6000 6001 6002 6003 6004 6005 6006 6007 6008 6009 6010 6011 6012 6013 6014 6015 6016

CODIGO BENEFICIO 95055444 EUTHYROX 95055452 EUTHYROX 95055460 EUTHYROX 95082646 EUTHYROX 95083901 EUTROPIN 95083898 EUTROPIN 95065776 EUTROPIN 95480439 EVISTA 95480447 EVISTA 95098704 EVOCANIL 95017968 EVOCANIL 95017941 EVOCANIL 95017950 EVOCANIL 95997687 EVOCANIL 95987860 EVOCARB 95987878 EVOCARB 95122966 EVOCICLO (Restrito Hosp,) 95899570 EVODAZIN 95899588 EVODAZIN 95037900 EVOLOX 95122974 EVOMID (Restrito Hosp,) 95122982 EVOMID (Restrito Hosp,) 95037918 EVOMIXAN 95065784 EVOPOSDO 95065792 EVORUBICIN 95065806 EVORUBICIN 95037926 EVOTABINA 95037934 EVOTABINA 95065814 EVOTAXEL 95065822 EVOTAXEL 95065830 EVOTAXEL 95065849 EVOTAXEL 95065857 EVOTECAN 95065873 EVOTERIN 95065865 EVOTERIN 95997717 EVOXALI 95997725 EVOXALI 95122990 EVOZAR (Restrito Hosp,)

APRESENTAÇÃO 25 mcg, cart, bl, al, al, x 50 cprs, 50 mcg, cart, bl, al, al, x 50 cprs, 75 mcg, cart, bl, al, al, x 50 cprs, 88 mcg cart, bl, al, al, x 50 cprs, 15 UI po ct, 1 FA+ dil, x 1,5 ml 4 UI po ct, 1 FA+ dil, x 1 ml 4 UI po ct, FA x 5+ dil, x 1 ml 60 mg, cx, 14 cprs, 60 mg, cx, 28 cprs, 200 mg, 20 caps, gel, mole Cx, 20 caps, 100 mg, Cx, 20 caps, 200 mg, Cx, 30 caps, 200 mg, Cx, 60 caps, 150 mg,cx, 1 FA 50 mg,cx, 1 FA 1 g po liof, inj, FA vd, 100 mg, 1 FA 200 mg, 1 FA 1 g po liof, inj, FA vd, x 1,5 g 10 mg, po liof, inj, 1 FA 5 mg, po liof, inj, FA vd, 20 mg, amp, 10 ml - 2 mg/ml 20 mg/ml sol, inj, ct, amp, amb, x 5 ml 10mg,poliof,inj,FAvd, 50 mg, po liof, inj, FA vd, 10 mg, amp, 1 ml - 10 mg/ml 50 mg, amp, 5 ml - 10 mg/ml 6 mg/ml sol, inj, ct FA vd, inc, x 5 ml 6 mg/ml sol, inj, ct, FA vd, inc, x 16,7 ml 6 mg/ml sol, inj, ct, FA vd, inc, x 25 ml 6 mg/ml sol, inj, ct, FA vd, inc, x 50 ml 4 mg, po liof, inj, FA vd, 20 mg/ml sol, inj, ct, FA vd, amb, x 2 ml 20 mg/ml sol, inj, ct, FA vd, amb, x 5 ml 100 mg,cx, 1 FA 50 mg,cx, 1 FA 1 g po liof, inj, FA vd, inc,

Laboratorio MERCK MERCK MERCK MERCK DISMEDICA DISMEDICA CRISTALIA ELI LILLY ELI LILLY ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS EVOLABIS

UNIDADE Pco Unt Base A COMP 0,33 COMP 0,38 COMP 0,42 COMP 0,38 FA 413,48 FA 127,13 FA 635,71 X CPR 5,56 CPR 5,54 COMP 1,69 CAPS 0,98 COMP 2,33 CAPS 1,21 CAPS 1,13 F,A, 325,80 F,A, 108,59 FA 30,14 FA 40,51 FA 84,23 FA 71,56 FA 744,00 FA 392,75 AMP 750,11 X AMP 40,69 FA 30,59 FA 127,09 AMP 141,65 AMP 644,68 FA 403,97 FA 1310,75 FA 2105,78 FA 4058,61 FA 776,75 FA 457,55 FA 1127,35 F,A, 2494,75 F,A, 1180,32 FA 536,75

157

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6017 6018 6019 6020 6021 6022 6023 6024 6025 6026 6027 6028 6029 6030 6031 6032 6033 6034 6035 6036 6037 6038 6039 6040 6041 6042 6043 6044 6045 6046 6047 6048 6049 6050 6051 6052 6053 6054

CODIGO BENEFICIO 95123008 EVOZAR (Restrito Hosp,) 95929940 EVRA 95400532 EXAVIR (*) 95420444 EXELMIN 95420436 EXELMIN 95929967 EXELON 95929975 EXELON 95997733 EXELON 95929983 EXELON 95893504 EXELON 95017992 EXJADE 95018000 EXJADE 95018018 EXJADE 95250778 EXPEC 95041923 EXPECDILAT 95041915 EXPECDILAT 95250786 EXPECTAMIN 95250794 EXPECTIL 95981870 EXPECTOMEL 95098712 EXPECTRAT 95250824 EXPECTUSS 95250816 EXPECTUSS 95037942 EXUBERA 95037950 EXUBERA 95037969 EXUBERA 95981888 EZETROL 95400540 EZOPEN 95400559 EZOPEN (*) 95123016 EZOPEN (Restrito Hosp,) 95540920 EZULEN 95540938 EZULEN 95123024 FABRAZYME 95123032 FABRAZYME 95037977 FACTIVE 95037985 FACTIVE 95098720 fa*gICO 95018026 FALMONOX 95018042 FALMONOX

APRESENTAÇÃO 200 mg, po liof, inj, FA vd, inc, Cart, 3 adesivos 200 mg 25 cprs, Cx, 6 cprs, Susp, fr, 30 ml, 1,5 mg, 28 cs, blister 3,0 mg, 28 cs, blister 3,0 mg, 56 cs, blister 4,5 mg, 28 cs, blister Sol, oral 2 mg, 50 ml 125 mg, 28 cp, 250 mg, 28 cp, 500 mg, 28 cp, Xpe, 120 ml Xpe, ad, 50 mg/5 ml fr, 120 ml Xpe, inf, 25 mg/5 ml fr, 120 ml Xpe, 100 ml, Xpe fr, 100 ml, Xpe, fr, 150 ml Xpe, fr, 150 ml Xpe, ad, 1 x 100 ml, Xpe, inf, 1 x 100 ml Insulin bl, 1 mg, x 30 Insulin bl, 3 mg, x 30 Starter kit+ 2 IRU+ 1 mg, x 30+ 3 mg, x 30 10 mg, cx, 1 bl, x 10 cprs, 5% cr, tb, 10 g 200 mg, bl, 25 cprs, 250 mg, po liof, IV inj, cx, c/5 (hosp,) 100 mg po liof, inj, f,a, vd, amb, 50 mg po liof, inj, f,a, vd, amb, 35 mg, po liof, inj, FA x 20 ml 5 mg, po liof, inj, FA x 5 ml 320 mg, bl, 5 cprs, rev, 320 mg, bl, 7 cprs, rev, 4 mg/ml sol, oral ct, fr, plast, opc, got, x 20 ml 100 mg, cx, 15 cprs, 500 mg, cx, 3 cprs,

Laboratorio EVOLABIS JANSSEN - CILAG UCI-FARMA UCI-FARMA UCI-FARMA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS LEGRAND SIGMA PHARMA SIGMA PHARMA LEGRAND BUNKER CAZI CAZI EMS EMS PFIZER PFIZER PFIZER MERCK SHARP & DOHME TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BIOSINTETICA BIOSINTETICA GENZYME DO BRASIL GENZYME DO BRASIL ACHE ACHE EUROFARMA SANOFI-AVENTIS SANOFI-AVENTIS

UNIDADE Pco Unt Base A FA 107,86 UND 19,24 CPR 1,68 CPR 2,79 GOTAS 0,02 CPR 4,97 CPR 5,71 COMP 5,61 CPR 6,47 ML 3,35 COMP 24,30 COMP 48,61 COMP 97,21 ML 0,15 ML 0,09 ML 0,08 ML 0,15 ML 0,08 ML 0,09 ML 0,11 ML 0,20 ML 0,13 UND 0,83 UND 2,14 UND 11,79 CPR 3,26 G 1,61 CPR 2,50 FA 61,57 FA 2627,36 X FA 1313,68 X FA 8906,12 FA 1272,29 CP 12,88 CP 15,09 GOTAS 0,03 COMP 0,68 COMP 3,56

158

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6055 6056 6057 6058 6059 6060 6061 6062 6063 6064 6065 6066 6067 6068 6069 6070 6071 6072 6073 6074 6075 6076 6077 6078 6079 6080 6081 6082 6083 6084 6085 6086 6087 6088 6089 6090 6091 6092

CODIGO BENEFICIO 95018034 FALMONOX 95030409 FAMOSET 95030425 FAMOSET 95030433 FAMOTID 95030441 FAMOTID 95030492 FAMOX 95030506 FAMOX 95030514 FAMOXIL 95030522 FAMOXIL 95030530 FAMOXIL 95030549 FAMOXIL 95400591 FANCLOMAX - FANCICLOVIR 95400605 FANCLOMAX - FANCICLOVIR 95400613 FANCLOMAX - FANCICLOVIR 95420495 FANSIDAR 95540954 FARMORUBICINA CS 95540989 FARMORUBICINA CS 95540970 FARMORUBICINA CS 95540997 FARMORUBICINA RD 95541004 FARMORUBICINA RD 95997768 FASLODEX 95065881 FASTFEN 95997784 FASTFEN 95997792 FASTFEN 95065890 FASTURTEC 95661689 FASULIDE 95981934 FASULIDE 95661670 FASULIDE 95661662 FASULIDE 95170065 FATOR ANTI-HEMOF, HUM, DUP, INAT, FANHDI 95170049 FATOR ANTI-HEMOF, HUM, DUP, INAT, FANHDI 95170057 FATOR ANTI-HEMOF, HUM, DUP, INAT, FANHDI 95065903 FAULBLASTINA 95065911 FAULDACAR 95065920 FAULDACAR 95065946 FAULDCARBO 95065954 FAULDCARBO 95065938 FAULDCARBO

APRESENTAÇÃO Susp, vd, 90 ml, 20 mg, cx, 30 cprs, 40 mg, cx, 30 cprs, 20 mg 1 bl,x 10 cprs, 40 mg 1 bl, x 10 cprs, 20 mg, cprs, cx, 10 40 mg, cprs, cx, 10 20 mg, blist, 10 cprs, 20 mg, blist, 30 cprs, 40 mg, blist, 10 cprs, 40 mg, blist, 30 cprs, 1 bl 125 mg, x 10 cprs, rev, 1 bl, 250 mg, x 21 cprs, rev, 1 bl, 250 mg, x 7 cprs, rev, 30 amps, 2,5 ml, 10 mg, sol, inj, FA plast, 200 mg, sol, inj, FA plast, 50 mg, sol, inj, FAplast, 10 mg, FA 50 mg, FA 250 mg, cx, 1 ser, 5 ml+ agulha esteril desc, 5 mcg/ml sol, inj, 25 amps, x 2 ml 50 mcg/ml - 10 amp, 5 ml 50 mcg/ml - 25 amp, 1 ml 1,5 mg, po liof, 3 FA vd, 100 mg, cx, 12 cprs, Gel, tb, 40 g Gts, fr, 15 ml, Susp, fr, 60 ml, 1000 UI 250 UI 500 UI 10 mg/10 ml 5 FA 200 mg, FA 600 mg, FA 150 mg/15 ml FA 450 mg/45 ml FA 50 mg/5 mlFA

Laboratorio SANOFI-AVENTIS SOLVAY FARMA SOLVAY FARMA NEO QUIMICA NEO QUIMICA ACHE ACHE HEBRON HEBRON HEBRON HEBRON BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL ROCHE PFIZER PFIZER PHARMACIA/PFIZER PFIZER PFIZER ASTRAZENECA CRISTALIA CRISTALIA CRISTALIA SANOFI-AVENTIS BUNKER BUNKER BUNKER BUNKER GRIFOLS GRIFOLS GRIFOLS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS

UNIDADE Pco Unt Base A ML 0,10 CPR 0,88 CPR 1,56 CPR 0,97 CPR 1,72 CPR 1,33 CPR 2,52 CPR 0,82 CPR 0,74 CPR 1,46 CPR 1,30 CPR 4,35 CPR 10,46 CPR 10,71 AP 0,43 AP 68,63 FA 1030,42 X AP 286,21 FA 61,40 FA 261,21 F,A, 2077,83 AMP 5,98 AMP 64,66 AMP 13,91 FA 317,13 CPR 1,50 G 0,43 GOTAS 0,04 ML 0,22 AP 1503,14 X AP 365,90 X AP 751,56 X FA 44,00 FA 109,82 FA 324,40 FA 391,28 FA 1013,80 FA 193,69

159

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6093 6094 6095 6096 6097 6098 6099 6100 6101 6102 6103 6104 6105 6106 6107 6108 6109 6110 6111 6112 6113 6114 6115 6116 6117 6118 6119 6120 6121 6122 6123 6124 6125 6126 6127 6128 6129 6130

CODIGO BENEFICIO 95065989 FAULDCISPLA 95065962 FAULDCISPLA 95065970 FAULDCISPLA 95066004 FAULDCITA 95065997 FAULDCITA 95066012 FAULDFLUOR 95066020 FAULDFLUOR 95066047 FAULDLEUCO 95066039 FAULDLEUCO 95066080 FAULDMETRO 95066071 FAULDMETRO 95066063 FAULDMETRO 95066055 FAULDMETRO 95066101 FAULDOXO 95066098 FAULDOXO 95066136 FAULDPAMI 95066144 FAULDVINCRI 95055525 FAXIMIN 95018050 FAXIMIN 95038086 FAZOLIX 95123040 FAZOLON (Restrito Hosp,) 95123059 FAZOLON (Restrito Hosp,) 95123067 FAZOLON (Restrito Hosp,) 95098739 FEBSEN 95098747 FEBSEN 95072055 FEGRAN 95074961 FEIBA 95074953 FEIBA 95970037 FELDENE (*) 95661700 FELDENE (*) 95661735 FELDENE (*) 95661743 FELDENE (*) 95970053 FELDENE (*) 95018077 FELIS 95970061 FELODIL 95970070 FELODIL 95029028 FELODIPINO - GENERICO 95970088 FELODIPINO - GENERICO

APRESENTAÇÃO 10 mg/10 ml FA 100 mg/100 ml FA 50 mg/50 ml FA 1 g sol, inj, FA de 10 ml de 100 mg/ml 500mg/5 mlcx,5FA 2,5 g/50 ml FA 500 mg/10 mlcx,5FA 300 mg/30 ml FA 50 mg/5 mlFA 1 g/10 ml FA 5 g/50 ml FA 50 mg/2 ml cx, 5 FA 500 mg/20 ml FA 10 mg/5 ml FA 50 mg/25 ml FA 90 mg/10 ml FA 1 mg/ml cx, 5 FA 1,5 g sol, oral x 15 saches 1,5 g x 15 saches x 4,0 g 1 g po liof, inj, cx, 50 FA vd, (hosp,) 1000 mg, po inj, cx, 100 FA vd, inc, 1000 mg, po inj, cx, 20 FA vd, inc, 1000 mg, po inj, cx, 50 FA vd, inc, 100 mg/ml susp, oral fr, plast, opc, got, x 20 ml 50 mg/ml susp, oral fr, plast, opc, got, x 30 ml 20 mg, 14 caps, 1000 U FA+ dil,+ equipo inf, 500 U FA+ dil,+ equipo inf, 20 mg, 10 supos, 20 mg, cx, 10 caps, 20 mg, fr, 10 cprs, sol, 40 mg, cx, 2 amps, SL 20 mg, 5 bl, x 2 cprs, 425 mg, 30 caps, 10 mg, cx, 20 cprs, 5 mg, cx, 20 cprs, 10 mg, cx, c/20 10 mg, cx, c/20

Laboratorio LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS SANDOZ NOVARTIS NOVAFARMA ARISTON ARISTON ARISTON MEDLEY MEDLEY DOVALLE BAXTER BAXTER PFIZER PFIZER PFIZER PFIZER PFIZER HEXAL HEXAL HEXAL SANDOZ HEXAL

UNIDADE Pco Unt Base A FA 38,24 FA 346,37 FA 178,92 FA 78,17 FA 94,42 FA 75,45 FA 15,40 FA 350,06 FA 65,33 FA 345,68 FA 1736,99 FA 23,43 FA 172,83 FA 56,03 FA 235,34 FA 684,80 FA 26,75 ENV 3,71 ENV 3,46 FA 6,39 FA 8,10 FA 8,10 FA 8,10 GOTAS 0,04 GOTAS 0,02 CAPS 1,87 FA 2561,06 X FA 1347,92 X UND 1,95 CPR 1,79 CPR 2,01 AP 8,47 CPR 3,82 CAPS 1,02 CPR 2,36 CPR 1,33 CPR 2,73 CPR 2,32

160

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6131 6132 6133 6134 6135 6136 6137 6138 6139 6140 6141 6142 6143 6144 6145 6146 6147 6148 6149 6150 6151 6152 6153 6154 6155 6156 6157 6158 6159 6160 6161 6162 6163 6164 6165 6166 6167 6168

CODIGO BENEFICIO 95029036 FELODIPINO - GENERICO 95970096 FELODIPINO - GENERICO 95541276 FEMARA 95893512 FEMIGESTROL 95611657 FEMINVIT 95098755 FEMME FOLICO 95970100 FEMOSTON 95970118 FEMOSTON CONTI 95661794 FENAFLAN 95661808 FENAFLAN 95661786 FENAFLAN 95970126 FENALGIN 95970134 FENALGIN 95970142 FENALGIN 95661840 FENAREN (*) 95661867 FENAREN (*) 95661883 FENAREN (*) 95661859 FENAREN (*) 95018085 FENATIL 95018093 FENATIL 95997830 FENDICAL 95997849 FENDICAL 95220054 FENERGAN 95220089 FENERGAN 95220020 FENERGAN 95055533 FENERGAN EXPECTORANTE 95055568 FENERGAN EXPECTORANTE 95055541 FENERGAN EXPECTORANTE 95055550 FENERGAN EXPECTORANTE 95377212 FENICLOR 95690085 FENIDEX 95150072 FENILEFRIN 95150080 FENILEFRINA 10% 95098763 FENIRAX 95098771 FENIRAX 95055576 FENITAL 95066152 FENITAL 95055584 FENITOINA - GENERICO

APRESENTAÇÃO 5 mg, cx, c/20 5 mg, cx, c/20 2,5 mg, 28 cprs, 160 mg, 3 bl, x 10 cprs, 30 cprs, rev, 5 mg, 30 cprs, rev, 1/10 cx, 28 cprs, rev, Cx, 28 cprs, rev, 50 mg, cx, 10 cprs, rev, D cx, 20 cprs, Susp, fr, gts, 15 ml, 750 mg, cx, 20 cprs, rev, 750 mg, cx, 200 cprs, rev, 750 mg, cx, 300 cprs, rev, 50 mg, cx, 20 cprs, 75 mg, inj, cx, 50 amps, 3 ml AP 100 mg, 10 cprs, Gts, 10 ml, 10 mg, bl, 20 drags, 25 mg, bl, 20 drags, Cx, 15 cprs, Cx, 30 cprs, 25 mg, est, 20 cprs, 25 mg/ml, cx, 25 amps, 2 ml, Creme tb, 30 g, Ad, 100 ml Ad, 120 ml Ped, 100 ml Ped, fr, 120 ml Sol, oft, fr, 10 ml 5 ml, 10 mg/ml cx, 50 amps, 1 ml Fr, 5 ml, Creme 30 g Sol, oral - 0,4 mg/ml - fr, 120 ml 2,5% sol,oral1fr,120ml 5% - 50 amps, 5 ml 100 mg, bl, lar, 25 cprs,

Laboratorio SANDOZ HEXAL NOVARTIS BERGAMO ATIVUS ACHE SOLVAY FARMA SOLVAY FARMA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, CIBRAN CIBRAN CIBRAN UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA NEO QUIMICA NEO QUIMICA UCI-FARMA UCI-FARMA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS LUPER ALLERGAN CRISTALIA ALLERGAN MULTILAB MULTILAB CRISTALIA CRISTALIA SANOFI-AVENTIS

UNIDADE Pco Unt Base A CPR 1,48 CPR 1,26 CPR 18,49 COMP 4,44 CPR 0,89 COMP 0,43 CPR 1,49 CPR 1,49 CPR 0,54 CPR 0,61 GOTAS 0,03 CPR 0,36 CPR 0,34 CPR 0,34 CPR 0,74 AP 1,62 CPR 1,25 GOTAS 0,06 DRAG 0,41 DRAG 0,87 COMP 1,46 COMP 0,68 CPR 0,38 AP 1,88 G 0,33 ML 0,10 ML 0,07 ML 0,10 ML 0,07 GOTAS 0,03 GOTAS 0,06 AP 6,36 GOTAS 0,07 GRAMA 0,28 ML 0,06 ML 0,35 AMP 2,28 COMP 0,12

161

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6169 6170 6171 6172 6173 6174 6175 6176 6177 6178 6179 6180 6181 6182 6183 6184 6185 6186 6187 6188 6189 6190 6191 6192 6193 6194 6195 6196 6197 6198 6199 6200 6201 6202 6203 6204 6205 6206

CODIGO BENEFICIO 95893539 FENITOINA - GENERICO 95082662 FENITOINA - GENERICO 95123075 FENITOINA - GENERICO (Restrito Hosp,) 95066179 FENITOINA SODICA - GENERICO 95123083 FENITOINA SODICA - GENERICO (Restrito Hosp,) 95018107 FENITON 95029052 FENOBARBITAL - GENERICO 95055592 FENOBARBITAL - GENERICO 95997903 FENOBARBITAL - GENERICO 95018115 FENOBARBITAL - GENERICO 95043640 FENOBARBITAL - GENERICO 95123091 FENOBARBITAL - GENERICO (Restrito Hosp,) 95123105 FENOBARBITAL - GENERICO (Restrito Hosp,) 95055606 FENOCRIS 95066187 FENOCRIS 95055614 FENOCRIS 95997911 FENOFIBRATO - GENERICO 95377220 FENOXIMETILPEN 400000 UI/5 ml - GENERICO 95997920 FENOXIMETILPENICILINA - GENERICO 95066195 FENTANEST 95066209 FENTANEST 95066225 FENTANEST (*) 95066233 FENTANEST (*) 95066217 FENTANEST (*) 95066241 FENTANEST (*) 95081470 FENTANIL 95083928 FENTANIL 95081461 FENTANIL 95086226 FENTANILA+ DROPERIDOL 95510150 FENTIZOL 95510168 FENTIZOL 95018123 FENTIZOL 95970177 FERID 95570730 FER-IN-SOL 95038094 FERMATHRON 95018158 FERRINI 95018140 FERRINI 95018166 FERRINI

APRESENTAÇÃO Laboratorio 100 mg, 30 cprs, TEUTO BRAS, 100 mg, cx, 25 cprs, CAZI 100 mg, 100 cprs, (hosp,) TEUTO BRAS, 50 mg/ml sol, inj, 72 amps, vd, x 5 ml (hosp,) TEUTO BRAS, 50 mg/ml sol, inj, 50 amps, 5 ml UNIAO QUIMICA 100 mg, 100 cprs, TEUTO BRAS, 100 mg, 30 cprs, TEUTO BRAS, 100 mg, bl, 20 cprs, SANOFI-AVENTIS 100 mg, bl, 30 cprs, UNIAO QUIMICA 100 mg, cx, 20 cprs, NEO QUIMICA 40 mg/ml sol, oral gts, 20 ml UNIAO QUIMICA 100 mg, 100 cprs, (hosp,) TEUTO BRAS, 100 mg, bl, 200 cprs, UNIAO QUIMICA 100 mg, 20bl,10cps, CRISTALIA 200 mg,50amps,2ml CRISTALIA 40 mg/ml 10 frs, 20 ml CRISTALIA Caps, 200 mg, fr, plast, x 30 APOTEX Fr, 60 ml, EMS 500,000 UI cx, 12 cprs, TEUTO BRAS, 25 mcg/h ades, transd, ct, sc, al, x 10 (rest, hosp,) CRISTALIA 75 mcg/h ades, transd, ct, sc, al, x 10 (rest, hosp,) CRISTALIA 0,05 mg/ml 25 amps, 5 ml CRISTALIA 0,05 mg/ml 25 frs, 10 ml CRISTALIA 0,05 mg/ml cx, isopor 50 est, c/ 1 amp, 2 ml CRISTALIA 0,05 mg/ml sol, inj, 50 amps, x 2 ml CRISTALIA 50 mcg, 5 amps, 10 ml JANSSEN - CILAG 50 mcg, 5 amps, 5 ml JANSSEN - CILAG Espinhal 50 mcg, 5 amps, 2 ml JANSSEN - CILAG Ampola de 2 ml com 50mcg/ml de fentanila+2,5mg/ml de droperidol CRISTALIA 2% creme gin, bisn, 40 g+ 7 aplic, ACHE 600 mg, 1 ovulo ACHE Creme derm, bisn, 30 g ACHE 5 mg, pom, derm, bisn, 10 g UNIAO QUIMICA Gts, 30 ml, B-MS 20 mg/2,0 ml sol. ser. 2,0 ml MERCK Cx, 30 cprs, rev, ATIVUS Gts, fr, 30 ml ATIVUS Liq, fr, 100 ml ATIVUS

UNIDADE Pco Unt Base A COMP 0,15 COMP 0,12 COMP 0,12 AMP 1,51 FA 1,34 COMP 0,20 CPR 0,15 COMP 0,13 COMP 0,15 COMP 0,15 GOTA 0,01 COMP 0,13 COMP 0,11 COMP 0,15 AMP 1,18 GOTA 0,16 CAPS 1,03 ML 0,14 COMP 0,67 UNID 33,11 UNID 87,23 AMP 6,16 ML 0,97 AMP 3,40 AMP 3,40 AMP 5,45 AMP 3,98 AMP 1,95 AP 5,79 G 0,52 UND 30,20 GRAMA 0,88 G 0,63 GOTAS 0,01 UND 228,48 x COMP 0,46 GOTA 0,04 ML 0,24

162

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6207 6208 6209 6210 6211 6212 6213 6214 6215 6216 6217 6218 6219 6220 6221 6222 6223 6224 6225 6226 6227 6228 6229 6230 6231 6232 6233 6234 6235 6236 6237 6238 6239 6240 6241 6242 6243 6244

CODIGO BENEFICIO 95098780 FERRINI FOLICO 95570772 FERRIPROX 95570802 FERRONIL 95570861 FERROTRAT 95570853 FERROTRAT 95970240 FETAFLEN 95970258 FETAFLEN 95970266 FEXODANE 95970274 FEXODANE 95970282 FEXODANE 95970290 FIBRASE 95970304 FIBRASE 95840915 FIBRASE COM CLORANFENICOL 95840923 FIBRASE COM CLORANFENICOL 95160221 FIBROGAMMIN P 250 UI 95550070 FILGRASTIM 95899669 FILGRASTINE 95899677 FILGRASTINE 95899685 FILGRASTINE 95899693 FILGRASTINE 95899707 FILGRASTINE 95899715 FILGRASTINE

APRESENTAÇÃO Cx, 30 cprs, rev, 500 mg cx, 100 cprs, 40 mg, cx, 50 drags 500 mg, cx, 20 drags B12 plus vd, 200 ml, Cart, bl, 20 drags, Susp, cart, fr, 20 ml 120 mg, cx, 10 cprs, rev, 180 mg, cx, 10 cprs, rev, 60 mg, cx, 10 caps, Pom, tb, 10 g, Pom, tb, 30 g, Pom, bisn, 10 g, Pom, bisn, 30 g, 62,5 UI/ml po liof, inj, ct fr, vd, inc,+ dil, x 4,0 ml 300 mcg sol, inj, cx, 5 FA 300 mcg 10 FA vd, 1 ml 300 mcg 12 amps, vd, 1 ml 300 mcg 12 FA vd, 1 ml 300 mcg 12 ser, preenchida vd, 1 ml 300 mcg 5 FA vd, 1 ml 300 mcg ser, preenchida vd, 1 ml

Laboratorio ATIVUS CHIESI TEUTO BRAS, MEDLEY MEDLEY OSORIO DE MORAES OSORIO DE MORAES UCI-FARMA UCI-FARMA UCI-FARMA PFIZER PFIZER CRISTALIA CRISTALIA CSL BEHRING BIOSINTETICA BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL

95899723 FILGRASTINE 95899731 FILGRASTINE 95899740 FILGRASTINE 95899758 FILGRASTINE 95899642 FILGRASTINE 95899650 FILGRASTINE 95899766 FILGRASTINE 95899774 FILGRASTINE 95899782 FILGRASTINE 95899790 FILGRASTINE 95970312 FILINAR 95970320 FILINAR 95740082 FILMCEL 95080325 FILOGASTER 95970339 FINASTEC 95970355 FINASTERIDA - GENERICO

300 mcg/ml 10 amps, vd, 1 ml 300 mcg/ml 10 ser, preenchida vd, 1 ml 300 mcg/ml 5 amps, vd, 1 ml 300 mcg/ml 5 ser, preenchida vd, 1 ml 300mcgamp,vd,1ml 300mcgFAvd, 1 ml 600 mcg 12 ser, preenchida vd, 0,5 ml 600 mcg ser, preenchida vd, 0,5 ml 600 mcg/ml 10 ser, preenchida vd, 0,5 ml 600 mcg/ml 5 ser, preenchida vd, 0,5 ml Ad, xpe, 10 mg/ml 120 ml+ cp, med, Ped, xpe, 5 mg/ml fr, 120 ml+ cp, med, 10 ml, 30 drags, 5 mg, cx, 2 bl, x 15 cprs, 1 mg, 2 bl, x 15 cprs,

BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL EUROFARMA EUROFARMA ALLERGAN CLIMAX NEO QUIMICA EMS

UNIDADE Pco Unt Base A COMP 1,20 CPR 9,36 CPR 0,19 CPR 0,53 ML 0,07 CPR 0,30 GOTAS 0,02 CPR 2,20 CPR 3,22 CPR 0,93 G 2,00 G 1,63 G 1,72 G 1,42 AP 277,48 FA 360,83 FA 335,06 AMP 335,06 FA 335,06 UNID 335,06 FA 335,06 UNID 335,06 AMP UNID AMP UNID AMP FA UNID UNID UNID UNID ML ML GOTAS CPR CPR CPR

335,06 335,06 335,06 335,06 335,06 335,06 349,74 349,74 349,74 349,74 0,14 0,10 0,03 0,48 2,57 1,13

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6245 6246 6247 6248 6249 6250 6251 6252 6253 6254 6255 6256 6257 6258 6259 6260 6261 6262 6263 6264 6265 6266 6267 6268 6269 6270 6271 6272 6273 6274 6275 6276 6277 6278 6279 6280 6281 6282

CODIGO BENEFICIO 95018182 FINASTERIDA - GENERICO 95997989 FINASTERIDA - GENERICO 95893547 FINASTERIDA - GENERICO 95018174 FINASTERIDA - GENERICO 95029060 FINASTERIDA - GENERICO 95055622 FINASTERIDA - GENERICO 95055649 FINASTERIDA - GENERICO 95997997 FINASTERIDA - GENERICO 95998004 FINASTERIDA - GENERICO 95029079 FINASTERIDA - GENERICO 95055657 FINASTERIDA - GENERICO 95998012 FINASTERIDA - GENERICO 95970363 FINASTERIDA - GENERICO 95970371 FINASTERIDA - GENERICO 95055630 FINASTERIDA - GENERICO 95893555 FINASTERIDA - GENERICO (*) 95893563 FINASTERIDA - GENERICO (*) 95970410 FINASTERIDA - GENERICO (*) 95018204 FINASTERIDA - GENERICO (*) 95018190 FINASTERIDA - GENERICO (*) 95029087 FINASTERIDA - GENERICO (*) 95055665 FINASTERIDA - GENERICO (*) 95055673 FINASTERIDA - GENERICO (*) 95997962 FINASTERIDA - GENERICO (*) 95133038 FINASTERIDA - GENERICO 95098798 FINASTERIDA - GENERICO 95098801 FINASTERIDA - GENERICO 95098810 FINASTERIDA - GENERICO (*) 95133046 FINASTERIDA - GENERICO (*) 95098828 FINASTIL 95133062 FINASTIL 95332537 FINDOR 95332529 FINDOR 95332545 FINDOR 95020560 FINIGAS 95020578 FINIGAS 95020586 FINIGAS 95123113 FIRAZYR

APRESENTAÇÃO 1 mg, 2 bl, x 15 cprs, rev, 1 mg, 2 bl, x 15 cprs, rev, 1 mg, 4 bl, x 15 cprs, 1 mg, 9 bl, x 10 cprs, rev, 1 mg, bl, 30 cprs, rev, 1 mg, bl, 30 cprs, rev, 1 mg, bl, 30 cprs, rev, 1 mg, bl, 30 cprs, rev, 1 mg, bl, 30 cprs, rev, 1 mg, bl, 60 cprs, rev, 1 mg, bl, 60 cprs, rev, 1 mg, bl, 60 cprs, rev, 1 mg, cprs, rev, ct, 1 bl, al, plas, inc, x 30 1 mg, cprs, rev, ct, 2 bl, al, plas, inc, x 30 5 mg, bl, 10 cprs, rev, 5 mg, 1 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, rev, 5 mg, 9 bl, x 10 cprs, rev, 5 mg, bl, 30 cprs, rev, 5 mg, bl, 30 cprs, rev, 5 mg, bl, 30 cprs, rev, 5 mg, bl, 30 cprs, rev, 5 mg, 30 cprs, 5 mg, bl, 30 cprs, rev, 5 mg, bl, 30 cprs, rev, 5 mg 30 cprs, 5 mg 30cprs, 5 mg, 2 bl, x 15 cprs, rev, 5 mg, 30 cprs, 10 ml, 200 cprs, 50 x 2 ml, Cx, 20 cprs, Gotas 1 fr, 10 ml, Gts, cx, 25 frs, x 10 ml (emb, HOSP,) 10 mg/ml ct, 1 ser, x 3 ml + agulha

Laboratorio GEN - LEGRAND GERMED EMS EMS NOVARTIS MEPHA-RATIOPHARM SANDOZ BIOSINTETICA MEDLEY NOVARTIS SANDOZ MEDLEY MERCK MERCK AUROBINDO PHARMA GERMED GERMED EMS GEN - LEGRAND EMS BIOSINTETICA MEPHA-RATIOPHARM SANDOZ MEDLEY MERCK COSMED TEUTO BRAS, EUROFARMA EUROFARMA SIGMA PHARMA SIGMA PHARMA CLIMAX CLIMAX CLIMAX APSEN APSEN APSEN SHIRE

UNIDADE Pco Unt Base A COMP 1,12 COMP 1,20 COMP 1,07 COMP 0,97 CPR 0,93 COMP 1,18 COMP 1,13 COMP 1,13 COMP 1,13 CPR 0,88 COMP 1,06 COMP 1,04 CPR 1,05 CPR 1,99 COMP 1,49 COMP 1,71 COMP 2,14 CPR 2,29 COMP 2,21 COMP 2,05 CPR 1,68 COMP 2,31 COMP 2,29 COMP 2,30 CPR 1,71 COMP 1,94 COMP 2,35 COMP 1,75 CPR 1,32 COMP 1,54 CPR 1,22 GOTAS 0,02 CPR 0,30 AP 0,63 CPR 0,52 GOTAS 0,05 GOTAS 0,02 UND 4794,92

164

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6283 6284 6285 6286 6287 6288 6289 6290 6291 6292 6293 6294 6295 6296 6297 6298 6299 6300 6301 6302 6303 6304 6305 6306 6307 6308 6309 6310 6311 6312 6313 6314 6315 6316 6317 6318 6319 6320

CODIGO BENEFICIO 95970436 FISIOREN 95072063 FISIOREN 95970444 FISIOREN 95985069 FISIOREN 95041931 FISIORINUS 95020594 FLAGASS 95020608 FLAGASS 95020616 FLAGASS BABY 95377239 FLAGYL 95377271 FLAGYL 95377247 FLAGYL 95018212 FLAGYL 95377263 FLAGYL 95377255 FLAGYL 95510176 FLAGYL NISTATINA CREME 95893571 FLAMADOR 95893580 FLAMADOR 95530231 FLAMADOR 95038116 FLAMADOR (*) 95055681 FLANAREN 95530274 FLANAREN 95530266 FLANAREN 95029095 FLANAX 95029109 FLANAX 95018247 FLANAX (*) 95029117 FLANAX (*) 95893601 FLANCOX 95893598 FLANCOX 95893628 FLANCOX 95893610 FLANCOX 95045163 FLATEX 95020659 FLATEX 95020675 FLATEX 95020624 FLATEX 95020667 FLATEX 95020691 FLATOL 95893636 FLATOL 95072071 FLATOL

APRESENTAÇÃO 50 mg cx, 1 bl, x 20 cprs, rev, Gts, 15 mg/ml fr, 10 ml Gts, 15 mg/ml fr, 20 ml Inj, 25 mg/ml cx, c/5 amp, 3 ml Fr, 30 ml 40 mg, bl, 20 cprs, 75 mg/ml emuls, oral fr, 10 ml, Gts, sol, fr, 15 ml 250 mg, est, 20 cprs, 40 mg/ml ped, susp, oral 1 fr, vd, 100 ml 400 mg, est, 24 cprs, 500 mg, sol, inj, bolsa plast, x 100 ml Ginec, gel bisn, 50 g c/ 10 apl, Ped, susp, oral x 120 ml, Creme vag ct bg al x 50 g+ 10 aplic, 50 mg, 24 caps, Gel bisn, 30 g Inj, 2 amps, 2 ml, 50 mg, 24 caps, 50 mg, 15 bl, x 20 cprs, rev, (hosp,) 50 mg, cx, 20 cprs, rev, Inj, 75 mg, 5 amps,/3 ml, 275 mg, 20 cprs, rev, 550 mg, 10 cprs, rev, 25 mg, susp,fr,100ml, 25 mg, susp,fr,100ml, 300 mg, cx, 30 cprs, rev, 300mg,cx,14cprs,rev, 400 mg, cx, 20 cprs, rev, 400mg,cx,10cprs,rev, 125 mg, bl, 10 caps, gel, mole 150 mg, 1 tb,12 cprs, 150 mg/ml gts,fr, 10 ml 40 mg, 2 bl, x10 cprs, 75 mg/ml gts, ped,fr, 15 ml Cx, 20 cprs Gts, fr, 10 ml Gts, fr, 15 ml

Laboratorio DUCTO DUCTO DUCTO DUCTO CAZI ACHE ACHE ACHE SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS LEGRAND LEGRAND SIGMA PHARMA LEGRAND TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BAYER BAYER ROCHE BAYER APSEN APSEN APSEN APSEN FARMASA FARMASA FARMASA FARMASA FARMASA LEGRAND LEGRAND LEGRAND

UNIDADE Pco Unt Base A CPR 0,26 GOTA 0,03 GOTAS 0,02 AMP 1,78 GOTA 0,01 CPR 0,59 GOTAS 0,06 GOTAS 0,04 CPR 0,56 ML 0,11 CPR 0,64 BOLSA 13,19 G 0,52 ML 0,09 G 0,66 CAPS 0,76 G 0,50 AP 1,74 CP 0,76 COMP 0,17 CPR 0,23 AP 1,68 CPR 1,03 CPR 1,97 ML 0,11 ML 0,14 COMP 0,96 COMP 0,96 COMP 1,28 COMP 1,28 CAPS 1,08 CPR 1,36 GOTAS 0,07 CPR 0,54 GOTAS 0,04 CPR 0,44 GOTA 6,53 GOTA 0,03

165

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6321 6322 6323 6324 6325 6326 6327 6328 6329 6330 6331 6332 6333 6334 6335 6336 6337 6338 6339 6340 6341 6342 6343 6344 6345 6346 6347 6348 6349 6350 6351 6352 6353 6354 6355 6356 6357 6358

CODIGO BENEFICIO 95970525 FLATOL MAX 95970533 FLATOL MAX 95083936 FLAVONID 95970541 FLAVONID 95098836 FLAXIN 95560165 FLAXIN 95970550 FLAZAL 95970568 FLAZAL 95970576 FLAZ-CORT 95998055 FLEXAMINA 95332570 FLEXDOR 95332553 FLEXDOR 95260307 FLEXTOSS 95210318 FLIXONASE 95210342 FLIXOTIDE 95210369 FLIXOTIDE 95210350 FLIXOTIDE 95098844 FLODIN DUO 95029125 FLODIN DUO 95098852 FLODIN DUO 95018263 FLODIN DUO 95661972 FLOGAN 95661956 FLOGAN 95661964 FLOGAN 95662014 FLOGAN AI 95662006 FLOGAN AI 95662022 FLOGENE 95662030 FLOGENE 95662057 FLOGILID 95662065 FLOGILID 95018280 FLOGIRAX 95018271 FLOGIRAX 95098860 FLOGORAL 95098879 FLOGORAL 95098887 FLOGORAL 95098895 FLOGORAL 95098909 FLOGORAL 95098917 FLOGORAL

APRESENTAÇÃO 125 mg, 1 bl, x 10 caps, gel, mole 125 mg, 20 bl, x 4 caps, gel, mole 450 mg,+ 50 mg, bl, 500 cprs, rev, (hosp,) 500 mg cx, 3 bl, x 10 cprs, rev, 5 mg, bl, al, plas, inc, x 30 cprs, rev, 5 mg, cx, 30 cprs, 30 mg,cx,1bl,x10cprs, 6 mg,cx,1bl,x20cprs, 6 mg, cx, 20 cprs, Cx, 50 amps, 3 ml Cx, 8 cprs, Gts, fr, 10 ml, Xpe, ad, fr, 100 ml Nasal aquoso fr, 60 doses 250 mcg, spray 60 ds, Diskus 250 mcg, 60 doses Diskus 50 mg, 60 doses 150 mg, bl 4 cprs, desint, lenta 150 mg, cx, 10 cprs, 150 mg, cx, 10 cprs, desint, lenta 150 mg, cx, 20 cprs, 25 mg/ml sol, inj, cx, 3 amps, x 3 ml, 50 mg, cx,20 cprs, Gts, fr,20 ml 100 mg, 10 cprs, sol, 50 mg, 20 cprs, sol, Bl,10 caps, gel, Gts, fr, 10 mg/20 ml 12 cprs, Gts, 15 ml 200 mg, cx, 2 bl, x 10 cprs, 400 mg, cx, 2 bl, x 10 cprs, 12 past str, (sabor menta) 12 past, str, (sabor cereja) 12 past, str, (sabor laranja) 12 past, str, (sabor limao) 150 ml col, fr, vd, + cp, med, (sabor laranja) 150 ml col, fr, vd, + cp, med, (tradicional)

Laboratorio LEGRAND LEGRAND NEO QUIMICA NEO QUIMICA MERCK MERCK NEO QUIMICA NEO QUIMICA CAZI CLIMAX BUNKER BUNKER TEUTO BRAS, GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE ZODIAC ZODIAC ZODIAC ZODIAC MERCK MERCK MERCK MERCK MERCK ACHE ACHE LUPER LUPER CELLOFARM CELLOFARM ACHE ACHE ACHE ACHE ACHE ACHE

UNIDADE Pco Unt Base A CPR 1,22 CPR 0,84 COMP 0,66 CPR 1,47 COMP 1,33 CPR 1,18 CPR 7,97 CPR 1,75 CPR 1,66 AMP 0,71 CPR 0,66 GOTAS 0,04 ML 0,10 DOSE 0,54 DOSE 1,14 DOSE 1,08 DOSE 0,80 COMP 2,10 CPR 1,84 COMP 2,32 COMP 1,56 AP 1,11 CPR 0,49 GOTAS 0,02 CPR 1,06 CPR 0,53 CPR 2,68 GOTAS 0,06 CPR 1,28 GOTAS 0,05 COMP 6,31 COMP 9,70 UNID 0,80 UNID 0,80 UNID 0,80 UNID 0,80 ML 0,08 ML 0,08

166

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6359 6360 6361 6362 6363 6364 6365 6366 6367 6368 6369 6370 6371 6372 6373 6374 6375 6376 6377 6378 6379 6380 6381 6382 6383 6384 6385 6386 6387 6388 6389 6390 6391 6392 6393 6394 6395 6396

CODIGO BENEFICIO 95098925 FLOGORAL 95098933 FLOGORAL 95098941 FLOGORAL 95098950 FLOGORAL 95098968 FLOGORAL 95098976 FLOGORAL 95098984 FLOGORAL 95098992 FLOGORAL 95099000 FLOGORAL 95099018 FLOGORAL 95099026 FLOGORAL 95662111 FLOGO-ROSA 95662120 FLOGO-ROSA 95970606 FLOMICIN 95970614 FLOMICIN 95099034 FLORALYTE 95099042 FLORALYTE 95055720 FLORALYTE 95055690 FLORALYTE 95055703 FLORALYTE 95055711 FLORALYTE 95055738 FLORALYTE 95099050 FLORALYTE 95790586 FLORATE 95040102 FLORATIL 95040129 FLORATIL 95040110 FLORATIL 95040137 FLORATIL 95029133 FLORAX 95040153 FLORAX 95099069 FLORAX 95038140 FLORAX 95099077 FLORAX 95029141 FLORAX 95040145 FLORAX 95038159 FLORAX 95099085 FLORAX 95123121 FLORAX (Restrito Hosp,)

APRESENTAÇÃO Laboratorio 250 ml col, fr, pet, + cp, med, (sabor cereja) ACHE 250 ml col, fr, pet, + cp, med, (sabor laranja) ACHE 250 ml col, fr, pet, + cp, med, (sabor limao) ACHE 250 ml col, fr, pet, + cp, med, (sabor menta) ACHE 30 ml col, fr, neb, (sabor cereja) ACHE 30 ml col, fr, neb, (sabor menta) ACHE Creme dental bisn, 70 g ACHE Laranja 25 str, x 4 past, ACHE Laranja fracao de venda ACHE Menta 25 str, x 4 past, ACHE Menta fracao de venda ACHE Liq, fr, 100 ml ACHE Po cx, 10 envs, x 9,4 g, ACHE 100 mg, vd, 12 caps, NEO QUIMICA 200 mg, po oral 4 sachet 1 g NEO QUIMICA 45 meq/l (2,05 + 2,16 + 0,98 + 22,75) mg/ml sol, oral fr, plast, MERCK trans, x 500 ml (maca) 45 meq/l (2,05 +2,16 + 0,98 + 22,75) mg/ml sol, oral fr, plast, MERCK trans, x 500 ml (coco) 45 meq/l (2,05+ 2,16+ 0,98+ 22,75) mg/ml sol, oral fr, plast,MERCK trans, x 500 ml (abacaxi) 45 meq/l (2,05+ 2,16+ 0,98+ 22,75) mg/ml sol, oral, fr, plast,MERCK trans, x 500 ml (guarana) 45 meq/l (2,05+ 2,16+ 0,98+ 22,75) mg/ml sol, oral, fr, plast,MERCK trans, x 500 ml (laranja) 45 meq/l (2,05+ 2,16+ 0,98+ 22,75)mg/ml sol, oral, fr, plast,MERCK trans,x500 ml (tutti frutti) 90 meq/l (4,68+ 2,16+ 0,98+ 20,00) mg/ml sol, oral fr, plast,MERCK trans, x 500 ml (abacaxi) 90 meq/l(4,68+2,16+0,98+20,00)mg/ml sol, oral fr, plast, trans, MERCK x 500 ml (sabor natural) Susp, oft, 5 ml, ALCON 100 mg, 12 caps, MERCK 200 mg, 6 caps, MERCK Ped, 4 envs,200 mg, MERCK Ped, 6 envs, 200 mg, MERCK Ad, cx, 100 flac, 5 ml (hosp,) HEBRON Ad, cx, 5 flac, HEBRON Ad, SM cx, 3 flac, 5 ml HEBRON Ad,SMcx,5flac,5ml HEBRON Inf, SM cx, 3 flac 5 ml HEBRON Ped, cx, 100 flac, 5 ml (hosp,) HEBRON Ped, cx, 5 flac, HEBRON Ped, SMcx, 5flac, 5 ml HEBRON Ped, susp, oral cx, 5 flac, de 5 ml HEBRON Ad, cx, 100 flac, 5 ml (hosp,) HEBRON

UNIDADE Pco Unt Base A ML 0,06 ML 0,06 ML 0,06 ML 0,06 ML 0,68 ML 0,68 GRAMA 0,19 UNID 0,78 UNID 3,11 UNID 0,78 UNID 2,86 ML 0,17 UND 2,37 CPR 1,76 ENV 3,80 ML 0,02 ML 0,02 ML 0,02 ML 0,02 ML 0,02 ML 0,02 ML 0,02 ML 0,02 GOTAS 0,18 CPR 1,92 CPR 3,97 ENV 4,45 ENV 3,65 FA 2,98 UND 4,58 UND 4,10 UND 4,58 UND 2,75 FA 2,29 UND 3,45 UND 3,54 UND 3,54 UND 2,85

167

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6397 6398 6399 6400 6401 6402 6403 6404 6405 6406 6407 6408 6409 6410 6411 6412 6413 6414 6415 6416 6417 6418 6419 6420 6421 6422 6423 6424 6425 6426 6427 6428 6429 6430 6431 6432 6433 6434

CODIGO BENEFICIO 95123130 FLORAX (Restrito Hosp,) 95018298 FLORENT 95018301 FLORENT 95450750 FLORINEFE 0,1 mg 95970649 FLORINY 95970657 FLORINY 95970665 FLORLAX 95123148 FLOSEAL (GELATINA+TROMBINA) (Restrito Hosp,) 95662138 FLOTAC 95377344 FLOX 95377352 FLOXACIN 95377379 FLOXATRAT 95123156 FLOXEN (Restrito Hosp,) 95662162 FLOXICAM 95099093 FLOXICAM 95099107 FLOXICAM 95987959 FLOXIMED 95970681 FLOXIN 95970690 FLOXINA 95377433 FLOXINOL 95377441 FLOXINOL 95055746 FLOXOCIP 95055754 FLOXOCIP 95055762 FLUCAZOL 95055770 FLUCAZOL 95893644 FLUCCIL 95893652 FLUCCIL 95099115 FLUCCIL 95240055 FLUCISTEIN 95970703 FLUCISTEIN 95240063 FLUCISTEIN 95240047 FLUCISTEIN 95893660 FLUCOCIN 95390650 FLUCOCIN 95055789 FLUCODAN 95018310 FLUCOLTRIX 95018328 FLUCOLTRIX 95390677 FLUCONAL

APRESENTAÇÃO Laboratorio Ped, cx, 100 flac, 5 ml (hosp,) HEBRON 100 mg, 12 caps, CIFARMA 200 mg, 4 saches 1 g de po CIFARMA Fr, 100 cprs, B-MS Cx, 20 cprs, rev, ATIVUS Fr, 100 ml ATIVUS Geleia oral fr, 100 g CAZI Kit, c/po liof,ct, 1 FA vd,inc,+1 FA dil, x 5 ml,+1 ser, preench,+ BAXTER conj, rec, e aplic, 70 mg 20 caps, NOVARTIS 400 mg, cx, 14 cprs, HEXAL 400 mg, cx, fr, 14 cprs, MERCK SHARP & DOHME 400 mg, cx, 1 bl, x 14 cprs, LUPER 500 mg, bl, 50 cprs, rev, (hosp,) ASPEN PHARMA 10 mg cx, 1 bl, x 15 caps, NEO QUIMICA 20 mg, cx, 1 bl, x 15 caps, NEO QUIMICA Gts, fr, 15 ml NEO QUIMICA 400 mg, cx, 14 cprs, rev, MEDQUIMICA 400 mg, 14 cprs, BRASTERAPICA 200 mg, cx, 10 cprs, CAZI 400 mg, vd, 14 cprs, MILLET-ROUX 400 mg, vd, 6 cprs, MILLET-ROUX 500 mg, bl, 14 cprs, rev, MERCK 500 mg, bl, 6 cprs, rev, MERCK 100 mg,1bl,08caps, CRISTALIA 50 mg, 1 bl, 08 caps, CRISTALIA 10 mg, bl, 20 cprs, DUCTO 4 mg/ml fr, 10 ml DUCTO Inj, 10 mg, cx, 100 amps, x 2 ml DUCTO 100 mg 15 envs, UNIAO QUIMICA 20 mg/ml xpe, 100 ml UNIAO QUIMICA 200 mg 15 envs, UNIAO QUIMICA Sol, inj, 10% c/ 5 amps, x 3 ml, UNIAO QUIMICA 150 mg, bl, 2 caps, EMS 150 mg, cx, 1 cap, EMS 150 mg, cx, 1 caps, ARROW 150 mg, cx, 1 cap, GALLIA 150 mg, cx, 2 caps, GALLIA 150 mg, 1 caps, LIBBS

UNIDADE Pco Unt Base A UND 2,19 CAPS 1,89 ENV 3,86 CPR 1,74 CPR 0,73 ML 0,16 G 0,16 FA 644,99 CPR 1,52 CPR 1,54 CPR 1,84 CPR 1,60 COMP 2,09 CPR 0,37 COMP 0,48 GOTAS 0,01 COMP 1,62 CPR 1,14 CPR 7,83 CPR 1,86 CPR 1,86 CPR 2,31 CPR 2,78 CAPS 12,71 CAPS 9,63 COMP 0,20 GOTA 3,73 FA 0,75 ENV 0,94 ML 0,15 ENV 1,31 AP 3,17 CAPS 14,93 CPR 17,00 CAPS 21,93 CAPS 17,41 CAPS 12,23 CPR 20,81

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6435 6436 6437 6438 6439 6440 6441 6442 6443 6444 6445 6446 6447 6448 6449 6450 6451 6452 6453 6454 6455 6456 6457 6458 6459 6460 6461 6462 6463 6464 6465 6466 6467 6468 6469 6470 6471 6472

CODIGO BENEFICIO 95099123 FLUCONAZOL - GENERICO 95390740 FLUCONAZOL - GENERICO 95390731 FLUCONAZOL - GENERICO 95970720 FLUCONAZOL - GENERICO 95018344 FLUCONAZOL - GENERICO 95893679 FLUCONAZOL - GENERICO 95893687 FLUCONAZOL - GENERICO 95893695 FLUCONAZOL - GENERICO 95055800 FLUCONAZOL - GENERICO 95055819 FLUCONAZOL - GENERICO 95082670 FLUCONAZOL - GENERICO 95082689 FLUCONAZOL - GENERICO 95082697 FLUCONAZOL - GENERICO 95083952 FLUCONAZOL - GENERICO 95099131 FLUCONAZOL - GENERICO 95038167 FLUCONAZOL - GENERICO 95038175 FLUCONAZOL - GENERICO 95390758 FLUCONAZOL - GENERICO 95390766 FLUCONAZOL - GENERICO 95029150 FLUCONAZOL - GENERICO 95045570 FLUCONAZOL - GENERICO 95985115 FLUCONAZOL - GENERICO 95018336 FLUCONAZOL - GENERICO 95998098 FLUCONAZOL - GENERICO 95123164 FLUCONAZOL - GENERICO (Restrito Hosp,) 95123172 FLUCONAZOL - GENERICO (Restrito Hosp,) 95123180 FLUCONAZOL - GENERICO (Restrito Hosp,) 95123199 FLUCONAZOL - GENERICO (Restrito Hosp,) 95123202 FLUCONAZOL - GENERICO (Restrito Hosp,) 95123210 FLUCONAZOL - GENERICO (Restrito Hosp,) 95893709 FLUCONAZOLE - GENERICO 95893717 FLUCONAZOLE - GENERICO 95987983 FLUCONAZON 95987991 FLUCONAZON 95390774 FLUCONEO 95123229 FLUCONEO (Restrito Hosp,) 95072144 FLUCOTON 95072136 FLUCOTON

APRESENTAÇÃO Laboratorio 100 mg, cx, 8 caps, CRISTALIA 150 mg cx, 1 cpr, TEUTO BRAS, 150 mg cx, 2 cprs, TEUTO BRAS, 150 mg, 1 cap, EMS 150 mg, 1 x 2 caps, ZYDUS 150 mg, 2 caps, EMS 150 mg, 2 caps, GERMED 150 mg, bl, 1 cap, GERMED 150 mg, bl, 1 cap, gel dura SANDOZ 150 mg, bl, 2 caps, gel dura SANDOZ 150 mg, cap, gel, dura ct, bl, al, plas, trans, x 1 PRATI DONADUZZI 150 mg, cap, gel, dura ct, bl, al, plas, trans, x 2 PRATI DONADUZZI 150 mg, cap, gel, dura ct, bl, al, plas, trans, x 20 PRATI DONADUZZI 150 mg, cap, gel, dura ct, bl, al, plas, trans, x 200 (emb, hosp,) PRATI DONADUZZI 150 mg, cap, gel, dura ct, bl, al, plas, trans, x 90 (frac,) PRATI DONADUZZI 150 mg, cx, bl, 1 cap, NEO QUIMICA 150 mg, cx, bl, 2 caps, NEO QUIMICA 150 mg, cx, c/1 MEDLEY 150 mg, cx, c/2 MEDLEY 150mg,5 bl,x6 caps, EMS 150mg,cx,100caps, TEUTO BRAS, 2 mg/ml 6 bolsas plast, x 100 ml EUROFARMA 2 mg/ml bolsa poliet, 100 ml ISOFARMA 2mg/mlbolsa 100ml HALEX ISTAR 150 mg, 500 caps, gel, dura (hosp,) TEUTO BRAS, 150 mg, cap, gel dura ct, bl, al, plas, trans, x 100 (hosp,) PRATI DONADUZZI 2 mg/ml 6 bolsas 100 ml SANOBIOL 2 mg/ml 6 bolsas plast, x 100 ml EUROFARMA 2 mg/ml bolsa 100 ml HALEX ISTAR 2 mg/ml bolsa poliet, 100 ml ISOFARMA 150 mg, bl, 1 cap, RANBAXY 150 mg, bl, 2 caps, RANBAXY 150 mg, cx, 1 cap, MEDQUIMICA 150 mg, cx, 2 caps, MEDQUIMICA 150 mg cx, 1 bl, x 1 cap, NEO QUIMICA 150 mg, bl, 500 caps, gel, dura (hosp,) NEO QUIMICA 100 mg, 8 caps, ROYTON 150 mg, 1 cap, ROYTON

UNIDADE Pco Unt Base A CAPS 15,65 CPR 7,49 CPR 7,49 CPR 20,75 CAPS 12,21 CAPS 20,44 CAPS 19,21 CAPS 19,55 CAPS 20,52 CAPS 20,23 CAPS 20,82 CAPS 20,28 CAPS 3,19 CAPS 6,16 CAPS 2,62 CP 20,69 CP 20,42 CPR 21,11 CPR 20,46 CPR 19,89 CAPS 18,66 UND 103,41 BOLSA 113,93 UNID 111,75 CAPS 16,19 CAPS 7,04 UND 90,57 UND 103,41 UND 111,75 UND 113,93 CAPS 16,10 CAPS 16,72 CAPS 11,36 CAPS 8,30 CPR 18,63 CAPS 13,60 CAPS 1,02 CAPS 6,32

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6473 6474 6475 6476 6477 6478 6479 6480 6481 6482 6483 6484 6485 6486 6487 6488 6489 6491 6492 6493 6494 6495 6496 6497 6498 6499 6500 6501 6502 6503 6504 6505 6506 6507 6508 6509 6510 6511

CODIGO BENEFICIO 95072128 FLUCOTON 95970738 FLUCOZEN 95970746 FLUCOZEN 95970754 FLUCOZIX 95123237 FLUDALIBBS (Restrito Hosp,) 95125868 FLUDARA 95125876 FLUDARA 95998101 FLUDARA 95099166 FLUDILAT 95099174 FLUDILAT 95055827 FLUFENAN 95055835 FLUFENAN DEPOT 95250859 FLUIBRON 95250832 FLUIBRON 95250840 FLUIBRON 95018379 FLUICIS 95018387 FLUICIS 95250905 FLUIMUCIL 95250930 FLUIMUCIL 95038191 FLUIMUCIL 95250948 FLUIMUCIL 95250964 FLUIMUCIL 95250956 FLUIMUCIL 95970762 FLUIMUCIL 95970770 FLUIMUCIL 95970789 FLUIMUCIL 95200827 FLUIR 95200851 FLUIR 95055843 FLUIR 95970827 FLUITEINA 95099182 FLUITEINA 95970835 FLUITEINA 95055851 FLUITEINA 95998110 FLUMAZEN 95018395 FLUMAZENIL - GENERICO 95998128 FLUMAZENIL - GENERICO 95123245 FLUMAZENIL - GENERICO (Restrito Hosp,) 95300228 FLUMAZIL

APRESENTAÇÃO 150 mg, 2 caps, 100 mg, cx, 8 caps, 150 mg, cx, 1 cap, 150 mg, 1 caps, 50 mg, 5 FA 50 mg, po liof, 5 FA Oral 1 bl, x 15 cprs, 10 mg, Oral 3 bl, x 5 cprs, 10 mg, Cx, 24 cprs, Retard, cx, 24 cprs, 5 mg, 20 bl, 10 cps, 25 mg/ml50amps,1ml Gts, fr, 50 ml, Xpe, ad, fr, 100 ml, Xpe, ped, fr, 100 ml, 200 mg, po 16 saches eferv, 600 mg, po 16 saches eferv, 10% sol, inj, ct, 5 amp, vd, 3 ml 100 mg, gran, 16 env, x 5 g, 200 mg, 6 sachets 200 mg, gran, 16 envs, x 5 g, 600 mg, comp, eferv, 2 st, x 8 D 600 mg, gran, 16 envs, x 5 g, Sol, nasal fr, 20 ml gotas Xpe, ad, fr, 120 ml Xpe, ped, fr, 120 ml 12 mcg 3 bl, x 10 caps,+ inal, 12 mcg 6 bl, x 10 caps, 12 mcg, po 6 bl, x 10 caps,+ inal, 200 mg, cx, 16 envs, x 5 g Xpe, ad, 40 mg/ml fr, 120 ml Xpe, fr, 100 ml Xpe, inf, 20 mg/ml fr, 120 ml 0,5 mg/ml 5 amps, x 5 ml 0,1 mg/ml sol, inj, 5 amps, Cx, 5 amps, Cx, 5 amps, 0,1 mg/ml 5 amps, 5 ml,

Laboratorio ROYTON CAZI CAZI LUPER LIBBS BAYER BAYER SCHERING SCHERING-PLOUGH SCHERING-PLOUGH CRISTALIA CRISTALIA CHIESI CHIESI CHIESI GLENMARK GLENMARK ZAMBON ZAMBON ZAMBON ZAMBON ZAMBON ZAMBON ZAMBON ZAMBON ZAMBON MANTECORP MANTECORP MANTECORP EMS EMS EMS EMS UNIAO QUIMICA UNIAO QUIMICA EUROFARMA EUROFARMA CRISTALIA

UNIDADE Pco Unt Base A CAPS 6,21 CPR 19,74 CPR 25,25 CPR 15,89 FA 487,87 x F,A, 607,34 CPR 117,25 COMP 118,23 COMP 0,76 COMP 1,49 COMP 33,68 AMP 3,00 GOTAS 0,01 ML 0,21 ML 0,13 ENV 1,00 ENV 1,89 AP 2,94 ENV 1,37 UND 1,24 ENV 1,52 CPR 4,00 ENV 3,38 GOTAS 0,04 ML 0,27 ML 0,21 CPR 1,29 CPR 0,69 CAPS 7,72 ENV 1,11 ML 0,17 ML 0,14 ML 0,16 AMP 126,38 AMP 92,48 AMP 78,51 AMP 78,51 AP 132,43

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6512 6513 6514 6515 6516 6517 6518 6519 6520 6521 6522 6523 6524 6525 6526 6527 6528 6529 6530 6531 6532 6533 6534 6535 6536 6537 6538 6539 6540 6541 6542 6543 6544 6545 6546 6547 6548 6549

CODIGO BENEFICIO APRESENTAÇÃO 95700099 FLUMEX 0,10% 10 ml 95700102 FLUMEX 0,25% 5 ml 95700110 FLUMEX (*) N 10 ml, 95320741 FLUNARIN Cx, 60 caps, 95970843 FLUNARIN Fr, 30 ml gts, 95075011 FLUNEXIL 0,5 mg/5 ml cx, 10 amps, 95074996 FLUNEXIL 0,5 mg/5 ml cx, 25 amps, 95075003 FLUNEXIL 0,5 mg/5 ml cx, 5 amps, 95099190 FLUOC, ACET, + HIDROQUINONA + TRETINOINA - GENERICO Creme derm, bisn, 15 g 95099204 FLUOC, ACET, + HIDROQUINONA + TRETINOINA - GENERICO Creme derm, bisn, 30 g 95072152 FLUOC, ACET, + SULF, NEOM, + POL,B + LID, HCL - GENERICO Fr, 10 ml 95740090 FLUORESCEINA Fr, 3 ml, 95075020 FLUORURACILA - GENERICO 25 mg/ml sol, inj, 50 fr, vd, x 10 ml 95123253 FLUORURACILA - GENERICO (Restrito Hosp,) 25 mg/ml sol. inj. ct. 20 fr. vd. inc. x 10 ml 95123261 FLUORURACILA - GENERICO (Restrito Hosp,) 50 mg/ml sol, inj, FA vd, inc, x 10 ml 95123270 FLUORURACILA - GENERICO (Restrito Hosp,) 50 mg/ml sol, inj, FA vd, inc, x 20 ml 95123288 FLUORURACILA - GENERICO (Restrito Hosp,) 50 mg/ml sol, inj, FA vd, inc, x 5 ml 95690093 FLUO-VASO Fr, 5 ml, 95018417 FLUOX Cx, 14 cprs, 95018409 FLUOX Cx, 28 cprs, 95099212 FLUOX Cx, 28 cprs, 95123296 FLUOXETIN (Restrito Hosp,) 20 mg, 50 bl, x 10 caps, 95123300 FLUSAN (Restrito Hosp,) 50 mg/ml sol, inj, 20 FA 20 ml 95123318 FLUSAN (Restrito Hosp,) 50 mg/ml sol, inj, 50 FA 10 ml 95998152 FLUTAMIDA - GENERICO 250 mg, fr, 20 cprs, rev, 95038205 FLUTEC 150 mg, cx, 1 cap, 95038213 FLUTEC 150 mg, cx, 2 caps, 95018425 FLUTICAN 50 mcg/dose sus, nas, ct, fr, plas, opc x 10 ml 95970851 FLUTICAPS 250 mcg po inal, cap, gel dura fr, plast, x 60 c/inal, 95970860 FLUTICAPS 250 mcg po inal, cap, gel dura fr, plast, x 60 refil 95970878 FLUTICAPS 50 mcg po inal, cap, gel dura fr, plast, x 60 c/inal, 95970886 FLUTICAPS 50 mcg po inal, cap, gel dura fr, plast, x 60 refil 95029168 FLUTINOL Colirio fr, cgt 5 ml susp, esteril 95300236 FLUVERT 10 mg, cx, 30 cprs, 95128662 FLUVIRAL 25 bl, x 6 cprs, 95970894 FLUVIRAL Fracao - 1 bl, x 6 cprs, 95970916 FLUXENE 10 mg, 28 caps, 95290770 FLUXENE 20 mg, 4 bl, x 7 caps,

Laboratorio ALLERGAN ALLERGAN ALLERGAN ACHE ACHE BIOCHIMICO BIOCHIMICO BIOCHIMICO MEDLEY MEDLEY GEN - LEGRAND ALLERGAN EUROFARMA BERGAMO ACCORD ACCORD ACCORD ALLERGAN SOMA SOMA THERASKIN CRISTALIA EUROFARMA EUROFARMA APOTEX SANDOZ SANDOZ GLENMARK BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA LATINOFARMA MEDLEY COSMED COSMED EUROFARMA EUROFARMA

UNIDADE Pco Unt Base A GOTAS 0,06 GOTAS 0,11 GOTAS 0,06 CPR 0,26 GOTAS 0,01 AMP 127,71 AMP 127,71 AMP 127,71 GRAMA 4,48 GRAMA 2,81 GOTA 0,03 AMP 6,56 AMP 2,20 FA 2,16 FA 3,21 FA 6,44 FA 1,61 GOTAS 0,05 COMP 0,69 COMP 0,64 COMP 0,64 COMP 1,92 FA 16,14 FA 8,07 COMP 2,61 CP 17,60 CP 12,72 DOSE 0,15 CPR 0,97 CPR 0,78 CPR 0,72 CPR 0,58 GOTA 0,17 CPR 0,16 COMP 0,76 CPR 0,76 CPR 0,84 CPR 1,44

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6550 6551 6552 6553 6554 6555 6556 6557 6558 6559 6560 6561 6562 6563 6564 6565 6566 6567 6568 6569 6570 6571 6572 6573 6574 6575 6576 6577 6578 6579 6580 6581 6582 6583 6584 6585 6586 6587

CODIGO BENEFICIO 95320750 FLUXON 95320768 FLUXON 95570896 FOLACIN 95570900 FOLACIN 95570888 FOLACIN 95840966 FOLDAN 95840958 FOLDAN 95570918 FOLICORIN 95570942 FOLIFER 95570934 FOLIFER 95099220 FOLIFOLIN 95570950 FOLIN (ACIDO FOLICO) 95041940 FOLINATO DE CALCIO - GENERICO 95123334 FOLINATO DE CALCIO - GENERICO (Restrito Hosp,) 95038230 FOLINIUM 95611665 FOLSANG B12 INJ, 95970940 FONERGIN 95970959 FONERGIN 95970967 FONTO-VIT E 95055878 FOR GAS 95072160 FOR GAS 95970975 FORADIL 95970983 FORADIL 95200860 FORADIL 95018433 FORANE 95200894 FORASEQ 95200908 FORASEQ 95055886 FORMARE 95038248 FORMET 95038256 FORMET 95123342 FORMET (Restrito Hosp,) 95123350 FORMET (Restrito Hosp,) 95970991 FORMOCAPS 95971009 FORMOCAPS 95971017 FORT E 95971025 FORT E 95377530 FORTAZ 95377522 FORTAZ

APRESENTAÇÃO 25 mg cx, 3 bl, x 10cprs, 75 mg cx, 3 bl, x 10 cprs, 5 mg, 20 cprs, rev, Gts, 30 ml Liq, fr, 100 ml Locao cremosa 50 ml, Pom, bisn, 45 g, 15 mg, cx, 10 cprs, Cx, 30 cprs, rev, Liq, fr, 100 ml, 5 mg, 2 bl, x 15 cprs, 5 mg, fr, 30 cprs, 50 mg, 50 FA (hosp,) 10 mg/ml sol, inj, IV/IM 10 FA vd, inc, x 30 ml 15 mg, fr, 10 cprs, Cx, 10 amps, 2 ml, Cx , 12 past, Spray fr, 15 ml 1000UI 25 caps, 40 mg, 20 cprs, 75 mg/ml sol, oral fr, plast, opc, got, x 10 ml 12 mcg 30 cs s/inal, 12 mcg 60 cs s/inal, DP 12 mcg, 30 cs, Fr, 100 ml 12/200 mcg 60+ 60 cs, 12/400 mcg 60+ 60 cs, 12 mcg cart, 60 caps,+ inal, 500 mg cx, 30 cprs, rev, 850 mg, 30 cprs, rev, 500 mg, cx, 200 cprs, rev, 850 mg cx, 20 x 10 cprs, 12 mcg caps, gel, dura po inal, fr, plast, x 30 12 mcg caps, gel, dura po inal, fr, plast, x 30 c/inal, 100 mg, cx, 100 caps, 100 mg, cx, 30 caps, 1 g, cx, FA 2 g, cx, FA

Laboratorio NEO QUIMICA NEO QUIMICA ATIVUS ATIVUS ATIVUS UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA ATIVUS ATIVUS EMS GEYER EUROFARMA EUROFARMA CAZI IQB FARMASA FARMASA FONTOVIT UNIAO QUIMICA UNIAO QUIMICA NOVARTIS NOVARTIS NOVARTIS ABBOTT NOVARTIS NOVARTIS LIBBS CELLOFARM CELLOFARM ASPEN PHARMA ASPEN PHARMA BIOSINTETICA BIOSINTETICA CAZI CAZI GLAXOSMITHKLINE GLAXOSMITHKLINE

UNIDADE Pco Unt Base A CPR 0,20 CPR 0,30 CPR 0,51 GOTAS 0,01 ML 0,10 ML 0,24 G 0,41 CPR 6,45 CPR 1,16 ML 0,23 COMP 0,27 CPR 0,57 FA 39,63 FA 139,32 CP 6,68 AP 4,84 CPR 0,39 DOSE 0,01 CPR 1,11 COMP 0,63 GOTA 0,04 CPR 1,32 CPR 1,32 CPR 1,56 ML 5,11 CPR 1,46 CPR 1,46 CAPS 0,79 CP 0,37 CP 0,31 COMP 0,25 COMP 0,30 CPR 1,00 CPR 1,23 CPR 0,63 CPR 1,01 FA 33,30 FA 70,10

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6588 6589 6590 6591 6592 6593 6594 6595 6596 6597 6598 6599 6600 6601 6602 6603 6604 6605 6606 6607 6608 6609 6610 6611 6612 6613 6614 6615 6616 6617 6618 6619 6620 6621 6622 6623 6624 6625

CODIGO BENEFICIO APRESENTAÇÃO 95971033 FORTPLEX Cx, 60 drags, 95480471 FOSAMAX 70 mg, 4 cprs, 95893725 FOSFATO DE CLINDAMICINA - GENERICO 10 mg/g gel bisn, 45 g 95893733 FOSFATO DE CLINDAMICINA - GENERICO 10 mg/g gel bisn, 45 g 95893741 FOSFATO DE CLINDAMICINA - GENERICO 10 mg/g gel bisn, 45 g 95046925 FOSFATO DE CLINDAMICINA - GENERICO 150 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml (emb, hosp,) 95066284 FOSFATO DE CLINDAMICINA - GENERICO 150 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml (emb, hosp,) 95046933 FOSFATO DE CLINDAMICINA - GENERICO 150 mg/ml sol, inj, cx, 50 amps, vd, x 4 ml (emb, hosp,) 95066292 FOSFATO DE CLINDAMICINA - GENERICO 150 mg/ml sol, inj, cx, 50 amps, vd, x 4 ml (emb, hosp,) 95043659 FOSFATO DE CLINDAMICINA - GENERICO 20 mg/g crem, vag, ct, bg, al, 20 g+ 3 aplic, 95893750 FOSFATO DE CLINDAMICINA - GENERICO 20 mg/g creme vag, 20 g+ 3 aplic, 95893768 FOSFATO DE CLINDAMICINA - GENERICO 20 mg/g creme vag, 20 g+ 3 aplic, 95893776 FOSFATO DE CLINDAMICINA - GENERICO 20 mg/g creme vag, 20 g+ 3 aplic, 95998225 FOSFATO DE CLINDAMICINA - GENERICO 600 mg, sol, inj, cx, 50 amps, x 4 ml 95123369 FOSFATO DE CLINDAMICINA - GENERICO (Restrito Hosp,) 150 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml (hosp,) 95123377 FOSFATO DE CLINDAMICINA - GENERICO (Restrito Hosp,) 150 mg/ml sol, inj, cx, 50 amps, vd, x 4 ml (hosp,) 95450785 FOSFATO DIS, DE DEXAMETASONA - GENERICO Sol, inj, 2 mg/ml cx, 1 amp, 1 ml, 95450793 FOSFATO DIS, DE DEXAMETASONA - GENERICO Sol, inj, 4 mg/ml cx, 1 amp, 2,5 ml, 95123385 FOSFATO DISSODICO DE BETAMETASONA - GENERICO (Restrito 4 mg/ml Hosp,) sol, inj, IM/IV cx, 50 amps, vd, amb, x 1 ml (hosp,) 95123393 FOSFATO DISSODICO DE DEXAMETASONA - GENERICO 2 mg/ml - cx, 50 amps, vd, x 1 ml 95123407 FOSFATO DISSODICO DE DEXAMETASONA - GENERICO 4 mg/ml - cx, 100 amps, vd, x 2,5 ml 95083979 FOSFATO DISSODICO DE DEXAMETASONA - GENERICO 4,0 mg/ml sol, inj, 100 FAvd, x 2,5 ml (hosp,) 95123415 FOSFATO DISSODICO DE DEXAMETASONA - GENERICO (Restrito 4,0 mg/ml Hosp,) sol, inj, 100 FA vd, x 2,5 ml (hosp,) 95581499 FOSFATO POTASSIO 2mEq/ml Amp com 10 ml

Laboratorio CAZI MERCK SHARP & DOHME EMS GERMED GEN - LEGRAND NOVAFARMA NOVAFARMA NOVAFARMA NOVAFARMA PRATI DONADUZZI EMS GERMED GEN - LEGRAND UNIAO QUIMICA NOVAFARMA NOVAFARMA TEUTO BRAS, TEUTO BRAS, NOVAFARMA FARMACE FARMACE TEUTO BRAS, TEUTO BRAS, B,BRAUN

95581480 FOSFATO POTASSIO 2mEq/ml 95893806 FOSFATO SODICO DE PREDNISOLONA 95893814 FOSFATO SODICO DE PREDNISOLONA 95893822 FOSFATO SODICO DE PREDNISOLONA 95018450 FOSFATO SODICO DE PREDNISOLONA 95893784 FOSFATO SODICO DE PREDNISOLONA 95893792 FOSFATO SODICO DE PREDNISOLONA 95893857 FOSFATO SODICO DE PREDNISOLONA 95893865 FOSFATO SODICO DE PREDNISOLONA 95893873 FOSFATO SODICO DE PREDNISOLONA 95893881 FOSFATO SODICO DE PREDNISOLONA 95893890 FOSFATO SODICO DE PREDNISOLONA 95893903 FOSFATO SODICO DE PREDNISOLONA 95893830 FOSFATO SODICO DE PREDNISOLONA

PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI

GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER

Fr com 250 ml 1 mg/ml sol, oral 100 ml c/50 fr, 1 mg/ml sol, oral 50 fr, plast, 100 ml (hosp,) 1 mg/ml sol, oral fr, plast, 100 ml 1 mg/ml sol, oral fr, plast, 120 ml 1mg/mlsol,oral100ml 1mg/mlsol,oral120ml 3 mg/ml sol, oral 100 ml c/50 fr, 3 mg/ml sol, oral 50 fr, plast, 100 ml (hosp,) 3 mg/ml sol, oral 50 fr, plast, 60 ml+ cp, med, (Hosp,) 3 mg/ml sol, oral fr, plast, 100 ml 3 mg/ml sol, oral fr, plast, 60 ml+ cp, med, 3 mg/ml sol, oral, fr, plast, 120 ml 3mg/mlsol,oral100ml

UNIDADE Pco Unt Base A CPR 0,30 CPR 27,85 GRAMA 0,40 GRAMA 0,38 GRAMA 0,39 AMP 4,28 AMP 4,91 AMP 8,18 AMP 9,38 G 1,23 GRAMA 25,47 GRAMA 24,00 GRAMA 23,78 AMP 9,23 AMP 4,91 AMP 9,38 AP 2,38 AP 5,09 AMP 2,40 FA 1,48 FA 2,04 FA 4,16 FA 4,16 FR 1,24 FR 16,69 ML 3,80 ML 4,03 ML 0,11 ML 0,12 ML 0,09 ML 0,09 ML 0,10 ML 0,10 ML 0,10 ML 0,12 ML 0,11 ML 0,12 ML 0,10

173

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6626 6627 6628 6629 6630 6631 6632 6633 6634 6635 6636 6637 6638 6639 6640 6641 6642 6643 6644 6645 6646 6647 6648 6649 6650 6651 6652 6653 6654 6655 6656 6657 6658 6659 6660 6661 6662 6663

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95893849 FOSFATO SODICO DE PREDNISOLONA - GENER 3mg/mlsol,oral120ml PRATI DONADUZZI 95055894 FOSFATO SODICO DE PREDNISOLONA - GENERICO 1 mg/ml sol, oral fr, vd, amb, x 100 ml+ cp, med, SANOFI-AVENTIS 95055908 FOSFATO SODICO DE PREDNISOLONA - GENERICO 3 mg/ml sol, or, ct, fr, plas, opc, x 100 ml+ ser, dosad, PRATI DONADUZZI 95055916 FOSFATO SODICO DE PREDNISOLONA - GENERICO 3 mg/ml sol, or, ct, fr, plas, opc, x 120 ml+ ser, dosad, PRATI DONADUZZI 95055924 FOSFATO SODICO DE PREDNISOLONA - GENERICO 3 mg/ml sol, or, ct, fr, plas, opc, x 60 ml+ ser, dosad, PRATI DONADUZZI 95450815 FOSFATO SODICO DE PREDNISOLONA - GENER, Sol, oral fr, vd, amb, x 100 ml+ dos, MEDLEY 95094687 FOSFATO SODICO DE PREDNISOLONA - GENERICO 3 mg/ml sol, oral fr, plast, opc, x 120 ml + pipeta BIOSINTETICA 95089632 FOSFATO SODICO DE PREDNISOLONA - GENERICO 3 mg/ml sol, oral fr, plast, opc, x 60 ml+ pipeta BIOSINTETICA 95123423 FOSFATO SODICO DE PREDNISOLONA - GENERICO (Restrito1 Hosp,) mg/ml, sol, or, cx, 50 fr, plas, opc, x 100 ml, + cp, dosad, 10 PRATI ml, (hosp,) DONADUZZI 95123431 FOSFATO SODICO DE PREDNISOLONA - GENERICO (Restrito3 Hosp,) mg/ml sol, or, cx, 50 fr, plast, opc, x 60 ml + cp, med, (hosp,) PRATI DONADUZZI 95123440 FOSFATO SODICO DE PREDNISOLONA - GENERICO (Restrito3 Hosp,) mg/ml, sol, or, cx, 50 fr, plas, opc, x 100 ml, (hosp,) PRATI DONADUZZI 95043667 FOSINOPRIL SODICO - GENERICO 10 mg, 14 cprs, bl, ARROW 95043675 FOSINOPRIL SODICO - GENERICO 10 mg, 28 cprs, bl, ARROW 95893911 FOSINOPRIL SODICO - GENERICO 10 mg, bl, 16 cprs, RANBAXY 95893920 FOSINOPRIL SODICO - GENERICO 10 mg, bl, 30 cprs, RANBAXY 95043683 FOSINOPRIL SODICO - GENERICO 20 mg, 14 cprs, bl, ARROW 95043691 FOSINOPRIL SODICO - GENERICO 20 mg, 28 cprs, bl, ARROW 95893938 FOSINOPRIL SODICO - GENERICO 20 mg, bl, 30 cprs, RANBAXY 95055932 FOSIPRAZ 10 mg, cx, 14 cprs, ARROW 95055959 FOSIPRAZ 10 mg, cx, 28 cprs, ARROW 95055967 FOSIPRAZ 20 mg, cx, 14 cprs, ARROW 95055940 FOSIPRAZ 20 mg, cx, 28 cprs, ARROW 95099239 FOSLAMER 800 mg, fr, 180 cprs, rev, GERMED PHARMA 95377611 FRADEMICINA 500 mg, est, 12 caps, PFIZER 95377603 FRADEMICINA 600 mg, cx, 1 amp, x 2 ml PFIZER 95377638 FRADEMICINA Ped, cx, c/1 amp, 1 ml, PFIZER 95160230 FRAGMIN 2500 UI - cx, 10 ser, 0,2 ml PFIZER 95160248 FRAGMIN 5000 UI - cx, 10 ser, 0,2 ml PFIZER 95038264 FRANOL 10 x 10 cprs, SANOFI-AVENTIS 95089640 FRANOL 120 mg,+ 15 mg, bl, 20 cprs, SANOFI-AVENTIS 95018468 FRANOL Fr, 60 ml, xpe, SANOFI-AVENTIS 95055975 FRAXIPARINA 0,3 ml 10 seringas GLAXOSMITHKLINE 95018557 FRAXIPARINA 0,4 ml, inj, c/5 ser, SANOFI-AVENTIS 95055983 FRAXIPARINA 0,6 ml 5 seringas GLAXOSMITHKLINE 95018565 FRAXIPARINA 0,8 ml, inj, c/5 ser, SANOFI-AVENTIS 95018573 FRAXIPARINA 1,0 ml, inj, c/5 ser, SANOFI-AVENTIS 95018492 FRAXIPARINA TX 0,6 ml x 10 ser, SANOFI-AVENTIS 95018484 FRAXIPARINA TX 0,6 ml x 2 ser, SANOFI-AVENTIS

UNIDADE Pco Unt Base A ML 0,11 ML 0,12 ML 0,13 ML 0,15 ML 0,14 ML 0,14 Unidade 0,13 ML 0,13 ML 0,23 ML 1,20 ML 1,18 CP 1,61 CP 1,44 COMP 1,31 COMP 1,17 CP 2,83 CP 2,83 COMP 2,30 COMP 1,93 COMP 1,60 COMP 3,03 COMP 2,74 COMP 3,73 CPR 5,73 AP 12,14 AP 7,35 UND 7,65 UND 13,28 CP 2,12 COMP 0,21 ML 0,08 UNID 19,15 UNID 21,74 UNID 35,38 UNID 40,77 UNID 54,35 UNID 53,01 UNID 53,39

174

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6664 6665 6666 6667 6668 6669 6670 6671 6672 6673 6674 6675 6676 6677 6678 6679 6680 6681 6682 6683 6684 6685 6686 6687 6688 6689 6690 6691 6692 6693 6694 6695 6696 6697 6698 6699 6700 6701

CODIGO BENEFICIO 95018514 FRAXIPARINA 95018506 FRAXIPARINA 95018530 FRAXIPARINA 95018522 FRAXIPARINA 95260331 FREENAL 95530339 FRENURIN 95530347 FRENURIN 95377646 FRESENIZOL 95094709 FRESH CLEAR 95094695 FRESH CLEAR 95998268 FRESOFOL 95998276 FRESOFOL 95998284 FRESOFOL 95899804 FRESOFOL 95390804 FRESOLCAN (FLUCONAZOL 2 MG/ML) 95083987 FRESOLCAN (FLUCONAZOL 2 MG/ML) SISTEMA FECHADO 95270698 FRISIUM 95270701 FRISIUM 95790632 FRIXOPEL 95270752 FRONTAL 95270760 FRONTAL 95270779 FRONTAL 95270744 FRONTAL 95998292 FRONTAL XR 95998306 FRONTAL XR 95998314 FRONTAL XR 95620281 FRUCTOGENASE 95620273 FRUCTOGENASE 95620303 FRUTOPLEX 95620311 FRUTOPLEX 95085645 FRUTOSE 5% - BLOWPACK 95085653 FRUTOSE 5% - ISTARBAG 95611770 FRUTOVENA 95611789 FRUTOVENA 95611797 FRUTOVITAM 95390812 FULCIN 95985190 FUMARATO DE CETOTIFENO - GENERIC 95018590 FUMARATO DE CETOTIFENO - GENERIC

APRESENTAÇÃO TX 0,8 ml x 10 ser, TX 0,8 ml x 2 ser, TX 1,0 ml x 10 ser, TX 1,0 ml x 2 ser, Sol, nasal fr, plast, 20 ml 5 mg, cx, 30 cprs, Xpe fr, 120 ml, 0,5% (s/ equipo) Metronidazol 1 x 100 ml Fr, 10 ml Fr, 5 ml 1% 100 ml, 1% 5 x 20 ml 1% 50 ml, 2% 50 ml, 1 x 100 ml 1 x 100 ml 10 mg, cx, 20 cprs, 20 mg, cx, 20 cprs, Pom, 1 x 25 g, 0,25 mg, est, c/30 cprs, em bl, 0,50 mg, est, c/30 cprs, em bl, 1,00 mg, est, c/30 cprs, em bl, 2,00 mg fr, vd, 30 cprs, 0,5 mg, 30 cprs, 1,0 mg, 30 cprs, 2,0 mg, 30 cprs, Cx, 100 amps, 10 ml, Cx, 50 amps, 20 ml, End, cx, 3 x 10 ml, End, cx, 3 x 20 ml, Cx, c/20 Bols PE 500 ml Cx, c/20 Bols PVC 500 ml 5 amps, 10 cc 5 amps, 20 cc Cx, 100 amps, x 10 ml 500 mg, cx, 20 cprs, 0,2 mg/ml xpe, fr, 120 ml+ cp, med, 0,2 mg/ml xpe, fr, plast, x 100 ml+ cp, med,

Laboratorio SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS ACHE UCI-FARMA UCI-FARMA FRESENIUS KABI ALLERGAN ALLERGAN FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI SANOFI-AVENTIS SANOFI-AVENTIS EMS PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER LUPER LUPER MARJAN MARJAN HALEX ISTAR HALEX ISTAR CHIESI CHIESI CRISTALIA ASTRAZENECA EMS BIOSINTETICA

UNIDADE Pco Unt Base A UNID 74,24 UNID 74,23 UNID 103,93 UNID 104,18 GOTAS 0,02 CPR 0,51 ML 0,17 FA 4,72 GOTA 0,03 GOTA 0,03 ML 1,39 F,A, 33,93 F,A, 70,64 FA 139,96 FA 123,41 UNID 141,56 CPR 0,46 CPR 0,85 G 0,48 CPR 0,47 CPR 0,92 CPR 1,63 CPR 2,57 COMP 0,92 COMP 1,63 COMP 2,57 AP 2,39 AP 4,73 AP 5,22 AP 8,57 UNID 8,96 UNID 8,96 AP 3,01 AP 5,04 AP 3,09 CPR 0,91 ML 0,21 ML 0,21

175

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6702 6703 6704 6705 6706 6707 6708 6709 6710 6711 6712 6713 6714 6715 6716 6717 6718 6719 6720 6721 6722 6723 6724 6725 6726 6727 6728 6729 6730 6731 6732 6733 6734 6735 6736 6737 6738 6739

CODIGO BENEFICIO 95985204 FUMARATO DE CETOTIFENO - GENERIC 95072187 FUMARATO DE CETOTIFENO - GENERICO 95072179 FUMARATO DE CETOTIFENO - GENERICO 95099247 FUMARATO DE BISOPROLOL - GENERICO 95099255 FUMARATO DE BISOPROLOL - GENERICO 95099263 FUMARATO DE BISOPROLOL - GENERICO 95099271 FUMARATO DE BISOPROLOL - GENERICO 95099280 FUMARATO DE CETOTIFENO - GENERICO 95230700 FUMARATO DE CETOTIFENO - GENERICO 95230742 FUMARATO DE CETOTIFENO - GENERICO 95230696 FUMARATO DE CETOTIFENO - GENERICO 95230726 FUMARATO DE CETOTIFENO - GENERICO 95230734 FUMARATO DE CETOTIFENO - GENERICO 95099298 FUMARATO DE CETOTIFENO - GENERICO 95230718 FUMARATO DE CETOTIFENO - GENERICO 95099301 FUMARATO DE QUETIAPINA - GENERICO 95099310 FUMARATO DE QUETIAPINA - GENERICO 95099328 FUMARATO DE QUETIAPINA - GENERICO 95099336 FUMARATO DE QUETIAPINA - GENERICO 95137947 FUMARATO DE QUETIAPINA - GENERICO 95099344 FUMARATO DE QUETIAPINA - GENERICO 95099352 FUMARATO DE QUETIAPINA - GENERICO 95099360 FUMARATO DE QUETIAPINA - GENERICO 95099379 FUMARATO DE QUETIAPINA - GENERICO 95137955 FUMARATO DE QUETIAPINA - GENERICO 95099387 FUMARATO DE QUETIAPINA - GENERICO 95099395 FUMARATO DE QUETIAPINA - GENERICO 95099409 FUMARATO DE QUETIAPINA - GENERICO 95099417 FUMARATO DE QUETIAPINA - GENERICO 95099425 FUMARATO DE QUETIAPINA - GENERICO 95137963 FUMARATO DE QUETIAPINA - GENERICO 95137939 FUMARATO DE QUETIAPINA - GENERICO 95099433 FUMARATO DE QUETIAPINA (C1) - GENERICO 95099441 FUMARATO DE QUETIAPINA (C1) - GENERICO 95099450 FUMARATO DE QUETIAPINA (C1) - GENERICO 95390839 FUNGIROX 95998365 FUNGISTATINA 95840974 FUNGOL

APRESENTAÇÃO Laboratorio 1 mg/ml sol, oral fr, 30 ml+ conta gts, EMS 0,2 mg/ml xpe, cx, 50 frs, plas, amb, x 120 ml+ 50 cp, med, HIPOLABOR 0,2 mg/ml xpe, fr, plast, x 120 ml+ cp, med, BIOSINTETICA 1,25 mg, 2 bl, x 15 cprs, rev, EMS 10 mg, 2 bl, x 15 cprs, rev, EMS 2,5 mg, 2 bl, x 15 cprs, rev, EMS 5 mg, 2 bl, x 15 cprs, rev, EMS 0,2 mg/ml 120 ml xpe,fr, vd, amb, + cp, med, TEUTO BRAS, 0,2 mg/ml xpe 100 ml MERCK 1 mg xpe fr, vd, ambar 100 ml ATIVUS 1 mg/5 ml xpe, fr, 120 ml, UNIAO QUIMICA 1 mg/ml sol, oral fr, 30 ml MEDLEY 1 mg/ml sol, oral fr, vd, cgt 30 ml ATIVUS Sol, oft, 0,345 mg/ml c/5 ml NEO QUIMICA Xpe, fr, 120 ml MEDLEY 100 mg, 3 bl, x 10 cprs, rev, GEN - LEGRAND 100 mg, 3 bl, x 10 cprs, rev, GERMED 100 mg, bl, 30 cprs, rev, ACHE 100 mg, bl, 30 cprs, rev, BIOSINTETICA 100 mg. 30 cprs. rev. GLAXOSMITHKLINE 200 mg 3 bl, x 10 cprs, rev, GEN - LEGRAND 200 mg 3 bl, x 10 cprs, rev, GERMED 200 mg, bl, 30 cprs, rev, ACHE 200 mg, bl, 30 cprs, rev, BIOSINTETICA 200 mg. 30 cprs. rev. GLAXOSMITHKLINE 25 mg, 2 bl, x 15 cprs, rev, GERMED 25 mg, bl, 14 cprs, rev, GEN - LEGRAND 25 mg, bl, 14 cprs, rev, GERMED 25 mg, bl, 15 cprs, rev, ACHE 25 mg, bl, 15 cprs, rev, BIOSINTETICA 25 mg. 10 cprs. rev. GLAXOSMITHKLINE 25 mg. 30 cprs. rev. GLAXOSMITHKLINE 100 mg, 3 bl, x 10 cprs, rev, EMS 200 mg, 3 bl, x 10 cprs, rev, EMS 25 mg, 14 cprs, rev, EMS 10 mg/g creme derm, bisn, 20 g, UCI-FARMA Susp, 100,000 UI vd, 50 ml MEDQUIMICA Fr, 30 ml, SANOFI-AVENTIS

UNIDADE Pco Unt Base A GOTA 25,43 ML 0,15 ML 0,16 COMP 1,04 COMP 1,66 COMP 1,20 COMP 1,46 ML 0,21 ML 0,19 ML 0,16 ML 0,20 GOTAS 0,05 GOTAS 0,04 ML 2,90 ML 0,21 COMP 5,25 COMP 5,25 COMP 5,07 COMP 5,07 COMP 4,56 COMP 9,45 COMP 9,45 COMP 9,12 COMP 9,12 COMP 8,20 COMP 1,26 COMP 1,58 COMP 1,58 COMP 1,52 COMP 1,52 COMP 1,37 COMP 1,37 COMP 5,25 COMP 10,14 COMP 1,58 G 1,20 ML 0,36 GOTAS 0,01

176

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6740 6741 6742 6743 6744 6745 6746 6747 6748 6749 6750 6751 6752 6753 6754 6755 6756 6757 6758 6759 6760 6761 6762 6763 6764 6765 6766 6767 6768 6769 6770 6771 6772 6773 6774 6775 6776 6777

CODIGO BENEFICIO 95998373 FUNGONAX 95998381 FUNGONAX 95083995 FUNTEX B 95971106 FUNTYL 95971114 FUNTYL 95971122 FUNTYL 95893962 FUROATO DE MOMETASONA - GENERICO 95893970 FUROATO DE MOMETASONA - GENERICO 95038310 FUROATO DE MOMETASONA - GENERICO 95038302 FUROATO DE MOMETASONA - GENERICO 95893954 FUROATO DE MOMETASONA - GENERICO 95893946 FUROATO DE MOMETASONA - GENERICO 95038299 FUROATO DE MOMETASONA - GENERICO 95893989 FUROATO DE MOMETASONA - GENERICO 95038280 FUROATO DE MOMETASONA - GENERICO 95893997 FUROATO DE MOMETASONA - GENERICO 95082700 FUROATO DE MOMETASONA - GENERICO 95123458 FUROSANTISA (Restrito Hosp,) 95894004 FUROSEFARMA 95099468 FUROSEFARMA 95100288 FUROSEM 95007938 FUROSEMIDA 95099476 FUROSEMIDA - GENERICO 95048405 FUROSEMIDA - GENERICO 95100350 FUROSEMIDA - GENERICO 95100369 FUROSEMIDA - GENERICO 95100342 FUROSEMIDA - GENERICO 95100318 FUROSEMIDA - GENERICO 95038329 FUROSEMIDA - GENERICO 95038337 FUROSEMIDA - GENERICO 95055991 FUROSEMIDA - GENERICO 95056009 FUROSEMIDA - GENERICO 95056017 FUROSEMIDA - GENERICO 95123466 FUROSEMIDA - GENERICO (Restrito Hosp,) 95123474 FUROSEMIDA - GENERICO (Restrito Hosp,) 95123482 FUROSEMIDA - GENERICO (Restrito Hosp,) 95123490 FUROSEMIDA - GENERICO (Restrito Hosp,) 95123504 FUROSEMIDA - GENERICO (Restrito Hosp,)

APRESENTAÇÃO 100 mg, cx, 15 caps, 100 mg, cx, 4 caps, 20 pcc sol, inj, cx, FA x 50 ml 1% creme bisn, 20 g, 250 mg, cx, 14 cps, 250 mg, cx, 28 cps, 1 mg/g creme bisn, 20 g 1 mg/g creme bisn, 20 g 1 mg/g creme derm, bisn, 20 g 1 mg/g pom, derm, bisn, 20 g 1mg/gpom,bisn, 20 g 1mg/gpom,bisn,20 g Creme bisn, 20 g Creme bisn, 20 g Pom, bisn, 20 g Pom, bisn, 20 g 1 mg/g pom, bisn, 20 g 20 mg, sol, inj, cx, 100 amps, vd, amb, x 2 ml 10 mg/ml amp, 2 ml 2 ml amp, vd, 40 mg, bl, 20 cprs, FR 60 ML C/ 10 MG/ML 10 mg/ml sol, inj, 5 amps, x 2 ml 10 mg/ml sol, inj, 60 amps, vd, x 2 ml (hosp,) 20 mg amp, 2 ml, 20 mg, cx, 100 x 2 ml 40 mg cx, 20 cprs, 40 mg, 2 bl, x 15 cprs, 40 mg, 20 cprs, 40 mg, bl, 100 cprs, (hosp,) 40 mg, bl, al, plas, vde, trans, x 20 cprs, 40 mg, com, ct, bl, al, pvc opc, x 20 40 mg, com, ct, bl, al, pvc opc, x 500 (hosp,) 10 mg/ml sol, inj, 60 amps, vd, x 2 ml (hosp,) 20 mg, amp, 2 ml, 40 mg, bl, 100 cprs, (hosp,) 40 mg, com, ct, bl, al, pvc opc, x 500 (hosp,) Inj, 10 mg/ml cx, 50 amps, 2 ml (hosp,)

Laboratorio TEUTO BRAS, TEUTO BRAS, MEIZLER CRISTALIA CRISTALIA CRISTALIA EMS GERMED MEDLEY MEDLEY GERMED EMS BIOSINTETICA GEN - LEGRAND BIOSINTETICA GEN - LEGRAND EMS SANTISA FARMACE FARMACE MEDLEY TEUTO BRAS, TEUTO BRAS, HALEX ISTAR HYPOFARMA TEUTO BRAS, BIOSINTETICA TEUTO BRAS, TEUTO BRAS, SANOFI-AVENTIS PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, HALEX ISTAR TEUTO BRAS, PRATI DONADUZZI TEUTO BRAS,

UNIDADE Pco Unt Base A CAPS 3,71 CAPS 6,00 FA 0,86 G 0,72 CPR 4,36 CPR 4,38 GRAMA 19,75 GRAMA 14,78 G 0,97 G 0,97 GRAMA 14,78 GRAMA 14,11 G 0,74 GRAMA 0,95 G 0,71 G 0,80 G 0,99 AMP 0,32 AMP 0,40 AMP 26,82 CPR 0,36 ML 0,07 AMP 1,04 AMP 0,59 AP 0,50 AP 0,65 CPR 0,58 CPR 0,29 CP 0,20 CP 0,15 COMP 0,29 COMP 0,24 COMP 0,12 AMP 0,59 AMP 0,50 COMP 0,17 COMP 0,13 AMP 0,27

177

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6778 6779 6780 6781 6782 6783 6784 6785 6786 6787 6788 6789 6790 6791 6792 6793 6794 6795 6796 6797 6798 6799 6800 6801 6802 6803 6804 6805 6806 6807 6808 6809 6810 6811 6812 6813 6814 6815

CODIGO BENEFICIO 95018603 FUROSEMIDE 95100377 FUROSEMIDE 95100385 FUROSEMIN 95123512 FUROSETRON (Restrito Hosp,) 95099484 FUROSIX 95100407 FUROZIX 95082719 GABANEURIN 95038345 GABANEURIN 95099492 GABANEURIN 95038353 GABANEURIN 95099506 GABANEURIN 95082751 GABAPENTINA - GENERICO 95099514 GABAPENTINA - GENERICO 95099522 GABAPENTINA - GENERICO 95082735 GABAPENTINA - GENERICO 95029184 GABAPENTINA - GENERICO 95029192 GABAPENTINA - GENERICO 95038361 GABAPENTINA - GENERICO 95894012 GABAPENTINA - GENERICO 95082727 GABAPENTINA - GENERICO 95082743 GABAPENTINA - GENERICO 95029206 GABAPENTINA - GENERICO 95029214 GABAPENTINA - GENERICO 95038370 GABAPENTINA - GENERICO 95894020 GABAPENTINA - GENERICO 95084851 GABAPENTINA - GENERICO 95099530 GABAPENTINA - GENERICO 95099549 GABAPENTINA - GENERICO 95160361 GADUOL 95038396 GALVUS 95038388 GALVUS 95056025 GALVUS 95038400 GALVUS MET 95038418 GALVUS MET 95056033 GALVUS MET COMBI PACK 95056041 GALVUS MET COMBI PACK 95018611 GAMA ANTI-D 95900152 GAMA ANTI-TETANO

APRESENTAÇÃO 40 mg, 20 cprs, Composto cx, 20 cprs, 20 cprs, Inj, 20 mg, cx, 50 amps, 2 ml Cx, 20 cprs Cx, 20 cprs, 300 mg, 3 bl, x 10 caps, 300mg,3 bl,x10 caps, 400 mg, 3 bl, x 10 caps, 400mg,3 bl,x10 caps, 600 mg, (c1) 3 bl, x 9 cprs, rev, 300 mg, 3 bl, x 10 caps, 300 mg, 3 bl, x 10 caps, 300 mg, 3 bl, x 10 caps, 300 mg, bl, 30 caps, gel dura 300mg,3 bl, x 10 caps, 300mg,3 bl, x 10 caps, 300mg,3bl,x10caps, 300mg,bl,3x10caps, 400 mg, 3 bl, x 10 caps, 400 mg, bl, 30 caps, gel dura 400mg,3 bl, x 10 caps, 400mg,3 bl, x 10 caps, 400mg,3bl,x10caps, 400mg,bl,3x10caps, 600 mg, 3 bl, x 9 cprs, rev, 600 mg, bl, 27 cprs, rev, 600 mg,, (C1) 3 bl, x 9 cprs, rev, Gts, 10 ml, 100 mg, 28 cp, 50 mg, 28 cp, 50 mg, 56 cp, 100 mg,+ 500 mg, 28+ 56 cp, 100 mg,+ 850 mg, 28+ 56 cp, 50 mg,+ 500 mg, 56+ 56 cp, 50 mg,+ 850 mg, 56+ 56 cp, 1500 UI 250 UI

Laboratorio CIFARMA MEDLEY BRASTERAPICA ARISTON DELTA BUNKER SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA GEN - LEGRAND EMS GERMED ARROW GERMED GEN - LEGRAND EMS RANBAXY EMS ARROW GERMED GEN - LEGRAND EMS RANBAXY GERMED COSMED EMS CLIMAX NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS GRIFOLS GRIFOLS

UNIDADE Pco Unt Base A COMP 0,21 CPR 0,33 CPR 0,19 AMP 0,58 COMP 0,35 CPR 0,33 CAPS 1,27 CP 0,92 CAPS 1,62 CP 1,30 COMP 2,54 CAPS 1,77 caps 1,86 Caps 1,40 CAPS 1,37 CPR 1,02 CPR 1,20 CP 1,35 CAPS 1,88 CAPS 2,27 CAPS 1,83 CPR 1,86 CPR 2,13 CP 1,65 CAPS 2,16 COMP 2,99 COMP 2,52 COMP 2,99 GOTAS 0,02 CP 4,81 CP 2,58 COMP 2,58 CP 1,60 CP 1,60 COMP 2,41 COMP 2,41 FA 150,06 AP 37,88

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6816 6817 6818 6819 6820 6821 6822 6823 6824 6825 6826 6827 6828 6829 6830 6831 6832 6833 6834 6835 6836 6837 6838 6839 6840 6841 6842 6843 6844 6845 6846 6847 6848 6849 6850 6851 6852 6853

CODIGO BENEFICIO 95998446 GAMAX 95998454 GAMAX 95099557 GAMIBETAL 95056050 GAMIBETAL 95056068 GAMIBETAL 95123520 GANCICLOTRAT (Restrito Hosp,) 95998462 GANCICLOVIR SODICO - GENERICO 95099565 GANVIRAX - GANCICLOVIR (ICMS 0%) 95377670 GARAMICINA 95377719 GARAMICINA 95377727 GARAMICINA 95377743 GARAMICINA 95377735 GARAMICINA 95377689 GARAMICINA 95377697 GARAMICINA 95377700 GARAMICINA 95690107 GARASONE 95971130 GARBITAL 95340327 GARDENAL 95340335 GARDENAL 95340351 GARDENAL 95998497 GASPIREN 95030620 GASTRIUM

APRESENTAÇÃO Cx, 15 caps, Cx, 30 caps, 300 mg, cx, 10 caps, 300 mg, cx, 30 caps, 400 mg, cx, 30 caps, 500 mg, po liof, FA vd, + dil, x 10 ml 500mg,50FA+dil, 250 mg, fr, 40 caps, Creme 1 bisn, 30 g, Inj, 120 mg, 2 amps, 1,5 ml, Inj, 160 mg, 1 amp, 2 ml, Inj, 20 mg, 2 amps, 1 ml, Inj, 280 mg, 1 amp, Inj, 40 mg, 2 amps, 1 ml, Inj, 60 mg, 2 amps, 1,5 ml, Inj, 80 mg, 2 amps, 2 ml, Col, 1 fr, 10 ml, 100 mg, cx, 2 bl, x 10 cprs, 100 mg, est, 20 cprs, 50 mg, est, 20 cprs, Ped, 4% fr, 20 ml, 40mg,cx, 1FA1+1dil, 20 mg, caps, gel, fr, c/7

Laboratorio HEBRON HEBRON ARROW ARROW ARROW UNIAO QUIMICA EUROFARMA BLAUSIEGEL MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP MANTECORP NEO QUIMICA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS BIOLAB SANUS ACHE

95971149 GASTRI-VYR 95018646 GASTROCIMET 95018620 GASTROCIMET 95020748 GASTROFLAT 95020756 GASTROFLAT 95971157 GASTROFLAT MAX 95998500 GASTROGEL 95072195 GASTROGEL 95010831 GASTROL 95010858 GASTROL 95010840 GASTROL 95018654 GASTROMAX 95018670 GASTROMAX 95099573 GASTROMAX 95018662 GASTROMAX

Susp, oral fr, 150 ml 20 mg, 14 caps, 20 mg, 7 caps, Cx, 20 cprs, Gts, fr, 10 ml, Cx, 1 bl 10 caps, gel Cx, 20 cprs, Susp, vd, 240 ml 20 past, mast, TC 240 ml TC 30 past, 300 mg, 20 cprs, 300 mg, 200 cprs, 300 mg, 200 cprs, Susp, oral 150 ml

CAZI BRASTERAPICA BRASTERAPICA BUNKER BUNKER BUNKER MEDQUIMICA MEDQUIMICA LUPER LUPER LUPER CIFARMA CIFARMA CIFARMA CIFARMA

UNIDADE Pco Unt Base A CAPS 2,80 CAPS 2,27 CAPS 2,03 CAPS 1,71 CAPS 2,13 FA 100,98 F,A, 74,61 CAPS 18,57 G 0,21 AP 7,32 AP 10,00 AP 2,15 AP 18,20 AP 2,57 AP 3,08 AP 5,25 GOTAS 0,03 CPR 0,21 CPR 0,25 CPR 0,21 GOTAS 0,01 F,A, 39,77 CPR 1,86 ML CAPS CAPS CPR GOTAS CPR CPR ML CPR ML CPR COMP COMP COMP ML

0,07 1,18 1,61 0,47 0,03 1,58 0,40 0,07 0,46 0,10 0,73 0,36 0,22 0,19 0,07

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6854 6855 6856 6857 6858 6859 6860 6861 6862 6863 6864 6865 6866 6867 6868 6869 6870 6871 6872 6873 6874 6875 6876 6877 6878 6879 6880 6881 6882 6883 6884 6885 6886 6887 6888 6889 6890 6891

CODIGO BENEFICIO 95029222 GASTROPAN 95010904 GAVIZ 95018689 GAZYME 95018697 GAZYME 95010955 GELMAX 95038426 GELMAX - LINHA CONSUMO 95971173 GELMIN 95971181 GELMIN 95971190 GELOL EMPLASTO 95971203 GELOL EMPLASTO 95971211 GELOL EMPLASTO 95971238 GELOL EMPLASTO 95971246 GELOL EMPLASTO 95971220 GELOL EMPLASTO 95011048 GELUSIL M 95011056 GELUSIL M 95038434 GEMCIT 95038442 GEMCIT 95541373 GEMZAR 95541381 GEMZAR 95018700 GENFIBROZILA - GENERICO 95998551 GENFIBROZILA - GENERICO 95998560 GENFIBROZILA - GENERICO 95998578 GENFIBROZILA - GENERICO 95180176 GENFIBROZILA - GENERICO 95998543 GENFIBROZILA - GENERICO 95018719 GENFIBROZILA - GENERICO 95998594 GENFIBROZILA - GENERICO 95985280 GENFIBROZILA - GENERICO 95971270 GENFIBROZILA - GENERICO 95998586 GENFIBROZILA - GENERICO 95084010 GENLIBBS 95123539 GENLIBBS (Restrito Hosp,) 95490205 GENOTROPIN 95998608 GENOTROPIN 95690123 GENTACORT 95377816 GENTAGRAN 95029230 GENTAMICIN

APRESENTAÇÃO 40mg,cx, 14cprs, rev, 240 ml, 40 mg, 20 cprs, 75 mg/ml gts, 10 ml Susp, fr, 240 ml, DIM susp, oral fr, 240 ml 250 mg, cart, 20 cprs, 40 mg/ml fr, 100 ml 1 env, x 10 pequeno 1 env, x 2 grande 1 env, x 4 medio 10 envs, x 2 grande 10 envs, x 4 medio 10envs,x10pequeno Liq, fr, 240 ml, Morango liq, fr, 240 ml 1 g po liof, inj, FA vd, 200 mg, po liof, inj, FA vd, Frasco-ampola 1 g Frasco-ampola 200 mg, 600 mg, 10 bl, x 6 cprs, 600 mg, 2 bl, x 12 cprs, rev, 600 mg, 24 cprs, rev, 600 mg, bl, 30 cprs, rev, 600 mg, cx, 30 cprs, 600mg,2bl,x12cprs, 900 mg, 10 bl, x 6 cprs, 900 mg, 12 cprs, rev, 900 mg, 2 bl, x 6 cprs, 900 mg, bl, 15 cprs, rev, 900mg,2 bl, x 6cprs,rev, 200 mg, po liof, inj, ct, FA vd, inc, 1 g po liof, inj, ct, FA vd, inc, 16 UI 1 FA 36 UI 1 FA Pom, bisn, 3,5 g Pom, oft, bisn, 3 g 20 mg/ml sol, inj, cx, 50 amps, vd,

Laboratorio NEO QUIMICA UNIAO QUIMICA CIFARMA CIFARMA EMS EMS OSORIO DE MORAES OSORIO DE MORAES COSMED COSMED COSMED COSMED COSMED COSMED UNIAO QUIMICA UNIAO QUIMICA SANDOZ SANDOZ ELI LILLY ELI LILLY EMS GEN - LEGRAND EMS MEDLEY BIOSINTETICA GERMED EMS EMS GERMED MEDLEY GEN - LEGRAND LIBBS LIBBS PFIZER PFIZER ALLERGAN LEGRAND NOVAFARMA

UNIDADE Pco Unt Base A CPR 2,59 ML 0,07 COMP 0,34 GOTA 0,04 ML 0,08 ML 0,08 CPR 0,34 ML 0,07 ENV 0,21 ENV 3,24 ENV 0,80 ENV 3,24 ENV 3,20 ENV 2,10 ML 0,06 ML 0,06 FA 541,07 FA 108,71 AP 541,08 AP 108,72 COMP 1,79 COMP 1,92 COMP 1,99 COMP 2,01 CPR 1,76 COMP 1,97 COMP 2,27 COMP 3,00 COMP 2,89 CPR 2,39 COMP 2,76 FA 108,71 FA 541,07 FA 422,81 F,A, 925,94 G 1,37 G 3,21 AMP 0,73

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6892 6893 6894 6895 6896 6897 6898 6899 6900 6901 6902 6903 6904 6905 6906 6907 6908 6909 6910 6911 6912 6913 6914 6915 6916 6917 6918 6919 6920 6921 6922 6923 6924 6925 6926 6927 6928 6929

CODIGO BENEFICIO 95029249 GENTAMICIN 95029257 GENTAMICIN 95690131 GENTAMICINA 95690140 GENTAMICINA 95377905 GENTAMIL 95377891 GENTAMIL 95377883 GENTAMIL 95377875 GENTAMIL 95123555 GENTAMISAN (Restrito Hosp,) 95123563 GENTAMISAN (Restrito Hosp,) 95123571 GENTAMISAN (Restrito Hosp,) 95377913 GENTARON 95894039 GENTARON 95894047 GENTARON 95971289 GENTEAL 95018743 GENTEAL 95075089 GENUXAL 95075070 GENUXAL 95072209 GENUXAL 95078509 GEODON 95541454 GEODON 95998624 GEODON 95099581 GEPEPROSTIN 95988084 GESTRADIOL 95971297 GESTROCON 95611924 GEVRAL SUPER 95971300 GIAMEBIL 95971319 GIAMEBIL 95971327 GIAMEBIL 95410171 GIARLAM 95410180 GIARLAM 95378030 GINCONAZOL 95018808 GINEC 95971351 GINO FIBRASE 95510265 GINO-CANESTEN 95510281 GINO-CANESTEN 95510273 GINO-CANESTEN 95018816 GINO-DACZOL

APRESENTAÇÃO 40 mg/ml sol, inj, cx, 50 amps, vd, 80 mg/2 ml sol, inj, cx, 50 amps, vd, Fr, 5 ml, Pom, oft, 1 bisn, 3,5 g, Inj, 160 mg, cx,1 amp, 2 ml, Inj, 20 mg, cx,2 amps, 1 ml, Inj, 280 mg, cx,1 amp, 2 ml, Inj, 80 mg, cx,1 amp, 2 ml, 10 mg, sol, inj, cx, 100 amps, vd, amb, x 1 ml 40 mg, sol, inj, cx, 100 amps, vd, amb, x 1 ml 80 mg, sol, inj, cx, 100 amps, vd, amb, x 2 ml 20 mg 100 amps, 1,0 ml 60 mg, cx, 100 amps, 1,5 ml 80 mg, cx, 100 amps, 2 ml 10 ml Gel 10 g 1 g, cx, 10 FA 200 mg, cx, 10 FA Cx, 50 drags, 80 mg, 14 caps, 80 mg, 30 cprs, IM 20 mg/ml po sol, FA+ 1 dil, 50 mg, bl, 30 cprs, rev, Cx, 21 cprs, 0,625 mg/g creme vag, (bg c/25 g) Fr, 120 ml Cx, 6 cprs, Gts, fr, 10 ml Xpe, fr, 60 ml Cx, 14 cprs, Susp, oral 70 ml, Bisn, 30 g, c/5aplic, 5 g, Creme 60 g Pom, vag,tb,30g, 1% cr, vag, bisn, 35 g,+ 6 aplic, 3 - 2% creme vag, bisn, 20 g+ 3 aplic, 500 mg, 1 cpr, vag,+ aplic, Creme vag, 2% bisn, 80 g 1 aplic,

Laboratorio NOVAFARMA NOVAFARMA ALLERGAN ALLERGAN DUCTO DUCTO DUCTO DUCTO SANTISA SANTISA SANTISA ARISTON ARISTON ARISTON NOVARTIS NOVARTIS BAXTER BAXTER BAXTER PFIZER PFIZER PFIZER SANDOZ NEO QUIMICA NEO QUIMICA WHITEHALL HEBRON HEBRON HEBRON UCI-FARMA UCI-FARMA HEBRON GLENMARK PFIZER BAYER BAYER BAYER CIFARMA

UNIDADE Pco Unt Base A AMP 0,80 AMP 0,93 GOTAS 0,06 G 2,05 AP 4,91 AP 2,36 AP 6,41 AP 3,26 AMP 0,31 AMP 0,36 AMP 0,43 AP 0,59 AMP 0,70 AMP 0,76 GOTAS 0,12 GRAMA 2,73 FA 30,60 FA 8,25 DRAG 0,74 CAPS 14,13 CPR 14,13 F,A, 122,23 COMP 17,57 CPR 0,88 G 0,83 ML 0,07 CPR 4,07 GOTAS 0,10 ML 0,37 CPR 0,49 ML 0,12 G 0,98 GRAMA 0,78 G 1,45 G 1,04 G 1,86 UND 40,40 GRAMA 0,25

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6930 6931 6932 6933 6934 6935 6936 6937 6938 6939 6940 6941 6942 6943 6944 6945 6946 6947 6948 6949 6950 6951 6952 6953 6954 6955 6956 6957 6958 6959 6960 6961 6962 6963 6964 6965 6966 6967

CODIGO BENEFICIO 95029273 GINO-PLETIL 95510389 GINOTARIN 95510362 GINOTARIN 95510370 GINOTARIN 95510397 GINO-TERACIN B 95099590 GLALFITAL 95145362 GLAMIGAN 95145370 GLAMIGAN 95072217 GLAUB 95018824 GLAUCOTRAT 95971378 GLAUCOTRAT 95720154 GLAUTIMOL 95038485 GLIANSOR 95038469 GLIANSOR 95038477 GLIANSOR 95043705 GLIBEN 95430334 GLIBENCLAMIDA - GENERICO 95998675 GLIBENCLAMIDA - GENERICO 95998683 GLIBENCLAMIDA - GENERICO 95971386 GLIBENCLAMIDA - GENERICO 95018832 GLIBENCLAMIDA - GENERICO 95998691 GLIBENCLAMIDA - GENERICO 95099646 GLIBENCLAMIDA - GENERICO 95099654 GLIBENCLAMIDA - GENERICO 95123580 GLIBENCLAMIDA - GENERICO (Restrito Hosp,) 95894080 GLIBENDIABE 95430369 GLIBEXIL 95018840 GLICARON 95018859 GLICARON 95050175 GLICEL 95050183 GLICEL 95099662 GLICENAX 12% 95050191 GLICERIN 95050205 GLICERIN 95581510 GLICERINA A 12% (C/ SONDA RETAL) 95123598 GLICINA (Restrito Hosp,) 95971432 GLICOBEN 95123610 GLICONATO DE CALCIO (Restrito Hosp,)

APRESENTAÇÃO 45 g c/7 aplic, Creme tb, 28 g, Locao fr, 30 ml, Po fr, 30 g, Creme vag, bisn, 45 g+ 10 aplic, 20 mg/ml + 5 mg/ml sol, oft, gts, x 5,0 ml 0,3 mg/ml fr. 3 ml 0,3 mg/ml fr. 5 ml 2mg/mlsol,oft,x5ml 0,25 sol, fr, x 5 ml 0,5% sol, oft, fr, plast, got, x 5 ml 0,5% fr, 5 ml, 1 mg, 2 bl, x 15 cprs, 2 mg, 2 bl, x 15 cprs, 4 mg, 2 bl, x 15 cprs, 5 mg, 20 bl, x 10 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 3 x 10 cprs, 5 mg, 30 cprs, 5 mg, com, ct, bl, al, plas, inc, x 30 5 mg, cx, 30 cprs, 5 mg, com, ct, bl, plas, inc, x 400 (hosp,) 5 mg, 30 cprs, 5 mg, cx, 30 cprs 80 mg, 20 cprs, 80 mg, 60 cprs, Ad, cx, 6 supos, Inf, cx, 6 supos, Frasco IRR azul - 1 x 500 ml Ad, 1 x 6 sup, Lactente 1 x 6 sup, Fr com 500 ml 1,5% sol, inj, bolsa plast, inc, x 3000 ml 250 mg, cx, 20 cprs, 10% amp, 10 ml

Laboratorio PFIZER BUNKER BUNKER BUNKER NEO QUIMICA TEUTO BRAS, LEGRAND LEGRAND UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA ALCON LEGRAND LEGRAND LEGRAND CRISTALIA BIOSINTETICA GERMED GEN - LEGRAND RANBAXY ZYDUS EMS PRATI DONADUZZI NEO QUIMICA PRATI DONADUZZI SIGMA PHARMA ROYTON CIFARMA CIFARMA BRASTERAPICA BRASTERAPICA FRESENIUS KABI EMS EMS FRESENIUS BAXTER CAZI HALEX ISTAR

UNIDADE Pco Unt Base A UND 30,18 G 0,53 ML 0,37 G 0,61 G 0,62 GOTAS 0,49 ML 0,88 ML 0,80 GOTA 0,31 GOTA 0,04 GOTAS 0,07 GOTAS 0,07 CP 0,37 CP 0,73 CP 1,39 CP 0,09 CPR 0,19 COMP 0,20 COMP 0,19 CPR 0,15 COMP 0,17 COMP 0,20 COMP 0,20 COMP 0,19 COMP 0,08 COMP 0,18 CPR 0,14 COMP 0,42 COMP 0,51 UND 1,49 UND 1,44 FR 6,83 UND 1,54 UND 1,48 FR 5,43 FR 25,25 CPR 0,27 Amp 1,13

182

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 6968 6969 6970 6971 6972 6973 6974 6975 6976 6977 6978 6979 6980 6981 6982 6983 6984 6985 6986 6987 6988 6989 6990 6991 6992 6993 6994 6995 6996 6997 6998 6999 7000 7001 7002 7003 7004 7005

CODIGO BENEFICIO 95123628 GLICONATO DE CALCIO (Restrito Hosp,) 95123636 GLICONATO DE CALCIO (Restrito Hosp,) 95123644 GLICONATO DE CALCIO (Restrito Hosp,) 95137793 GLICOPIO 95137815 GLICOPIO 95137807 GLICOPIO 95137823 GLICOPIO 95137831 GLICOPIO 95137840 GLICOPIO 95998705 GLICORP 95123652 GLICORP (Restrito Hosp,) 95988122 GLICOSE 95988130 GLICOSE 95090517 GLICOSE 95620389 GLICOSE 95988149 GLICOSE 95041982 GLICOSE 95988157 GLICOSE 95988165 GLICOSE 95136720 GLICOSE 95136738 GLICOSE 95620397 GLICOSE 95620400 GLICOSE 95988173 GLICOSE 95988181 GLICOSE 95988190 GLICOSE 95123660 GLICOSE (Restrito Hosp,) 95123679 GLICOSE (Restrito Hosp,) 95123687 GLICOSE (Restrito Hosp,) 95123695 GLICOSE (Restrito Hosp,) 95123709 GLICOSE (Restrito Hosp,) 95123717 GLICOSE (Restrito Hosp,) 95123725 GLICOSE (Restrito Hosp,) 95136410 GLICOSE (Restrito Hosp,) 95581618 GLICOSE 10% SOLUCAO INJETAVEL 95581596 GLICOSE 10% SOLUCAO INJETAVEL 95581600 GLICOSE 10% SOLUCAO INJETAVEL 95581723 GLICOSE 5% SOLUCAO INJETAVEL

APRESENTAÇÃO 10% cx, 100 amps, plast, x 10 ml 10% cx, 200 amps, plast, x 10 ml 10% cx, 50 amps, plast, x 10 ml 15 mg. bl. 10 cprs. 15 mg. bl. 30 cprs. 30 mg. bl. 10 cprs. 30 mg. bl. 30 cprs. 45 mg. bl. 10 cprs. 45 mg. bl. 30 cprs. 250 mg, cx, 5 bl, x 10 cprs, 250 mg, cx, 50 bl, x 10 cprs, rev, (hosp,) 25% - 10 ml 25% - 20 ml 25% 10 ml amp, plast, 25% amp, 10 ml, 25% cx, 100 x 10 ml vidro 25% cx, 200 x 10 ml plast, 50% - 10 ml 50% - 20 ml 50% 10 ml cx, 200 amp, plast, 50% 20 ml cx, 100 amp, plast, 50% amp, 10 ml, 50% amp, 20 ml, 50% cx, 100 x 10 ml vidro 50% cx, 100 x 20 ml plast, 50% cx, 200 x 10 ml plast, 25% amp, 10 ml 25% cx, 200 x 10 ml plast, 50% - 10 ml 50% amp, 10 ml 50% amp, 20 ml 50% cx, 100 x 20 ml plast, 50% cx, 200 x 10 ml plast, 75% cx, 100 amps, vd, 10 ml Bolsa/Frasco em sistema fechado com 1000 ml Bolsa/Frasco em sistema fechado com 250 ml Bolsa/Frasco em sistema fechado com 500 ml Bolsa/Frasco em sistema fechado com 1000 ml

Laboratorio ISOFARMA ISOFARMA ISOFARMA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA NEO QUIMICA NEO QUIMICA BEKER BEKER FARMACE HALEX ISTAR HYPOFARMA HYPOFARMA BEKER BEKER FARMACE FARMACE HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA HYPOFARMA HALEX ISTAR HYPOFARMA BEKER HALEX ISTAR HALEX ISTAR HYPOFARMA HYPOFARMA HALEX ISTAR FRESENIUS FRESENIUS FRESENIUS FRESENIUS

UNIDADE Pco Unt Base A Amp 1,12 Amp 1,12 Amp 1,12 FA 2,76 ML 2,76 CPR 2,93 COMP 2,92 COMP 5,71 COMP 5,71 COMP 0,29 COMP 0,25 AMP 0,35 AMP 0,45 AMP 0,57 AP 0,51 AMP 0,72 AMP 0,58 AMP 0,40 AMP 0,58 AMP 0,29 AMP 0,58 AP 0,59 AP 0,84 AMP 0,83 AMP 1,32 AMP 0,75 AMP 0,47 AMP 0,53 AMP 0,38 AMP 0,55 AMP 0,78 AMP 1,18 AMP 0,67 AMP 0,95 FR 5,58 FR 2,47 FR 3,32 FR 4,44

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7006 7007 7008 7009 7010 7011 7012 7013 7014 7015 7016 7017 7018 7019 7020 7021 7022 7023 7024 7025 7026 7027 7028 7029 7030 7031 7032 7033 7034 7035 7036 7037 7038 7039 7040 7041 7042 7043

CODIGO BENEFICIO 95581731 GLICOSE 5% SOLUCAO INJETAVEL 95581707 GLICOSE 5% SOLUCAO INJETAVEL 95581715 GLICOSE 5% SOLUCAO INJETAVEL 95007814 GLICOSE HIPERTÔNICA 95998713 GLICOSE ISOTONICA 95430393 GLIfa*gE 95430407 GLIfa*gE 95430385 GLIfa*gE 95099670 GLIfa*gE XR 95099689 GLIfa*gE XR 95018891 GLIfa*gE XR 95084860 GLIfa*gE XR 95084878 GLIfa*gE XR 95430415 GLIMEPIBAL 95430423 GLIMEPIBAL 95430431 GLIMEPIBAL 95430466 GLIMEPIL 95430458 GLIMEPIL 95430440 GLIMEPIL 95971440 GLIMEPIL 95894098 GLIMEPIRIDA - GENERICO 95099697 GLIMEPIRIDA - GENERICO 95072276 GLIMEPIRIDA - GENERICO 95038523 GLIMEPIRIDA - GENERICO 95056084 GLIMEPIRIDA - GENERICO 95072233 GLIMEPIRIDA - GENERICO 95072284 GLIMEPIRIDA - GENERICO 95043713 GLIMEPIRIDA - GENERICO 95971459 GLIMEPIRIDA - GENERICO 95894101 GLIMEPIRIDA - GENERICO 95894110 GLIMEPIRIDA - GENERICO 95099700 GLIMEPIRIDA - GENERICO 95072250 GLIMEPIRIDA - GENERICO 95038531 GLIMEPIRIDA - GENERICO 95056092 GLIMEPIRIDA - GENERICO 95072241 GLIMEPIRIDA - GENERICO 95072292 GLIMEPIRIDA - GENERICO 95038558 GLIMEPIRIDA - GENERICO

APRESENTAÇÃO Bolsa/Frasco em sistema fechado com 125 ml Bolsa/Frasco em sistema fechado com 250 ml Bolsa/Frasco em sistema fechado com 500 ml Bolsa/Frasco em sistema fechado com500 ml a 50% Bolsa/Frasco em sistema fechado com250 ml a 5% 1000 mg, 30 cprs, rev, 500 mg, cx, 30 cprs, rev, 850 mg, 30 cprs, rev, 1 g ct, bl, al, plas, inc, x 10 cprs, 1 g ct, bl, al, plas, inc, x 30 cprs, 500 mg, 30 cprs, 750 mg, acao prolong, ct, bl, al, plas, inc, x 10 cprs, 750 mg, acao prolong, ct, bl, al, plas, inc, x 30 cprs, 1 mg cx, 30 cprs, 2 mg cx, 30 cprs, 4 mg cx, 30 cprs, 1 mg, 30 cprs, 2 mg, 30 cprs, 4 mg, 30 cprs, 6 mg, 30 cprs, 1 mg, 30 cp, 1 mg, 30 cprs, 1 mg, bl, 10 cprs, 1 mg, bl, 30 cprs, 1 mg, bl, 30 cprs, 1 mg, bl, 30 cprs, 1 mg, bl, 450 cprs, (hosp,) 1 mg, cprs, ct, bl, al, plas, inc, x 30 1 mg, ct, bl, al, plast, inc, x 30 1 mg, ct, bl, al, plast, inc, x 30 cprs, 2 mg, 30 cp, 2 mg, 30 cprs, 2 mg, bl, 10 cprs, 2 mg, bl, 30 cprs, 2 mg, bl, 30 cprs, 2 mg, bl, 30 cprs, 2 mg, bl, 450 cprs, (hosp,) 2 mg, bl, 60 cprs,

Laboratorio FRESENIUS FRESENIUS FRESENIUS GLAXOSMITHKLINE MERCK MERCK MERCK MERCK MERCK MERCK MERCK MERCK BALDACCI BALDACCI BALDACCI FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA NOVARTIS BUNKER ACCORD MEDLEY SANDOZ ACCORD ACCORD SANOFI-AVENTIS BIOSINTETICA MERCK NOVARTIS BUNKER ACCORD MEDLEY SANDOZ ACCORD ACCORD MEDLEY

UNIDADE Pco Unt Base A FR 1,50 FR 2,12 FR 2,75 FR 3,87 FR 1,55 CPR 0,77 CPR 0,36 CPR 0,49 COMP 0,81 COMP 0,81 COMP 0,35 COMP 0,59 COMP 0,59 CPR 0,52 CPR 0,85 CPR 1,67 CPR 0,54 CPR 1,08 CPR 1,95 CPR 2,73 COMP 0,34 COMP 0,36 COMP 0,49 CP 0,48 COMP 0,50 COMP 0,48 COMP 0,39 CP 0,44 CPR 0,43 COMP 0,48 COMP 0,56 COMP 0,69 COMP 0,95 CP 0,83 COMP 0,81 COMP 0,83 COMP 0,75 CP 0,72

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7044 7045 7046 7047 7048 7049 7050 7051 7052 7053 7054 7055 7056 7057 7058 7059 7060 7061 7062 7063 7064 7065 7066 7067 7068 7069 7070 7071 7072 7073 7074 7075 7076 7077 7078 7079 7080 7081

CODIGO BENEFICIO 95043721 GLIMEPIRIDA - GENERICO 95043730 GLIMEPIRIDA - GENERICO 95971467 GLIMEPIRIDA - GENERICO 95894128 GLIMEPIRIDA - GENERICO 95029281 GLIMEPIRIDA - GENERICO 95099719 GLIMEPIRIDA - GENERICO 95894136 GLIMEPIRIDA - GENERICO 95099727 GLIMEPIRIDA - GENERICO 95099735 GLIMEPIRIDA - GENERICO 95072314 GLIMEPIRIDA - GENERICO 95038540 GLIMEPIRIDA - GENERICO 95056106 GLIMEPIRIDA - GENERICO 95072268 GLIMEPIRIDA - GENERICO 95072306 GLIMEPIRIDA - GENERICO 95038566 GLIMEPIRIDA - GENERICO 95056114 GLIMEPIRIDA - GENERICO 95043748 GLIMEPIRIDA - GENERICO 95971475 GLIMEPIRIDA - GENERICO 95894144 GLIMEPIRIDA - GENERICO 95043756 GLIMEPIRIDA - GENERICO 95123733 GLIMEPIRIDA - GENERICO (Restrito Hosp,) 95123741 GLIMEPIRIDA - GENERICO (Restrito Hosp,) 95123750 GLIMEPIRIDA - GENERICO (Restrito Hosp,) 95971483 GLIMEPRID 95430474 GLIMEPRID 95971491 GLIMEPRID 95998721 GLIMERAN 95099743 GLIMIL 95056122 GLIMIL 95998730 GLIMIPERIDA - GENERICO 95998748 GLIMIPERIDA - GENERICO 95123768 GLINEON FRUTOSE 95430512 GLIONIL 95099751 GLIONIL 95133070 GLIOTEN 95133089 GLIOTEN 95133100 GLIOTEN 95133097 GLIOTEN

APRESENTAÇÃO 2 mg, cprs, ct, bl, al, plas, inc, x 30 2 mg, cprs, ct, bl, al, plas, inc, x 60 2 mg, ct, bl, al, plast, inc, x 30 2 mg, ct, bl, al, plast, inc, x 30 cprs, 4 mg 60 cp, 4 mg, 2 bl, x 15 cprs, 4 mg, 30 cp, 4 mg, 30 cprs, 4 mg, 4 bl, x 15 cprs, 4 mg, bl, 10 cprs, 4 mg, bl, 30 cprs, 4 mg, bl, 30 cprs, 4 mg, bl, 30 cprs, 4 mg, bl, 450 cprs, (hosp,) 4 mg, bl, 60 cprs, 4 mg, bl, 60 cprs, 4 mg, cprs, ct, bl, al, plas, inc, x 30 4 mg, ct, bl, al, plast, inc, x 30 4 mg, ct, bl, al, plast, inc, x 30 cprs, 4 mg,cprs, ct, bl, al, plas, inc,x60 1 mg, bl, 450 cprs, (hosp,) 2 mg, bl, 450 cprs, (hosp,) 4 mg, bl, 450 cprs, (hosp,) 1 mg, 30 cprs, 2 mg 30 cprs, 4 mg, 30 cprs, 2 mg, 2 bl, x 15 cprs, 5 mg, 20 cprs, 5 mg, cx, 30 cprs 2 mg, 30 cprs, 4 mg, 30 cprs, 480 ml 5 mg cx, 1 bl, x 30 cprs, 5 mg, cx, 1 bl, x 30 cprs, 10 mg 30 cprs, 2,5 mg 30 cprs, 20 mg 30 cprs, 5,0 mg 30 cprs,

Laboratorio SANOFI-AVENTIS SANOFI-AVENTIS BIOSINTETICA MERCK NOVARTIS EMS NOVARTIS BUNKER EMS ACCORD MEDLEY SANDOZ ACCORD ACCORD MEDLEY SANDOZ SANOFI-AVENTIS BIOSINTETICA MERCK SANOFI-AVENTIS ACCORD ACCORD ACCORD HEXAL HEXAL HEXAL NEO QUIMICA MULTILAB MILIAN EUROFARMA EUROFARMA DOVALLE NEO QUIMICA NEO QUIMICA BAGO BAGO BAGO BAGO

UNIDADE Pco Unt Base A CP 0,75 CP 0,65 CPR 0,72 COMP 0,84 CP 0,65 COMP 1,32 COMP 0,98 COMP 1,35 COMP 1,06 COMP 1,83 CP 1,44 COMP 1,43 COMP 1,44 COMP 1,45 CP 1,22 COMP 0,95 CP 1,29 CPR 1,25 COMP 1,45 CP 1,03 COMP 0,43 COMP 0,82 COMP 1,59 CPR 0,45 CPR 0,80 CPR 1,39 COMP 0,81 COMP 0,22 COMP 0,14 COMP 0,68 COMP 1,33 UNID 18,18 CPR 0,14 COMP 0,20 CPR 0,61 CPR 0,53 CPR 0,83 CPR 0,40

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7082 7083 7084 7085 7086 7087 7088 7089 7090 7091 7092 7093 7094 7095 7096 7097 7098 7099 7100 7101 7102 7103 7104 7105 7106 7107 7108 7109 7110 7111 7112 7113 7114 7115 7116 7117 7118 7119

CODIGO BENEFICIO 95133119 GLIOTENZIDE 95133127 GLIOTENZIDE 95611959 GLIPLEX 95611967 GLIPLEX 95378073 GLITISOL 95378081 GLITISOL 95998756 GLIVEC (ICMS 0%) 95998764 GLIVEC (ICMS 0%) 95971505 GLOSSALIV 95998772 GLUCAGEN HYPOKIT 95123776 GLUCANTIME 95410198 GLUCANTIME 95430555 GLUCOBAY 95430547 GLUCOBAY 95430571 GLUCOFORMIN 95430563 GLUCOFORMIN 95066330 GLUCONATO DE CALCIO 95018905 GLUCOREUMIN 95018913 GLUCOREUMIN 95998799 GLUCOSIL 95099760 GLUCOVANCE 95099778 GLUCOVANCE 95430610 GLUCOVANCE 95099786 GLUCOVANCE 95099794 GLUCOVANCE 95430628 GLUCOVANCE 95430636 GLUCOVANCE 95998810 GLYCOPHOS 95099808 GLYCOPIRIDA 95099816 GLYCOPIRIDA 95099824 GLYCOPIRIDA 95099832 GLYFLUCAN 95099840 GLYFLUCAN 95170090 GLYFLUCAN 95044710 GLYPRESSIN 95971530 GLYQUIN 95490213 GLYVENOL 95090541 GONADOPIN (Restrito Hosp,)

APRESENTAÇÃO 10/25 mg, 30 cprs, 20/12,5 mg, 30 cprs, Inj, cx, 5 amps, 10 ml, Inj, cx, 5 amps, 20 ml, 2 env, gran, x 8 g 500 mg, caps, gel, dura 2 bl, x 10 100 mg, 60 ce 400 mg, 30 ce Pom, bisn, 45 g Fr, c/ 1 mg/1 UI+ dil, 300 mg/ml sol, inj, cx, 50 amps, x 5 ml 300 mg/ml sol, inj, cx,25 amps, x 5 ml 100 mg, x 30 cprs, 50 mg, x 30 cprs, 500 mg, cx, 30 cprs 850 mg, cx, 30 cprs 10% inj, cx, 100 amps, x 10 ml 1500 mg, po sol, or, 10 saches x 3,95 g 1500 mg, po sol, or, 30 saches x 3,95 g 5 mg, cx, 3 bl,x10 cprs, 1000 mg, + 5 mg, bl, 10 cprs, rev, 1000 mg, + 5 mg, bl, 30 cprs, rev, 250 mg+ 1,25 mg 2 bl, x 15 cprs, rev, 500 mg, + 2,5 mg, bl, x 10 cprs, rev, 500 mg, + 5 mg, bl, x 10 cprs, rev, 500 mg+ 2,5 mg 2 bl, x 15 cprs, rev, 500 mg+ 5 mg 2 bl, x 15 cprs, 10 x 20 ml 1 mg, 2 bl, x 15 cprs, 2 mg, 2 bl, x 15 cprs, 4 mg, 2 bl, x 15 cprs, 150 mg, 1 bl, x 1 cap, 150 mg, 1 bl, x 2 caps, 150 mg, 1 cap, 1 mg, cart,1amp,transp, po liof,+1amp,dil, Creme 1 fr, 28 g 40 drags, 150 UI sol, inj, ct, fr, 1 ml

Laboratorio BAGO BAGO FARMASA FARMASA ZAMBON ZAMBON NOVARTIS NOVARTIS SIGMA PHARMA NOVO NORDISK SANOFI-AVENTIS SANOFI-AVENTIS BAYER BAYER NOVO NORDISK PROD, NOVO NORDISK PROD, ARISTON ZAMBON ZAMBON LUPER MERCK MERCK MERCK MERCK MERCK MERCK MERCK FRESENIUS KABI SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA GERMED PHARMA GERMED PHARMA LEGRAND FERRING VALEANT NOVARTIS BERGAMO

UNIDADE Pco Unt Base A CPR 0,81 CPR 1,28 AP 1,40 AP 1,46 ENV 11,22 CPR 2,27 COMP 81,48 COMP 325,91 G 0,13 UNID 92,15 AMP 5,00 AP 5,76 CPR 1,49 CPR 1,00 CPR 0,43 CPR 0,60 AMP 1,01 ENV 4,32 ENV 3,89 COMP 0,16 COMP 1,33 COMP 1,41 CPR 0,31 COMP 0,60 COMP 0,82 CPR 0,63 CPR 0,82 AMP 65,35 COMP 0,41 COMP 0,62 COMP 1,08 CAPS 17,41 CAPS 17,41 CPR 14,67 AMP 201,54 G 1,78 CPR 0,84 UND 325,29 X

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7120 7121 7122 7123 7124 7125 7126 7127 7128 7129 7130 7131 7132 7133 7134 7135 7136 7137 7138 7139 7140 7141 7142 7143 7144 7145 7146 7147 7148 7149 7150 7151 7152 7153 7154 7155 7156 7157

CODIGO BENEFICIO 95090550 GONADOPIN (Restrito Hosp,) 95123784 GONAL F 95123792 GONAL F PEN 95123806 GONAL F PEN 95123814 GONAL F PEN

APRESENTAÇÃO 75 UI sol, inj, ct, fr, 1 ml 75 UI cx, 1 FA po liof, p/inj, + 1 ser, solv, 300 UI (22 mcg)/0,5 ml 450 UI (33 mcg)/0,75 ml 900 UI (66 mcg)/1,5 ml

Laboratorio BERGAMO MERCK MERCK MERCK MERCK

UNIDADE Pco Unt Base A UND 155,94 X FA 164,54 FA 658,17 FA 987,29 FA 1974,55

95490264 GONAPEPTYL DEPOT 95998853 GRANISETRONA CLOR, - GENERICO 95123822 GRANISETRONA CLOR, - GENERICO (Restrito Hosp,) 95890050 GRANOCYTE 95123830 GRANOMAX (Restrito Hosp,) 95123849 GRANOMAX (Restrito Hosp,) 95890084 GRANULOKINE 95890076 GRANULOKINE 95894179 GUAIFENESINA - GENERICO 95894187 GUAIFENESINA - GENERICO 95099859 GUAIFENESINA - GENERICO 95099867 GUAIFENESINA - GENERICO 95050221 GUTTALAX 95050213 GUTTALAX 95971548 GYNAZOLE 95510451 GYNO FUNGIX 95510460 GYNO IRUXOL 95018972 GYNO MICOSIN 95510494 GYNO-DAKTARIN 95490272 GYNODAL 95510516 GYNO-ICADEN 95510524 GYNO-ICADEN 95510532 GYNOMAX 95971556 GYNO-MICOSIN 95894195 GYNOPAC PLUS 95018980 GYNOPLUS 95066349 HAEMATE P (CONCENTRADO DE FATOR VIII) 95170111 HAEMATE P (CONCENTRADO DE FATOR VIII) 95075097 HAEMOCOMPLETTAN-P 95280219 HALDOL 95998950 HALDOL 95280251 HALDOL 95280200 HALDOL

3,75 mg/ml cart, 1 ser,de po+ 1 ser, dil, Inj, 1 amp, vd, x 3 ml 1 mg/ml sol, inj, 10 amps, vd, x 3 ml 5 ser, preenchidas dil, 1 ml+ 5 FA inj, 33,6 MUI 300 mcg 5 FA vd, 300 mcg sol, inj, 1 ser, preench, plast, x 1 ml 30 - 1 ser, preenchida 0,3 mg/0,5 ml 30 MIO cx, 5 FA 1 ml, 200 mg/12,5 ml xpe, mel fr, 120 ml Xpe, 200 mg/12,5 ml fr, 120 ml Xpe, cereja 13,3 mg/ml 120 ml Xpe, mel 16 mg/ml fr, 120 ml Perolas gel, fr, c/50 Sol, oral fr, 20 ml, Creme vag, 2% 1 aplic, env, 5 g Bisn, 30 g, c/5 aplic, Pom, ginec, bg, c/30 g,+ 1 aplic, Creme vag, bisn, 80 g Bisn, alum, 80 g, 160 mg, cx, 30 cprs, Creme vag, 40 g,+ 7 aplic, Ovulo 600 mg, - bl, c/1 ovulo Creme bisn, 35 g,+ 7 aplic, Creme vag, 20 mg/g bisn, 80 g Creme bisn, 35 g+ 7 aplic, vag,+ 4 cprs, 1000 mg, Creme bisn, 40 g+ 7 aplic, 500 UI - 25 UI/ml liof, inj, ct, fr,+ dil, x 10 ml 250 UI - 25 UI/ml liof, inj, ct fr,+ dil, x 5 ml - por UI 1 g po liof, ct, FA vd, inc, 1 mg, blister 20 cprs, 2 mg, gts, fr, 30 ml, 5 mg, inj, cart, 5 amps, 1 ml 5 mg, vd, 20 cprs,

FERRING FA EUROFARMA AMP EUROFARMA AMP SANOFI-AVENTIS UND DR, REDDY'S/GLAXOSMITHKLINE FA DR, REDDY'S/GLAXOSMITHKLINE UND ROCHE AP ROCHE FA EMS ML GEN - LEGRAND ML NEO QUIMICA ML NEO QUIMICA ML BOEHRINGER INGELHEIM UND BOEHRINGER INGELHEIM GOTAS SIGMA PHARMA G JANSSEN - CILAG G ABBOTT G MEDIC GRAMA JANSSEN - CILAG G ASTA MEDICA ONCOLOGIA CPR SCHERING G SCHERING UND FARMOQUIMICA G MEDIC G FARMOQUIMICA G GALLIA GRAMA CSL BEHRING FA CSL BEHRING FA CSL BEHRING FA JANSSEN - CILAG CPR JANSSEN - CILAG GOTA JANSSEN - CILAG AP JANSSEN - CILAG CPR

494,96 76,95 76,94 388,98 315,99 315,98 353,30 352,40 0,06 0,06 0,07 0,07 0,35 0,02 8,80 1,27 1,06 0,13 0,20 4,27 0,98 44,41 1,16 0,13 1,33 0,51 1099,00 X 565,59 1427,66 X 0,17 0,01 3,10 0,33

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7158 7159 7160 7161 7162 7163 7164 7165 7166 7167 7168 7169 7170 7171 7172 7173 7174 7175 7176 7177 7178 7179 7180 7181 7182 7183 7184 7185 7186 7187 7188 7189 7190 7191 7192 7193 7194 7195

CODIGO BENEFICIO 95123857 HALDOL (Restrito Hosp,) 95056157 HALO 95056130 HALO 95056165 HALO 95056149 HALO 95066357 HALO 95280278 HALO DECANOATO 95123865 HALOPER (Restrito Hosp,) 95123873 HALOPER (Restrito Hosp,) 95280316 HALOPERIDOL - GENERICO 95894225 HALOPERIDOL - GENERICO 95123881 HALOPERIDOL - GENERICO (Restrito Hosp,) 95123890 HALOPERIDOL - GENERICO (Restrito Hosp,) 95123903 HALOPERIDOL - GENERICO (Restrito Hosp,) 95530371 HANTINA 95099875 HECLIVIR 95400664 HECLIVIR (*) 95123911 HECLIVIR (Restrito Hosp,) 95099883 HEIMER 95099891 HEIMER 95099905 HEIMER 95378162 HELICOPAC 95971564 HELICOPAC IBP 95056190 HELLEVA 95056181 HELLEVA 95420568 HELMIBEN 95420576 HELMIBEN 95378197 HELMIZOL 95378200 HELMIZOL 95378219 HELMIZOL 95378189 HELMIZOL 95123920 HELMIZOL (Restrito Hosp,) 95570993 HEMATIASE 95571000 HEMATOFER 95123938 HEMATOFER (Restrito Hosp,) 95571043 HEMAX 95571027 HEMAX 95571078 HEMAX

APRESENTAÇÃO 5 mg, inj, cart, 5 amps, 1 ml 1 mg, 20 bl, 10 cps, 10 mg, 20 bl, 10 cps, 2 mg/ml 10 fr, 1 ml 5 mg, 20 bl, 10 cps, 5 mg/ml50amps,1ml Cx, 3 amps, 50 mg/ml x 1 ml 5 mg, 100 cprs, (hosp,) Sol, inj, 5 mg/ml cx, 25 amps, x 1 ml (hosp,) 2 mg/ml gts, fr, 20 ml, Sol, oral fr, 20 ml 5 mg/ml cx, 50 amps, x 1 ml 5 mg/ml inj, cx, 50 amps, (hosp,) 5 mg/ml sol, inj, 1 ml c/60 (hosp,) 5 mg/ml susp, oral fr, 120 ml, Creme bisn, 10 g 200 mg cx, 5 bl, x 5 cprs, 200 mg, cx, bl, 500 cprs, (hosp,) 10 mg, bl, 15 cprs, rev, 10 mg, bl, 30 cprs, rev, 10 mg, bl, 60 cprs, rev, 7 cart, bl, x 6 cprs, 7 cart,+ 1 bl, x 14 80 mg, cprs, ct, bl, al, plast, inc, x 4 80 mg, cprs, ct, bl, plast, inc, x 2 NF 6 cprs, Susp, inf, fr, 30 ml Bl, 20 cprs, 250 mg, Bl, 20 cprs, 500 mg Gel bisn, 50 g+ aplic, Susp, 80 ml, 250 mg, 50 bl, x 10 cprs, (hosp,) B12 fr, 150 ml, 109 mg 500 cprs, 109 mg, com, rev, ct, 25 bl, al, plas, inc, x 20 (hosp,) 10000 U,I, 1 FA 2000 UI 1 FA 3000 UI 1 FA

Laboratorio JANSSEN - CILAG CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA TEUTO BRAS, TEUTO BRAS, UNIAO QUIMICA GEN - LEGRAND HYPOFARMA TEUTO BRAS, TEUTO BRAS, APSEN NEO QUIMICA NEO QUIMICA NEO QUIMICA EUROFARMA EUROFARMA EUROFARMA SIGMA PHARMA SIGMA PHARMA CRISTALIA CRISTALIA EUROFARMA EUROFARMA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, GROSS PRATI DONADUZZI PRATI DONADUZZI BIOSINTETICA BIOSINTETICA BIOSINTETICA

UNIDADE Pco Unt Base A AMP 3,36 CAPS 0,10 CAPS 0,20 GOTA 0,16 CAPS 0,16 AMP 2,95 AP 9,35 COMP 0,04 AMP 0,35 GOTAS 0,01 GOTAS 0,01 AMP 1,93 AMP 1,54 AMP 1,54 ML 0,13 GRAMA 1,70 CPR 2,37 COMP 2,09 COMP 1,36 COMP 1,29 COMP 1,27 CPR 2,56 CPR 7,89 COMP 11,61 COMP 11,61 CPR 2,18 ML 0,42 CPR 0,47 CPR 0,56 G 0,30 ML 0,13 COMP 0,33 ML 0,12 CPR 0,03 COMP 0,03 FA 310,28 FA 63,21 FA 90,74

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7196 7197 7198 7199 7200 7201 7202 7203 7204 7205 7206 7207 7208 7209 7210 7211 7212 7213 7214 7215 7216 7217 7218 7219 7220 7221 7222 7223 7224 7225 7226 7227 7228 7229 7230 7231 7232 7233

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio UNIDADE Pco Unt Base A 95571035 HEMAX 4000 UI 1 FA BIOSINTETICA FA 96,17 95123946 HEMITARTARATO DE NOREPINEFRINA - GENERICO (Restrito2 Hosp,) mg/ml sol, inj, IV cx, 50 amps, vd, x 4 ml NOVAFARMA AMP 6,85 95123954 HEMITARTARATO DE RIVASTIGMINA - GENERICO (Restrito Hosp,) 2 mg/ml sol, or, fr, vd, amb, x 120 ml, + ser, dos, BERGAMO AMP 203,84 95971572 HEMOBLOCK 250 mg, 4 str, x 6 cprs, SIGMA PHARMA CPR 9,27 95971580 HEMOBLOCK 250 mg/5 ml, inj, 5 amps, 5 ml SIGMA PHARMA AP 5,08 95971599 HEMOBLOCK 500 mg, 2 str, x 6 cprs, SIGMA PHARMA CPR 4,64 95099913 HEMOCORT Pom, bisn, 25 g CIFARMA GRAMA 0,78 95019022 HEMOPREX 1000 UI ct, 1 ser, vd, preench, x 1 ml BERGAMO UNID 291,34 95571094 HEMOPREX 4000 UI cx, 6 amps, BERGAMO AP 123,52 95899855 HEPA MERZ 0,5 g/ml inf, ct, 5 amps, vd, amb, x 10 ml BIOLAB SANUS AMP 37,28 95899863 HEPA MERZ 0,6 g/g gran, ct, 10 envs, al, poliet, x 5 g BIOLAB SANUS ENV 6,26 95123970 HEPAMAX S 5000 UI/ml cx, 25 FA vd, x 5 ml BLAUSIEGEL FA 6,53 95160370 HEPARIN 5000 UI/0,25 ml, subc, 25 amp, CRISTALIA AP 1,61 95160388 HEPARIN 5000 UI/ml, 25 fr, 5 ml, CRISTALIA FA 6,77 95075127 HEPATECT CP 100 UI amp, 2 ml MARCOS PEDRILSON AMP 275,85 X 95075135 HEPATECT CP 2000 UIamp,40ml MARCOS PEDRILSON AMP 4125,39 X 95075143 HEPATECT CP 500 UI amp, 10 ml MARCOS PEDRILSON AMP 1186,58 X 95099921 HEPATOREGIUS 120 ml DOVALLE UNID 14,64 95099930 HEPATOX 100 flaconetes x 10 ml CIFARMA UNID 1,35 95999051 HEPTAR Display c/50 EUROFARMA UND 5,80 95019081 HEPTRON 100 mg, sol, inj, cx, 2 ser, preench, x 1,0 ml CELLOFARM UNID 13,63 95019049 HEPTRON 20 mg, sol, inj, cx, 10 ser, preench, x 0,2 ml CELLOFARM UNID 13,95 95019057 HEPTRON 40 mg, sol, inj, cx, 10 ser, preench, x 0,4 ml CELLOFARM UNID 27,11 95019065 HEPTRON 60 mg, sol, inj, cx, 10 ser, preench, x 0,6 ml CELLOFARM UNID 40,35 95019073 HEPTRON 80 mg, sol, inj, cx, 10 ser, preench, x 0,8 ml CELLOFARM UNID 54,15 95541470 HERCEPTIN 440 mg, 1 fr,+ 1 fr, dil, x 20 ml ROCHE MG 19,77 X 95400672 HERPESIL Cr, bisn, 10 g, HEXAL G 1,55 95999060 HERPESIL (*) 200 mg, 5 bl, x 5 cprs, HEXAL COMP 1,79 95400699 HERPESINE Sol, 1 cpr, 10 mg, c/1 fr, amp, c/10 ml, NIKKHO UND 28,13 95400702 HERPEX GEL 10 g, UNIAO QUIMICA G 2,57 95099948 HERPSTAL 500 mg, 2 bl, x 5 cprs, rev, SIGMA PHARMA COMP 6,01 95988211 HESTAR 0,06 g/ml sol, inj, bolsa PVC plas, x 500 ml CLARIS UNID 78,00 95988220 HESTAR 0,06 g/ml sol, inj, fr, vd, x 500 ml CLARIS UNID 78,00 95988238 HESTAR 0,1 g/ml sol, inj, bolsa PVC plas, x 500 ml CLARIS UNID 106,50 95988246 HESTAR 0,1 g/ml sol, inj, fr, vd, x 500 ml CLARIS UNID 106,50 95971629 HEXOMEDINE Col,fr,vd,spray50ml SANOFI-AVENTIS ML 0,58 95125795 HIALURONATO SODIO + SULFATO CONDROITINA DE SODIOSERINGA/DISCOVISC; (USO EXCLUSIVO NODOSAGEM: HPM) 1,65% HIALURONATOAlcon SODIO + 4% SULFATO CONDROITINA Unidade 109,50 95999108 HIBUTAN (CLOR, DOBUTAMINA) 250 mg, bolsa 250 ml HALEX ISTAR UNID 55,11

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7234 7235 7236 7237 7238 7239 7240 7241 7242 7243 7244 7245 7246 7247 7248 7249 7250 7251 7252 7253 7254 7255 7256 7257 7258 7259 7260 7261 7262 7263 7264 7265 7266 7267 7268 7269 7270 7271

CODIGO BENEFICIO 95999116 HIBUTAN (CLOR, DOBUTAMINA) 95378235 HICACINA (AMICACINA) 95378251 HICACINA (AMICACINA) 95662227 HICLOFEN (DICLOFENACO SODICO) 95390944 HICONAZOL (FLUCONAZOL) 95378286 HICONCIL 95378294 HICONCIL 95378260 HICONCIL 95378308 HICONCIL 95340378 HIDANTAL 95340360 HIDANTAL 95066438 HIDANTAL INJETAVEL 95085661 HIDAZOL (METRONIDAZOL 0,5%) - BLOWPACK 95894233 HIDRABENE 95894241 HIDRAFIX 95580948 HIDRAFIX 95894250 HIDRAFIX 95894268 HIDRAFIX 95999124 HIDRAFIX 95894276 HIDRAFIX 95971637 HIDRATIL 95971645 HIDRATIL 95971653 HIDRATIL 95099956 HIDRATIL 95099964 HIDRATIL 95971670 HIDRATIL 95099972 HIDRATIL 95910557 HIDRATO DE CLORAL A 10% 95099980 HIDRAZIM 95099999 HIDRAZIM 95072357 HIDRAZIN 95072349 HIDRAZIN 95100415 HIDRION 95100423 HIDRION 95110500 HIDROALERG 95019090 HIDROCIN 95750410 HIDROCIN 95019120 HIDROCLOROTIAZIDA - GENERICO

APRESENTAÇÃO 500mg,bolsa250ml 100 mg amp, 2 ml, 500 mg amp, 2 ml, Amp, 3 ml, Bolsa 100 ml, 125 mg/5 ml po p/susp, fr, 150 ml 250 mg/5 ml po p/susp, fr, 150 ml 500 mg, 3 bl, 5 caps, 500 mg/5 ml po p/susp, fr, 150 ml Cx, 25 cprs, Inj, cx, 50 amps, Cx, 50 amps, Cx, 60 bolsas PE 100 ml Po 27,9 g 4 sachet 90 - sol, oral conc, ct, 2 flac, x 25 ml 90 sol, oral fr, 250 ml Framboesa sol, oral conc, ct, 2 flac, x 25 ml Laranja sol, oral conc, ct, 2 flac, x 25 ml Sol, oral fr, 250 ml Uva sol, oral conc, ct, 2 flac, x 25 ml 45 po sol oral (laranja) cx, 12 envs, 45 po sol oral (laranja) cx, 50 envs, 45 po sol, oral (framboesa) cx, 12 envs, 45 po sol, oral (framboesa) cx, 50 envs, 45 po sol, oral (laranja) cx, 50 envs, 90 po sol, oral cx, 12 envs, 90 po sol, oral cx, 50 envs, Fr c/ 200 ml 25 mg, - 2 strip, 10 cprs, 50 mg, - 2 strip, 10 cprs, 25 mg, cx, 20 cprs, 50 mg, cx, 20 cprs, Cx, 1 bl, x 20 cprs, Cx, 2 bl, x 15 cprs, 2 mg/ml sol, oral fr, 120 ml Sol, nasal fr, plast, spray 20 ml Spray, fr, 10 ml, 25 mg, 2 bl, x 15 cprs,

Laboratorio HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR B-MS B-MS B-MS B-MS SANOFI-AVENTIS AVENTIS PHARMA SANOFI-AVENTIS HALEX ISTAR LEGRAND NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO DUCTO MULTILAB MULTILAB MILIAN MILIAN GROSS GROSS SIGMA PHARMA ACHE ACHE GERMED

UNIDADE Pco Unt Base A UNID 99,26 AP 1,23 AP 3,35 AP 0,62 UND 92,09 ML 0,15 ML 0,22 CPR 1,96 ML 0,35 CPR 0,24 AP 2,20 AMP 2,63 UNID 7,31 ENV 2,95 UNID 2,92 ML 0,03 UND 2,92 UNID 2,92 ML 0,03 UNID 2,81 ENV 2,74 ENV 2,31 ENV 2,74 ENV 2,74 ENV 2,74 ENV 3,19 ENV 2,94 ML 0,19 COMP 0,19 COMP 0,21 COMP 0,17 COMP 0,19 CPR 0,58 CPR 0,55 ML 0,17 DOSE 0,08 DOSE 0,04 COMP 0,12

190

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7272 7273 7274 7275 7276 7277 7278 7279 7280 7281 7282 7283 7284 7285 7286 7287 7288 7289 7290 7291 7292 7293 7294 7295 7296 7297 7298 7299 7300 7301 7302 7303 7304 7305 7306 7307 7308 7309

CODIGO BENEFICIO 95019146 HIDROCLOROTIAZIDA - GENERICO 95019103 HIDROCLOROTIAZIDA - GENERICO 95072365 HIDROCLOROTIAZIDA - GENERICO 95056203 HIDROCLOROTIAZIDA - GENERICO 95056220 HIDROCLOROTIAZIDA - GENERICO 95971696 HIDROCLOROTIAZIDA - GENERICO 95019138 HIDROCLOROTIAZIDA - GENERICO 95019154 HIDROCLOROTIAZIDA - GENERICO 95019111 HIDROCLOROTIAZIDA - GENERICO 95072373 HIDROCLOROTIAZIDA - GENERICO 95056211 HIDROCLOROTIAZIDA - GENERICO 95056238 HIDROCLOROTIAZIDA - GENERICO 95110518 HIDROCLOROTIAZIDA - GENERICO 95123989 HIDROCLOROTIAZIDA - GENERICO (Restrito Hosp,) 95123997 HIDROCLOROTIAZIDA - GENERICO (Restrito Hosp,) 95450831 HIDROCORTEX 95450823 HIDROCORTEX 95019197 HIDROCORTISONA - GENERICO 95019170 HIDROCORTISONA - GENERICO 95019219 HIDROCORTISONA - GENERICO 95988254 HIDROFLUX 95056246 HIDROSAN 95038590 HIDROSONE 95038582 HIDROSONE 95056254 HIDROXIDO DE ALUMINIO 95056262 HIDROXIDO DE ALUMINIO 95056270 HIDROXIDO DE ALUMINIO 95072381 HIDROXIDO DE ALUMINIO - GENERICO 95072390 HIDROXIDO DE ALUMINIO - GENERICO 95971726 HIDROXIDO DE ALUMINIO - GENERICO 95999140 HIDROXIDO DE ALUMINIO - GENERICO 95985417 HIDROXIDO DE ALUMINIO - GENERICO 95011137 HIDROXIDO DE ALUMINIO - GENERICO 95056289 HIDROXIDO DE ALUMINIO + MAGNESIO 95056297 HIDROXIDO DE ALUMINIO + MAGNESIO 95056300 HIDROXIDO DE ALUMINIO + MAGNESIO 95072403 HIDROXIMED 95378316 HIFLOXAN (CIPROFLOXACINA)

APRESENTAÇÃO Laboratorio 25 mg, 2 bl, x 15 cprs, GEN - LEGRAND 25 mg, 30 cprs, EMS 25 mg, bl, 30 cprs, SANOFI-AVENTIS 25 mg, com, ct, bl, al, plas, inc, x 30 PRATI DONADUZZI 25 mg, com, ct, bl, al, plas, inc, x 400 (hosp,) PRATI DONADUZZI 50 mg, 1 bl, x 20 cprs, NEO QUIMICA 50 mg, 2 bl, x 10 cprs, GERMED 50 mg, 2 bl, x 10 cprs, GEN - LEGRAND 50 mg, 20 cprs, EMS 50 mg, bl, 20 cprs, SANOFI-AVENTIS 50 mg, com, ct, bl, al, plas, inc, x 30 PRATI DONADUZZI 50 mg, com, ct, bl, al, plas, inc, x 400 (hosp,) PRATI DONADUZZI 25 mg, cx, 30 cprs, NEO QUIMICA 25 mg, com, ct, bl, al, plas, inc, x 400 (hosp,) PRATI DONADUZZI 50 mg, com, ct, bl, al, plas, inc, x 400 (hosp,) PRATI DONADUZZI 500 mg cx, 50 FA s/dil, BERGAMO 500 mg cx, 50 FA+ dil, BERGAMO 10 mg/mlpom,bisn,30 g GERMED 10mg/gpom,bisn, 30 g EMS 10mg/gpom,bisn, 30 g GEN - LEGRAND 50 mg, cx, 20 cprs, MEDQUIMICA 50 mg, 20 cprs, BIO MACRO 100 mg, cx, 50 FA CELLOFARM 500 mg, cx, 50 FA CELLOFARM 60 mg/ml susp, or, fr, 100 ml MARIOL 60 mg/ml susp, or, fr, 150 ml MARIOL 60 mg/ml susp, or, fr, 240 ml MARIOL 61,5 mg/ml sus, or, ct, fr, plas, opc, x 240 ml+ cp, med, PRATI DONADUZZI 61,5 mg/ml sus, or, cx, 50 fr, plas, opc, x 240 ml+ cp, med, (hosp,) PRATI DONADUZZI 61,5 mg/ml susp, 100 ml 50 frs, PRATI DONADUZZI 61,5 mg/ml susp, 240 ml 50 frs, PRATI DONADUZZI 61,5 mg/ml susp, 240 ml fr, PRATI DONADUZZI Fr, 240 ml EMS 60 mg,+ 40 g susp, or, fr, 100 ml MARIOL 60 mg,+ 40 g susp, or, fr, 150 ml MARIOL 60 mg,+ 40 g susp, or, fr, 240 ml MARIOL 6% fr, 240 ml MEDQUIMICA Bolsa 100 ml, HALEX ISTAR

UNIDADE Pco Unt Base A COMP 0,12 COMP 0,12 COMP 0,12 COMP 0,12 COMP 0,08 CPR 0,12 COMP 0,12 COMP 0,18 COMP 0,18 COMP 0,18 COMP 0,15 COMP 0,13 COMP 0,12 COMP 0,09 COMP 0,15 FA 13,04 FA 12,73 GRAMA 0,31 GRAMA 0,40 GRAMA 0,34 CPR 0,19 COMP 0,18 FA 3,09 FA 8,28 ML 0,05 ML 0,05 ML 0,05 ML 0,02 ML 0,02 ML 0,02 ML 0,91 ML 0,02 ML 0,03 ML 0,09 ML 0,09 ML 0,09 ML 0,05 UND 75,01

191

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7310 7311 7312 7313 7314 7315 7316 7317 7318 7319 7320 7321 7322 7323 7324 7325 7326 7327 7328 7329 7330 7331 7332 7333 7334 7335 7336 7337 7338 7339 7340 7341 7342 7343 7344 7346 7347 7348

CODIGO BENEFICIO 95378324 HIFLOXAN (CIPROFLOXACINA) 95110526 HIGROMIL 95072420 HIGROMIL 95110534 HIGROMIL 95072411 HIGROMIL 95011161 HIGROTON 95011153 HIGROTON 95011145 HIGROTON 95011170 HIGROTON-RESERPINA 95378359 HINCOMOX 95110542 HINCOMOX 95378367 HINCOMOX 95056319 HINCOMOX 95056327 HINCOMOX 95124004 HINCOMOX (Restrito Hosp,) 95612017 HINOX 95110550 HINOX 90 95894284 HIOARISTON 95894292 HIOSFARMA 95971742 HIOSPAN 95971750 HIOSPAN COMPOSTO 95038604 HIOSPAN COMPOSTO 95971777 HIOSPAN COMPOSTO 95124012 HIOSPAN COMPOSTO (Restrito Hosp,) 95988262 HIPERNOLOL 95988270 HIPERNOLOL 95894306 HIPERTIL 95110569 HIPERTIN - MALEATO DE ENALAPRIL 95133151 HIPERTIN-MALEATO DE ENALAPRIL 95133178 HIPERTIN-MALEATO DE ENALAPRIL 95133160 HIPERTIN-MALEATO DE ENALAPRIL 95082760 HIPERTONIC 95038639 HIPNAZOLAM 95038647 HIPNAZOLAM 95038620 HIPNAZOLAM 95580972 HISOCEL SOL, INJET, GEL, a 3,5% 95580964 HISOCEL SOL, INJET, GEL, a 3,5% 95230769 HISTADIN

APRESENTAÇÃO Laboratorio Bolsa 200 ml, HALEX ISTAR 25 mg, - 3 bl, x 14 cprs, MULTILAB 25 mg, cx, 42 cprs, MILIAN 50 mg, - 2 bl, x 14 cprs, MULTILAB 50 mg, cx, 28 cprs, MILIAN 12,5 mg, 42 cprs, NOVARTIS 25 mg, 42 cprs, NOVARTIS 50 mg, 28 cprs, NOVARTIS 20 cprs, NOVARTIS 250 mg/5 ml, susp, 60 ml TEUTO BRAS, 50 mg/ml po prep, ext, sus, or, ct, fr, vd, amb, x 150 ml + cp,TEUTO med, BRAS, 500 mg, bl, 12 caps TEUTO BRAS, 500 mg, cx, 300 caps, TEUTO BRAS, Susp, 250 mg/5 ml cx, 50 fr, x 60 ml TEUTO BRAS, Susp, 250 mg/5 ml cx, 50 fr, x 60 ml (hosp,) TEUTO BRAS, Fr, 30 cprs, HEBRON Fr, plast, 90 cprs, HEBRON Cx, 50 amps, 5 ml ARISTON 20 mg/1 ml amp, 2 ml FARMACE Sol, inj, 20 mg/ml cx, 6 amps, TEUTO BRAS, Cx, 20 drags, TEUTO BRAS, Sol, inj, 5 ml c/100 TEUTO BRAS, Sol, oral gts, fr, 20 ml TEUTO BRAS, Sol, inj, 5 ml c/100 (hosp,) TEUTO BRAS, 40 mg, cx, 2 bl, x 20 cprs, NEO QUIMICA 80 mg, cx, 2 bl, x 10 cprs, NEO QUIMICA Cx, 28 cprs, CHIESI 20 mg, cx, 30 cprs, LUPER 10 mg, cx, 30 cprs, LUPER 20 mg, cx, 30 cprs, LUPER 5 mg, cx, 30 cprs, LUPER 50 mg/ml sol, oft, fr, plast, trans, got, x 10 ml OPHTHALMOS 15 mg, 2 bl, x 15 cprs, rev, SIGMA PHARMA 15 mg, fr, 10 cprs, rev, SIGMA PHARMA 7,5 mg, 2 bl, x 15 cprs, rev, SIGMA PHARMA RB 1 x 500 ml FRESENIUS KABI Vd, 1 x 500 ml FRESENIUS KABI 1 mg, xpe, fr, 100 ml UNIAO QUIMICA

UNIDADE Pco Unt Base A UND 134,12 COMP 0,25 COMP 0,19 COMP 0,38 COMP 0,29 CPR 0,22 CPR 0,39 CPR 0,59 CPR 0,50 ML 0,34 ML 0,17 CPR 1,72 CAPS 0,50 ML 0,07 ML 0,79 CPR 1,63 COMP 1,17 AMP 2,78 AMP 54,62 AP 2,71 CPR 0,41 CP 1,90 GOTAS 0,03 AMP 1,90 COMP 0,13 COMP 0,24 COMP 2,50 COMP 1,04 CPR 0,63 CPR 0,89 CPR 0,41 Gota 0,08 CP 0,98 CP 1,84 CP 0,66 FA 25,60 FA 27,83 ML 0,26

192

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7349 7350 7351 7352 7353 7354 7355 7356 7357 7358 7359 7360 7361 7362 7363 7364 7365 7366 7367 7372 7373 7374 7375 7376 7377 7378 7379 7380 7381 7382 7383 7384 7385 7386 7387 7388 7389 7390

CODIGO BENEFICIO 95230750 HISTADIN 95971807 HISTADIN 95230777 HISTADIN 95056343 HISTADIN D 95056335 HISTADIN D 95230793 HISTAMIN 95230807 HISTAMIN 95124020 HISTAMIN (Restrito Hosp,) 95124039 HISTAMIN (Restrito Hosp,) 95230815 HISTAMIX 95230823 HISTAMIX 95019251 HIXIZINE 95110585 HIXIZINE 95125892 HOLOXANE 95125906 HOLOXANE 95125914 HOLOXANE 95971815 HOMATROPIN 95971823 HORMODOSE 95894314 HORMONIOL 95019278 HORMOTROP 95999205 HORMOTROP 95019308 HORMOTROP 95124047 HORMOTROP (Restrito Hosp,) 95999213 HUMALOG 95430687 HUMALOG 95894322 HUMALOG 95430679 HUMALOG 95971831 HUMECTOL 95110593 HUMECTOL D 95110607 HUMULIN 95110615 HUMULIN 95110623 HUMULIN 95770127 HYALOZIMA (*) 95770135 HYALOZIMA (*) 95541519 HYCAMTIN 95030662 HYCIMET 95988289 HYCLIN 95300449 HYDERGINE

APRESENTAÇÃO 10 mg, cx, 12 cprs, D - 5/12 mg 12 drags, D - xpe, fr, 60 ml, 5/120mg,12drags, Xpe, fr, 60 ml 2 mg cx, 1 bl, x 20 cprs, Liq, 2 mg/5 ml vd, 100 ml 2 mg, cx, 25 bl, x 20 cprs, (hosp,) Xpe, 2 mg/5 ml 50 vds, 100 ml (hosp,) Cx, 12 cprs, Xpe, fr, 120 ml 25 mg, cx, 30 cprs, Xpe, fr, 120 ml Cx, 10 FA 2 g Cx, 10 FA, 1 g Cx, 10 FA, 500 mg, Sol, gts, fr, 15 ml Gel, tb, plast, c/80 g 1 mg/g creme bisn, 50 g 12 UI 1 fr, x 1,5 ml 12 UI cx, 1 FA+ dil, bacterostatico 2 ml 4 UI 1 fr, x 0,5 ml 4 UI + dil, FA 100 UI/mlsol,inj,10ml, 2 carpules 3 ml, 5 refis c/3,0 ml Mix 25 100 UI/ml 5 carp,x 3 ml, Cx,20drags, Cx, 20 cprs, rev, 70N/30R FA 10 ml NPH FA 10 ml R FA 10 ml 2,000 UTR cx, 3 doses 20,000 UTR cx, 3 doses Inj, 4 mg, FA 300 mg, cx, 100 x 2 ml 600mg,cx,50 x 4 ml 1 mg 36 cs,

Laboratorio UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA HEBRON HEBRON THERASKIN THERASKIN BAXTER BAXTER BAXTER CAZI FARMASA TEUTO BRAS, BERGAMO BERGAMO BERGAMO BERGAMO ELI LILLY ELI LILLY ELI LILLY ELI LILLY COSMED COSMED ELI LILLY ELI LILLY ELI LILLY APSEN APSEN GLAXOSMITHKLINE HYPOFARMA HYPOFARMA NOVARTIS

UNIDADE Pco Unt Base A CPR 1,83 CPR 1,78 ML 0,37 DRAG 2,11 ML 0,43 CPR 0,28 ML 0,09 COMP 0,26 ML 0,08 CPR 1,08 ML 0,11 COMP 0,75 ML 0,19 FA 155,98 FA 86,91 X FA 45,57 GOTAS 0,03 G 0,41 GRAMA 23,33 AMP 29,00 F,A, 366,08 AMP 29,89 FA 125,83 UI 0,07 AP 25,55 FA 29,43 AP 29,99 CPR 0,28 COMP 0,29 UI 0,04 UI 0,04 UI 0,04 AP 14,24 AP 30,27 AP 817,64 AP 0,66 AMP 12,33 CPR 1,06

193

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7391 7392 7393 7394 7395 7396 7397 7398 7399 7400 7401 7402 7403 7404 7405 7406 7407 7408 7409 7410 7411 7412 7413 7414 7415 7416 7417 7418 7419 7420 7421 7422 7423 7424 7425 7426 7427 7428

CODIGO BENEFICIO 95300473 HYDERGINE 95300465 HYDERGINE 95300490 HYDERGINE 95120670 HYDREN 95124055 HYLINC 95332723 HYNALGIN 95332731 HYNALGIN 95971840 HYNALGIN 95133291 HYPERIUM 95133283 HYPERIUM 95332740 HYPLEX 95982426 HYPNOMIDATE 95084061 HYPNOMIDATE 95988300 HYPOCAINA 95999256 HYPOCAINA 95988319 HYPOCAINA 95019340 HYPOCALCIO 95332758 HYPOCINA 95760369 HYPOCINA 95988327 HYPOCINA 95124063 HYPOCINA COMPOSTA (Restrito Hosp,) 95066454 HYPOMAGNE 95971858 HYPONASAL 95120696 HYPONOR 8 MG 95320776 HYPONOR 8 MG 95320784 HYPOSIL 95740139 HYPOTEARS PLUS 95988343 HYPOVERIN 95988351 HYTAMICINA 95075216 HYTAS 95075208 HYTAS 95075194 HYTAS 95260374 HYTOS PLUS 95260366 HYTOS PLUS 95133313 HYTRIN 95133321 HYTRIN 95133305 HYTRIN 95150099 HYTROPIN

APRESENTAÇÃO 1 ml, 50 amps, 4,5 mg 14 cp, SRO 6 mg 14 cs, Cx, 100 x 1 ml, 600 mg, 2 ml cx, 50 amps, 50% cx, 100 x 2 ml 50% cx, 100 x 5 ml 50% gts, 10 ml, cx, 144 frs, 15 cprs, 30 cprs, Inj, cx, 100 x 2 ml, 2 MG - CX C/ 5 AMP x 10 ML 2 mg, 5 amps, 10 ml 1% s/v cx, 25 FA x 20 ml 2% c/v cx, 25 FA x 20 ml 2%s/vcx,100FA 5 ml 10% 10 ml vd, cx, 100 amps, 20 mg/ml cx, 100 x 1 ml Composta cx, 100 x 5 ml Composta gts, cx, 80 frs, 20 ml, Cx, 50 x 5 ml 50% cx, 100 x 10 ml 0,9%cx,100frs,20ml (equiv, a 4 mg norepinefrina base) cx, 10 x 4 ml, (equiv, a 4 mg norepinefrina base) cx, 50 x 4 ml, Cx, 100 x 2 ml 10 ml, Cx, 10 x 2 ml 80mg,cx,100x2 ml 100 mg/ml sol, inj, FA vd, x 10 ml 100 mg/ml sol, inj, FA vd, x 5 ml 25 mg/ml sol, inj, FA vd, x 2 ml Sol, oral gts, 15 ml Xpe, 100 ml 2 mg, cx, 14 cprs, 5 mg, 15 cprs, 5 mg, 30 cprs, 0,25 mg, cx, 100 x 1 ml

Laboratorio NOVARTIS NOVARTIS NOVARTIS HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA SERVIER SERVIER HYPOFARMA JANSSEN - CILAG JANSSEN - CILAG HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA HYPOFARMA NOVARTIS HYPOFARMA HYPOFARMA ACCORD ACCORD ACCORD UNIAO QUIMICA UNIAO QUIMICA ABBOTT ABBOTT ABBOTT HYPOFARMA

UNIDADE Pco Unt Base A AP 1,83 CPR 3,61 CPR 3,63 UND 0,47 AMP 1,46 AP 0,57 AP 0,85 GOTAS 0,48 CPR 1,99 CPR 1,98 AP 0,54 AMP 12,37 AMP 13,79 ML 0,12 F,A, 3,30 ML 0,16 AMP 1,45 AP 0,81 AP 0,62 GOTA 0,01 GOTAS 0,01 AMP 1,17 GOTAS 1,25 AP 15,68 AP 11,20 AP 0,51 GOTAS 0,09 AMP 9,66 AMP 1,88 FA 147,83 FA 79,34 FA 12,75 GOTAS 0,05 ML 0,13 CPR 4,65 CPR 6,31 CPR 7,06 AP 0,47

194

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7429 7430 7431 7432 7433 7434 7435 7436 7437 7438 7439 7440 7441 7442 7443 7444 7445 7446 7447 7448 7449 7450 7451 7452 7453 7454 7455 7456 7457 7458 7459 7460 7461 7462 7463 7464 7465 7466

CODIGO BENEFICIO 95150102 HYTROPIN 95133348 HYZAAR 95133330 HYZAAR 95662243 IBUFRAN 95110640 IBUPLEX 95110658 IBUPRIL (*) 95124071 IBUPRIL (Restrito Hosp,) (*) 95124080 IBUPRIL (Restrito Hosp,) (*) 95662278 IBUPROFAN 95110666 IBUPROFENO - GENERICO 95110674 IBUPROFENO - GENERICO 95110682 IBUPROFENO - GENERICO 95110690 IBUPROFENO - GENERICO 95110704 IBUPROFENO - GENERICO 95110712 IBUPROFENO - GENERICO 95894349 IBUPROFENO - GENERICO 95894357 IBUPROFENO - GENERICO 95894330 IBUPROFENO - GENERICO 95110720 IBUPROFENO - GENERICO 95110739 IBUPROFENO - GENERICO 95082778 IBUPROFENO - GENERICO 95110747 IBUPROFENO - GENERICO 95056378 IBUPROFENO - GENERICO 95056386 IBUPROFENO - GENERICO 95110763 IBUPROFENO - GENERICO 95090568 IBUPROFENO - GENERICO 95082786 IBUPROFENO - GENERICO 95110771 IBUPROFENO - GENERICO (*) 95124098 IBUPROFENO - GENERICO (*) (Restrito Hosp,) 95124101 IBUPROFENO - GENERICO (Restrito Hosp,) 95136436 IBUPROFENO - GENERICO (Restrito Hosp,)(Liberado) 95072454 ICADEN 95390960 ICADEN 95390979 ICADEN 95971866 ICTUS 95110780 ICTUS 95971874 ICTUS 95110798 ICTUS

APRESENTAÇÃO 0,50 mg, cx, 100 x 1 ml 100/25 mg, cx,2 bl, x 15 cprs, 50/12,5 mg, cx,2 bl, x 15 cprs, 600 mg cx, 3 bl, x 10 cprs, rev, 100 mg, susp, fr, 30 ml 600 mg, bl, 20 cprs, 600 mg, 50 bl, x 10 cprs, (hosp,) 600 mg, bl, 200 cprs, (hosp,) 600 mg, cx, 20 cprs, 100 mg/ml fr, 20 ml 100 mg/ml fr, gts, 20 ml 100 mg/ml gts, fr, 20 ml 100 mg/ml susp, or, ct, fr, plast, opc, got, x 20 ml 100 mg/ml susp, oral fr, 20 ml 20 mg/ml susp, oral fr, 100 ml 200 mg, 2 bl, x 10 cprs, 200 mg, 2 bl, x 10 cprs, 200mg,bl,20cprs,rev, 400 mg, bl, 10 cprs, rev, 400 mg, cx, 10 cprs, 50 mg, fr, 30 ml 50 mg/ml fr, 30 ml 50 mg/ml fr, gts, 30 ml 50 mg/ml gts, fr, 30 ml 50 mg/ml susp, or, ct, fr, plast, opc got, x 30 ml 50 mg/ml susp, oral 50 fr, got, plßst, x 30 ml (hosp,) 50 mg/ml susp, oral fr, 30 ml 300 mg, 2 bl, x 10 cprs, rev, 600 mg, com, rev, ct, bl, al, plas, inc, x 500 (hosp,) 200 mg, com, rev, ct, bl, al, plas, inc, x 400 (mult,) 50 mg/ml susp, oral 50 fr, got, plßst, x 30 ml (hosp,) Creme 20 g Sol, fr, 30 ml Spray fr, 60 ml 12,5 mg, 2 bl, x 15 cprs, rev, 12,5 mg, bl, 60 cprs, 25 mg, 2 bl, x 15 cprs, rev, 25 mg, bl, 60 cprs,

Laboratorio HYPOFARMA MERCK SHARP & DOHME MERCK SHARP & DOHME NEO QUIMICA LEGRAND TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BUNKER GERMED BIOSINTETICA BRAINFARMA MEDLEY GEN - LEGRAND GERMED GERMED GEN - LEGRAND EMS GERMED NEO QUIMICA EMS GERMED BIOSINTETICA BRAINFARMA MEDLEY TEUTO BRAS, GEN - LEGRAND EMS PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, SCHERING SCHERING SCHERING BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS

UNIDADE Pco Unt Base A AP 0,48 CPR 1,66 CPR 1,01 CPR 0,82 GOTAS 0,02 COMP 0,71 COMP 0,59 COMP 0,67 CPR 1,16 GOTAS 0,02 GOTAS 0,02 GOTAS 0,03 GOTAS 0,02 GOTAS 0,02 ML 0,08 COMP 0,35 COMP 0,35 COMP 0,42 COMP 0,73 COMP 0,80 ML 0,22 GOTAS 0,01 GOTA 0,01 GOTA 0,01 GOTAS 0,01 GOTAS 0,01 ml 0,24 COMP 0,30 COMP 0,21 COMP 0,33 FR 6,94 G 0,99 ML 0,93 ML 0,86 CPR 0,94 COMP 0,63 CPR 1,11 COMP 0,63

195

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7467 7468 7469 7470 7471 7472 7473 7474 7475 7476 7477 7478 7479 7480 7481 7482 7483 7484 7485 7486 7487 7488 7489 7490 7491 7492 7493 7494 7495 7496 7497 7498 7499 7500 7501 7503 7505 7506

CODIGO BENEFICIO 95971882 ICTUS 95110801 ICTUS 95971890 ICTUS 95110810 ICTUS 95999264 IDA 95999272 IDA 95999280 IFOSFAMIDA - GENERICO 95124128 IFOSFAMIDA - GENERICO (Restrito Hosp,) 95124136 IFOSFAMIDA - GENERICO (Restrito Hosp,) 95124144 IFOSFAMIDA - GENERICO (Restrito Hosp,) 95100440 IGUASSINA 95571140 ILOBAN 95378413 ILOSONE 95378421 ILOSONE 95378448 ILOSONE 95971947 ILOSONE 95971955 ILOSONE 95042016 IMIPENEM + CILASTATINA - GENERICO 95899880 IMIPENEM + CILASTATINA - GENERICO 95042008 IMIPENEM GENERICO IMIPENEM + + CILASTATINA CILASTATINA -SODICA - GENERICO (Restrito 95090576 Hosp,) 95090584 IMIPENEM + CILASTATINA SODICA - GENERICO (Restrito 95056394 Hosp,) IMIPRA

APRESENTAÇÃO 3,125 mg, 2 bl, x 15 cprs, rev, 3,125 mg, bl, 60 cprs, 6,25 mg, 2 bl, x 15 cprs, rev, 6,25 mg, bl, 60 cprs, 10 mg, po liof, inj, FA vd,+ amp, vd, dil, x 10 ml 5 mg, po liof, inj, FA vd,+ amp, vd, dil, x 5 ml 1000 mg, fr, 10 1 g po liof, p/sol, inj, IV FA vd, x 25 ml 1 g po prep, ext, inj, 10 FA vd, 2 g po prep, ext, inj, 10 FA vd, 50 mg, comp, 5 st, x 4 Vd, 20 caps, 500 mg, 10 drags, 500 mg, 12 blister 4 drags, Liq, 125 mg, 100 cc Sol, fr, vd, 250 mg, x 100 ml Top, sol, fr, vd, 20 mg, x 120 ml 500 mg, 10 FA s/bolsa 500 mg, 10 FA+ bolsa sist, fechado 500 mg, FA+ bolsa sist, fechado 500 mg,+ 500 mg, po sol, inj, cx, 10 FA vd, x 20 ml (hosp,) 500 mg,+ 500 mg, po sol, inj, cx, 10 FA vd, x 20 ml+ bolsa plast, 100 ml (hosp,) 25 mg,sist, 20 fech, bl, 10xcps,

95125922 IMMUNATE 95125930 IMMUNATE 95029362 IMMUNINE 95029370 IMMUNINE 95040170 IMOSEC 95040188 IMOSEC 95040196 IMOSEC 95270825 IMOVANE 95110828 IMPLANON 95640304 IMUNEN 95044850 Imuno BCG 95089756 IMUNOGLOBULINA HUMANA NORMAL - Ig IV 95999361 IMUNOGLUCAN 95110836 IMUSSUPREX 95541551 INCEL

250 UI FA+ dil,+ equipo inf, 500 UI FA+ dil,+ equipo inf, 200 UI FA+ dil,+ equipo inf, 600 UI FA+ dil,+ equipo inf, Blister 2 x 6 cprs, Disp, 50 bl, x 4 cprs, Fr, de venda bl, 4 cprs, 7,5 mg, est, 20 cprs, 1 implante 50 mg, 20 bl, x 10 caps, ICMS 0% 1 ampola Sol, Injetável - CADA 1,0 GRAMA Inj, FA 5 ml 50 mg, 5 bl, x 10 cprs, Sol, inj, 10 mg cx, 1 FA

Laboratorio BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS CHEMICALTECH CHEMICALTECH EUROFARMA GLENMARK EUROFARMA EUROFARMA ZAMBON MERCK VALEANT VALEANT VALEANT VALEANT VALEANT ABL ABL ABL NOVAFARMA NOVAFARMA CRISTALIA BAXTER BAXTER BAXTER BAXTER JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG SANOFI-AVENTIS SCHERING-PLOUGH CRISTALIA F, ATAULPHO PAIVA HEBRON GERMED PHARMA DARROW

UNIDADE Pco Unt Base A CPR 0,73 COMP 0,63 CPR 0,82 COMP 0,63 F,A, 752,67 F,A, 393,29 F,A, 56,50 FA 62,04 FA 56,50 FA 99,63 CPR 0,33 CPR 0,77 CPR 2,43 CPR 2,38 ML 0,11 ML 0,26 ML 0,14 FA 59,50 FA 59,50 FA 59,48 FA 56,96 FA 56,96 COMP FA F,A, FA FA CPR CPR CPR CPR UND CPR AMP GRAMA F,A, COMP FA

0,23 680,12 1292,21 X 607,70 1649,48 0,44 0,37 0,36 1,70 772,55 x 1,63 195,75 221,06 X 132,80 1,32 31,79

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7507 7508 7509 7510 7511 7512 7513 7514 7515 7516 7517 7518 7519 7520 7521 7522 7523 7524 7525 7526 7527 7530 7531 7532 7533 7534 7535 7536 7537 7538 7539 7540 7541 7542 7543 7544 7545 7546

CODIGO BENEFICIO 95541560 INCEL 95530398 INCONTINOL 95530401 INCONTINOL 95140581 INCORIL 95140590 INCORIL 95140603 INCORIL 95140573 INCORIL 95999370 INDAPAMIDA - GENERICO 95999388 INDAPAMIDA - GENERICO 95971998 INDAPEN SR 95120718 INDERAL 95120700 INDERAL 95120726 INDERAL 95007920 INDIGO CARMIM 95007903 INDOCIANINA VERDE 95110844 INDOCID 95110852 INDOCID 95662308 INDOCID 95019391 INDUSON 95019405 INDUSON 95972005 INDUX 95378510 INFECTRIN

APRESENTAÇÃO Sol, inj, 50 mg cx, 1 FA 5 mg, cx, 20 cprs, 5 mg, cx, 30 cprs, 120 mg, AP 30 cprs, 180 mg, AP 30 cprs, 240 mg, AP 30 cprs, 90 mg, AP 30 cprs, 2,5 mg, fr, 15 cprs, rev, 2,5 mg, fr, 30 cprs, rev, 1,5 mg, cx, 30 cprs, 10 mg, cx, 24 cprs, 40 mg, cx, 20 cprs, 80 mg, cx, 20 cprs, AMP 2 ML A 15 AMP 10 ML C/ 25 MG 25 mg, bl, 30 caps, gel, 50 mg, bl, 30 caps, gel, Cx, 10 supos, 15 mg/3 ml sol, inj, cx, 5 amps, 50 mg/10 ml sol, inj, cx, 5 amps, 50 mg, 1 bl, x 10 cprs, 400 mg, cx, 2 bl, x 10 cprs,

Laboratorio DARROW MILLET-ROUX MILLET-ROUX BAGO BAGO BAGO BAGO APOTEX APOTEX TORRENT ASTRAZENECA ASTRAZENECA ASTRAZENECA

95378529 INFECTRIN 95378502 INFECTRIN 95378499 INFECTRIN 95662324 INFLADOREN 95662340 INFLAGEL 95662359 INFLALID 95662367 INFLALID 95110860 INFLAMAX 95662405 INFLAMENE 95662421 INFLAMENE 95662413 INFLAMENE 95662383 INFLAMENE 95988360 INFLAMEX SODICO 95662456 INFLANAN 95662510 INFLAREN 95662553 INFLAREN

F 800 mg, 10 cprs, Susp, ped, 120 ml, Vd, 50 ml, susp, 100 mg,cx, 10 cprs, Cx, 10 cprs, Cx, 12 cprs, Gts, fr, 15 ml, Cx, 20 cprs, 20 mg, cx, 15 caps, Cx, 10 sup, 30 mg, Cx, 8 caps, 20 mg, Gts, fr, 10 ml, 50 mg, cx, 20 cprs, FC 20 mg, cx, 16 cprs, K 50 mg, x 20 cprs, Retard 100 mg,x 10 caps,

BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM HEXAL EMS LEGRAND LEGRAND ELOFAR CHIESI CHIESI CHIESI CHIESI MEDQUIMICA MARJAN CIBRAN CIBRAN

ASPEN ASPEN MERCK SHARP & DOHME CELLOFARM CELLOFARM SIGMA PHARMA BOEHRINGER INGELHEIM

UNIDADE Pco Unt Base A FA 167,01 CPR 0,64 CPR 0,52 CPR 1,55 CPR 1,79 CPR 2,61 CPR 1,14 COMP 0,32 COMP 0,32 CPR 0,43 CPR 0,18 CPR 0,27 CPR 0,36 AMP 3,11 FA 204,75 COMP 0,48 COMP 0,69 UND 1,56 AMP 8,72 AMP 21,57 CPR 2,21 CPR 0,56 CPR ML ML CPR CPR CPR GOTAS COMP CAP UND CAP GOTAS CPR CPR CPRS CPR

1,24 0,09 0,10 0,87 1,96 1,30 0,05 0,58 1,58 1,95 1,59 0,06 0,34 1,20 0,31 0,81

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7547 7548 7549 7550 7551 7552 7553 7554 7555 7556 7557 7558 7559 7560 7561 7562 7563 7564 7565 7566 7567 7568 7569 7570 7571 7572 7573

CODIGO BENEFICIO 95999400 INFLAX 95662561 INFLAX 95999418 INFLAX 95999426 INFLAX 95999442 INFLAX 95662570 INFLAX 95110879 INFRALAX 95084681 INIBINA 95110887 INIBINA 95084673 INIBINA 95662588 INICOX 95662596 INICOX 95999469 INICOX 95110895 INLACT 95972030 INNOSFEN 95972048 INNOSFEN 95510559 INOFUNGIN 95988378 INOTROPISA 95430890 INSULINA HUMANA 95972072 INSULINA HUMANA 95972080 INSULINA HUMANA PENFILL 95972099 INSULINA HUMANA PENFILL 95972102 INSULINA HUMANA PENFILL 95038698 INSULINA HUMANA PENFILL 95038680 INSULINA HUMANA PENFILL 95038701 INSULINA HUMANA FRASCO 95038710 INSULINA HUMANA FRASCO

APRESENTAÇÃO 10 mg, cx, 16 cprs, rev, 20 mg, 16 cprs, rev, 20 mg, cx, 10 cprs, sol, 20 mg, cx, 8 cprs, rev, Gts, 10 mg/ml fr, 10 ml Inj, 2 amps, 2 ml 2 bl, x 15 cprs, 10 mg, 25 amps, 10 mg, cx, 20 cprs, 10 mg, cx, 5 amps, 15 mg, cx, 10 cprs, DP 15 mg, 5 cprs, Inj,15mg,5amps,1,5ml 667 mg/ml xpe, ameixa fr, 120 ml 0,25 mcg cart, 30 caps, gel, 1,0 mcg cart, 30 caps, gel, Creme vag, 60 g,+ aplic, cx, 50 bisn, Cx, 50 amps, 10 ml Biohulin NPH-N-U - 100 fr, 10 ml, Biohulin regular UI 100 - 100 UI sol, inj, cx, 1 fr, 10 ml Novolin 70/30 Penfill 100 UI/3 ml cx, c/5 Novolin 80/20 Penfill 100 UI/3 ml cx, c/5 Novolin 90/10 Penfill 100 UI/3 ml cx, c/5 Novolin N Penfill 100 UI/3 ml cx, c/5 Novolin R Penfill 100 UI/3 ml cx, c/5 Novolin N - 100 UI -10 ml Novolin R - 100 UI -10 ml

Laboratorio ATIVUS ATIVUS ATIVUS ATIVUS ATIVUS ATIVUS EMS APSEN APSEN APSEN FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA SIGMA PHARMA BERGAMO BERGAMO BERGAMO HYPOFARMA NOVO NORDISK NOVO NORDISK PROD, NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK PROD, NOVO NORDISK PROD, NOVO NORDISK PROD, NOVO NORDISK PROD,

7574 95019430 INSULINA HUMANA HUMULIN

70/30 2 refis, 3,0 ml

ELI LILLY

7575 7576 7577 7578 7579 7580 7581 7582 7583 7584

N 2 refis, 3,0 ml R 2 refis, 3,0 ml Novolin 70/30 - 100 UI - fr, 10 ml Neosulin NPH UI 100 - 100 UI susp, inj, cx, 1 fr, 10 ml Neosulin regular UI 100 - 100 UI sol, inj, cx, 1 fr, 10 ml Levemir FlexPen cx, c/5 Levemir FlexPen cx, c/5 Levemir Penfill 3 ml cx, c/5 Levemir Penfill 3 ml cx, c/5 NovoMix 30 FlexPen cx, c/5

ELI LILLY ELI LILLY NOVO NORDISK NOVO NORDISK PROD, NOVO NORDISK PROD, NOVO NORDISK PROD, NOVO NORDISK NOVO NORDISK PROD, NOVO NORDISK NOVO NORDISK PROD,

95019448 INSULINA HUMANA HUMULIN 95019421 INSULINA HUMANA HUMULIN 95430970 INSULINA HUMANA MC 95972200 INSULINA SUINA MONOCOMPONENTE 95972218 INSULINA SUINA MONOCOMPONENTE 95038787 INSULINAS ANALOGAS 95894365 INSULINAS ANALOGAS 95038779 INSULINAS ANALOGAS 95894373 INSULINAS ANALOGAS 95038728 INSULINAS ANALOGAS

UNIDADE Pco Unt Base A COMP 0,33 CPR 0,75 COMP 0,75 COMP 0,49 GOTA 0,02 AP 5,17 COMP 0,71 Amp 8,88 COMP 2,58 Amp 8,99 CPR 2,89 CPR 3,04 AMP 4,76 ML 0,18 CPR 1,94 CPR 4,72 G 12,67 AMP 1,58 UI 0,03 AP 29,18 AP 17,85 AP 15,09 AP 15,09 UND 18,33 UND 18,33 UI 0,04 UI 0,04 UI

0,07

UI UI UI AP AP UND FA UND FA UND

0,07 0,07 0,03 20,04 20,04 55,01 50,16 51,92 47,35 33,95

198

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7585 7586 7587 7588 7589 7590 7591 7592 7593 7594 7595 7596 7597 7598 7599 7600 7601 7602 7603 7604 7605 7606 7607 7608 7609 7610 7611 7612 7613 7614 7615 7616 7617 7618 7619 7620 7621 7622

CODIGO BENEFICIO 95999485 INSULINAS ANALOGAS 95038736 INSULINAS ANALOGAS 95999493 INSULINAS ANALOGAS 95038752 INSULINAS ANALOGAS 95999515 INSULINAS ANALOGAS 95038760 INSULINAS ANALOGAS 95999523 INSULINAS ANALOGAS 95038744 INSULINAS ANALOGAS 95999507 INSULINAS ANALOGAS 95972226 INSULINAS MISTAS 95972234 INSULINAS MISTAS 95431276 INSUMAN 95431284 INSUMAN 95431233 INSUMAN 95431217 INSUMAN 95431306 INSUMAN 95431241 INSUMAN 95431225 INSUMAN 95431292 INSUMAN 95110909 INSUNORM 70/30 95124160 INSUNORM 70/30 (Restrito Hosp,) 95124179 INSUNORM 70/30 (Restrito Hosp,) 95082794 INSUNORM N 95082808 INSUNORM R 95072462 INTAL 95972242 INTAL 95220119 INTAL 95220127 INTAL 95110917 INTELENCE 95378545 INVANZ 95152806 INVEGA SUSTENNA 95152814 INVEGA SUSTENNA 95152822 INVEGA SUSTENNA 95152830 INVEGA SUSTENNA 95400796 INVIRASE 95972250 IODETON 95124187 IONCLOR (Restrito Hosp,) 95124195 IONCLOR (Restrito Hosp,)

APRESENTAÇÃO Laboratorio NovoMix 30 FlexPen cx, c/5 NOVO NORDISK NovoMix 30 Penfill 3 ml cx, c/5 NOVO NORDISK PROD, NovoMix 30 Penfill 3 ml cx, c/5 NOVO NORDISK NovoRapid FlexPen 3 ml cx, c/5 NOVO NORDISK PROD, NovoRapid FlexPen 3 ml cx, c/5 NOVO NORDISK NovoRapid fr, 10 ml 100 UI/ml inj, NOVO NORDISK PROD, NovoRapid fr, 10 ml 100 UI/ml inj, NOVO NORDISK NovoRapidPenfill3ml cx, c/5 NOVO NORDISK PROD, NovoRapidPenfill3ml cx, c/5 NOVO NORDISK Iolin NPH UI 100 - 100 UI susp, inj, cx, 1 fr, 10 ml NOVO NORDISK PROD, Iolin regular UI 100 - 100 UI sol, inj, cx, 1 fr, 10 ml NOVO NORDISK PROD, Comb, 75N/25R UI/ml susp,inj, 1 FA vd, inc, x 5 ml SANOFI-AVENTIS Comb, 85N/15R 100 UI/ml susp,inj, 1 FA vd, inc, x 5 ml, SANOFI-AVENTIS N 100 UI/ml 5 carp, x 3 ml SANOFI-AVENTIS N 100 UI/ml FA 5 ml SANOFI-AVENTIS N optiset 100 UI/ml 5 carp, x 3 ml+5 sist,aplic, plas, SANOFI-AVENTIS R 100 UI/ml 5 carp, x 3 ml SANOFI-AVENTIS R 100 UI/ml FA 5 ml SANOFI-AVENTIS R optiset 100 UI/ml 5 carp, x 3 ml+ 5 sist, aplic, plas, SANOFI-AVENTIS 100 UI/ml susp, inj, ct, 1 FA vd, inc, x 10 ml ASPEN PHARMA 100 UI/ml susp, inj, ct, 100 FA vd, inc, x 10 ml ASPEN PHARMA 100 UI/ml susp, inj, ct, 50 FA vd, inc, x 10 ml ASPEN PHARMA 100 UI/ml susp, inj, FA x 10 ml CELLOFARM 100 UI/ml sol, inj, FA x 10 ml CELLOFARM 4% sol, nasal fr, spray x 15 ml+ aplic, nasal SANOFI-AVENTIS Aerosol fr, 15 g SANOFI-AVENTIS Sol, nasal 13 ml, 4% c/dos, SANOFI-AVENTIS Sol, nebul, 24 amps, 2 ml SANOFI-AVENTIS 100 mg, fr, plast, 120 cprs, JANSSEN - CILAG 1 g IV FA MERCK SHARP & DOHME 100 mg/ml susp. inj. lib. prol. ct. 1 ser. preenchida x 0,50 mlJANSSEN - CILAG 100 mg/ml susp. inj. lib. prol. ct. 1 ser. preenchida x 0,75 mlJANSSEN - CILAG 100 mg/ml susp. inj. lib. prol. ct. 1 ser. preenchida x 1,00 mlJANSSEN - CILAG 100 mg/ml susp. inj. lib. prol. ct. 1 ser. preenchida x 1,50 mlJANSSEN - CILAG 200 mg fr, 270 caps, ROCHE 30 mg/ml xpe,fr,100 ml CAZI 60 mg/ml sol, or, cx, 50 fr, plas, opc, x 100 ml + 50 cp, med,PRATI (hosp,)DONADUZZI 60 mg/ml sol, or, cx, 50 fr, plas, opc, x 150 ml + 50 cp, med,PRATI (hosp,)DONADUZZI

UNIDADE Pco Unt Base A UNID 30,96 UND 30,86 UNID 28,14 UND 29,20 UNID 26,63 UI 0,07 UI 0,08 UND 26,11 UNID 23,81 AP 19,58 AP 19,58 UI 0,03 UI 0,03 UI 0,05 UI 0,03 UI 0,12 UI 0,05 UI 0,03 UI 0,12 UI 0,03 UI 0,03 UI 0,14 FA 33,47 FA 33,47 JATO 0,30 DOSE 0,31 DOSE 0,12 AP 1,33 COMP 11,95 FA 262,16 AMP 654,88 AMP 851,9 AMP 1046,93 AMP 1046,93 CPR 3,12 ML 0,07 FR 1,31 FR 1,91

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7623 7624 7625 7626 7627 7628 7629 7630 7631 7632 7633 7634 7635 7636 7637 7638 7639 7640 7641 7642 7643 7644 7645 7646 7647 7648 7649 7650 7651 7652 7653 7654 7655 7656 7657 7658 7659 7660

CODIGO BENEFICIO 95999604 IPRABON 95260390 IPRANEO 95124209 IPRANEO (Restrito Hosp,) 95170162 IPSILON 95170120 IPSILON 95170146 IPSILON 95170154 IPSILON 95170138 IPSILON 95124217 IPSILON (Restrito Hosp,) 95110925 IRBESARTANA - GENERICO 95110933 IRBESARTANA - GENERICO 95110941 IRBESARTANA - GENERICO 95110950 IRBESARTANA - GENERICO 95137912 IRBESARTANA + HIDROCLOROTIAZIDA - GENERICO 95137920 IRBESARTANA + HIDROCLOROTIAZIDA - GENERICO 95066500 IRENAX 95110968 IRESSA 95100466 IRIDUX 95899898 IRNOCAM 95899901 IRNOCAM 95075259 IRONOTEL 95019456 IRONOTEL 95999647 IRUXOL 95860037 IRUXOL 95124225 IRUXOL (Restrito Hosp,) 95019472 IRUXOL MONO 95019464 IRUXOL MONO 95124233 IRUXOL MONO (Restrito Hosp,) 95160426 ISCOVER 95019499 ISILAX 95019480 ISILAX 95320822 ISKEMIL 95300546 ISKETAM 95972293 ISOCORD 95972307 ISOCORD 95972315 ISOFACE 95972323 ISOFACE 95066519 ISOFLURANO - GENERICO

APRESENTAÇÃO 0,25 mg/ml sol, fr, vd, 20 ml Sol, 0,25 mg/ml vd, 20 ml, Sol, inal, 0,25 mg/ml cx, 50 fr, vd, x 20 ml + cgt, (hosp,) Cx, 6 envs, 6 cprs, Fracao de venda Inj, 1g, fr, amp, Inj, 4 g, fr, amp, Xpe, fr, 60 cc Cx, 50 envs, 6 cprs, 150 mg, est, 2 bl, x 15 cprs, 150 mg, est, bl, 15 cprs, 300 mg, est, 2 bl, x 15 cprs, 300 mg, est, bl, 15 cprs, 150 mg. + 12,5 mg. bl. 30 cprs. 300 mg. + 12,5 mg. bl. 30 cprs. 20 mg/ml sol, inj, fr, amp, vd, x 5 ml 250 mg, bl, 30 cprs, rev, F200 cx, 24 caps, 100 mg, 1 FA 40 mg, 1 FA 20 mg/ml cx, 1 FA x 2 ml 20 mg/ml sol, inj, FA vd, x 5 ml Bisn, 30 g (cx, c/50) Pom, derm, bisn, 30 g Pom, derm, 50 bisn, 30 g 1,2 U/g pom, derm, 15 g+ esp, 1,2 U/g pom, derm, 30 g+ esp, 12 U/g pom, derm, 50 bisn, x 30 g 75 mg, 1 bl, x 14 cprs, rev, 5 mg, 100 cprs, 5 mg, 20 cprs, 6 mg, 20 caps, Cx, 20 cprs, 20 mg, cx, 30 caps, 40 mg, cx, 30 caps, 10mg,cx,3bl,10caps, 20 mg, cx, 3 bl, 10 caps, Fr, vd, amb, x 50 ml

Laboratorio ZAMBON NEO QUIMICA NEO QUIMICA NIKKHO NIKKHO NIKKHO NIKKHO NIKKHO NIKKHO RANBAXY RANBAXY RANBAXY RANBAXY EUROFARMA EUROFARMA SANDOZ ASTRAZENECA SANOFI-AVENTIS DR, REDDY'S DR, REDDY'S BIOCHIMICO BIOCHIMICO ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT B-MS CIFARMA CIFARMA ACHE ACHE EVOLABIS - SIF EVOLABIS - SIF ICN ICN BIOCHIMICO

UNIDADE Pco Unt Base A ML 0,02 GOTAS 0,03 GOTAS 0,33 CPR 0,63 UND 2,60 FA 17,51 FA 20,04 CPR 0,18 COMP 0,43 COMP 1,99 COMP 2,08 COMP 1,99 COMP 2,08 COMP 1,54 COMP 1,54 FA 1097,90 X COMP 93,82 CPR 0,52 FA 1128,74 FA 454,46 FA 507,26 X FA 1268,15 G 1,11 G 1,24 GRAMA 1,11 GRAMA 2,04 GRAMA 1,59 GRAMA 1,44 CPR 9,83 COMP 0,29 COMP 0,28 CPR 3,58 CPR 0,72 CPR 0,27 CPR 0,31 CPR 1,61 CPR 3,00 ML 3,19

200

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7661 7662 7663 7664 7665 7666 7667 7668 7669 7670 7671 7672 7673 7674 7675 7676 7677 7678 7679 7680 7681 7682 7683 7684 7685 7686 7687 7688 7689 7690 7691 7692 7693 7694 7695 7696 7697 7698

CODIGO BENEFICIO APRESENTAÇÃO 95066527 ISOFLURANO - GENERICO Fr, vd, amb,x100ml 95066535 ISOFLURANO - GENERICO Fr, vd, amb,x240ml 95066543 ISOFORINE 1 fr, 100 ml 95066551 ISOFORINE 1 fr, 240 ml 95720170 ISOPTO CARPINE 2% fr, 15 ml, 95700129 ISOPTO CETAPRED Pom, bisn, 3,5 g 95700137 ISOPTO CETAPRED Susp, fr, 5 ml 95038795 ISORAN Fr, vd, 100 ml 95038809 ISORAN Fr, vd, 240 ml 95075267 ISORAN Fr, vd, x 50 ml 95972331 ISORBID 10 mg, cx, 24 cprs, 95042032 ISORDIL 10 mg, 10 bl, x 10 cprs, oral 95110348 ISORDIL 10 mg, bl, 30 cprs, oral 95110356 ISORDIL AP 40 mg, bl, 30 cprs, 95042040 ISORDIL Sublingual 5 mg, 9 bl, x 10 cprs, 95110364 ISORDIL Sublingual 5 mg, bl, 30 cprs, 95894381 ISOTRETINOINA - GENERICO 10 mg, bl, 30 cprs, 95894390 ISOTRETINOINA - GENERICO 20 mg, bl, 30 cprs, 95136444 ISTARHES (HEA 130/0,42 - 6% + R,ACETATO) SOLUFLEX - SIST,FECHADO(Restrito Bolsa 500 ml Hosp,) 95136460 ISTARPLAS 200/0,5 (HIDROXIETILAMIDO) SOLUFLEX - SIST, 10% FECHADO(Restrito bolsa 500 ml Hosp,) 95136452 ISTARPLAS 200/0,5 (HIDROXIETILAMIDO) SOLUFLEX - SIST, 6% FECHADO(Restrito bolsa 500 ml Hosp,) 95136479 ISTARPLAS S(200/0,5 - 6% + CL, 7,2%) SOLUFLEX - SIST, FECHADO(Restrito Bolsa 500 ml Hosp,) 95056483 ITRACONAZOL - GENERICO 100 mg, 10 caps, 95972382 ITRACONAZOL - GENERICO 100 mg, 10 cprs, 95056475 ITRACONAZOL - GENERICO 100 mg, 15 caps, 95972390 ITRACONAZOL - GENERICO 100 mg, 15 cprs, 95056467 ITRACONAZOL - GENERICO 100 mg, 4 caps, 95972404 ITRACONAZOL - GENERICO 100 mg, 4 cprs, 95999655 ITRACONAZOL - GENERICO 100 mg, bl, 10 caps, gel, dura 95999663 ITRACONAZOL - GENERICO 100 mg, bl, 15 caps, gel, dura 95999671 ITRACONAZOL - GENERICO 100 mg, bl, 4 caps, gel, dura 95056432 ITRACONAZOL - GENERICO 100 mg, caps, gel, dura ct, bl, al, plas, inc, x 10 95056440 ITRACONAZOL - GENERICO 100 mg, caps, gel, dura ct, bl, al, plas, inc, x 15 95056424 ITRACONAZOL - GENERICO 100 mg, caps, gel, dura ct, bl, al, plas, inc, x 4 95972358 ITRACONAZOL - GENERICO 100mg,1bl,x10caps, 95972366 ITRACONAZOL - GENERICO 100mg,1bl,x15caps, 95972374 ITRACONAZOL - GENERICO 100mg,1bl,x4caps, 95124284 ITRACONAZOL - GENERICO (Restrito Hosp,) 100 mg, caps, gel, dura ct, bl, al, plas, inc, x 400 (hosp,)

Laboratorio BIOCHIMICO BIOCHIMICO CRISTALIA CRISTALIA ALCON ALCON ALCON BIOCHIMICO BIOCHIMICO BIOCHIMICO TEUTO BRAS, SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA RANBAXY RANBAXY HALEX ISTAR HALEX ISTAR HALEX ISTAR HALEX ISTAR MEPHA-RATIOPHARM RATIOPHARM MEPHA-RATIOPHARM RATIOPHARM MEPHA-RATIOPHARM RATIOPHARM BRAINFARMA BRAINFARMA BRAINFARMA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI RANBAXY RANBAXY RANBAXY PRATI DONADUZZI

UNIDADE Pco Unt Base A ML 3,19 ML 2,87 ML 3,43 ML 3,42 GOTAS 0,03 G 4,23 GOTAS 0,09 ML 4,09 ML 4,09 ML 4,09 CPR 0,10 COMP 0,18 CPR 0,19 CPR 0,74 COMP 0,19 CPR 0,20 COMP 1,63 COMP 3,02 UNID 23,30 UNID 22,13 UNID 18,45 UNID 50,13 CAPS 4,46 CPR 4,46 CAPS 3,42 CPR 3,26 CAPS 5,31 CPR 5,31 CAPS 4,40 CAPS 3,67 CAPS 5,23 CAPS 5,95 CAPS 4,96 CAPS 7,09 CPR 4,33 CPR 3,61 CPR 5,16 CAPS 1,91

201

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7699 7700 7701 7702 7703 7704 7705 7706 7707 7708 7709 7710 7711 7712 7713 7714 7715 7716 7717 7718 7719 7720 7721 7722 7723 7724 7725 7726 7727 7728 7729 7730 7731 7732 7733 7734 7735 7736

CODIGO BENEFICIO 95391029 ITRACOTAN 95056491 ITRAHEXAL 95972412 ITRAHEXAL 95972420 ITRAHEXAL 95972439 ITRAHEXAL 95110976 ITRALEX 95391061 ITRASPOR 95391070 ITRASPOR 95391088 ITRAZOL 95420665 IVERMEC 95972455 IXEL 95029389 JANUVIA 95029397 JANUVIA 95029400 JANUVIA 95029419 JANUVIA 95982434 JEVITY 95124292 JEVTANA (Restrito Hosp,) 95972463 JOSVERM 95350187 JUMEXIL 95350179 JUMEXIL 95019502 K,U, DOXORRUBICIN 95019510 K,U, DOXORRUBICIN 95066578 KABIVEN 900 95066586 KABIVEN PERIPHERAL 1000 95066594 KABIVEN PERIPHERAL 1400 95110984 KAMILLOSAN 95110992 KAMILLOSAN 95170197 KANAKION MM 95170189 KANAKION MM 95011188 KAOMAGMA 95972498 KARVIL 95972501 KARVIL 95972510 KARVIL 95042059 KAVASEDON 95043764 KAVIT 95124306 KEFADIM (Restrito Hosp,) 95378570 KEFALEXIN 95378561 KEFALEXIN

APRESENTAÇÃO 100 mg, cx, 4 caps, 100 mg, bl, 10 caps, dura 100 mg, cx, 15 caps, 100 mg, cx, 28 caps, 100 mg, cx, 4 caps, 100 mg, bl, 4 caps, 100 mg 15 caps, 100mg 4 caps, 100 mg, 4 caps, 6 mg, cx, 4 cprs, 25 mg 28 caps, 100 mg, cx, 1 bl, x 14 cprs, 100 mg, cx, 2 bl, x 14 cprs, 25 mg, cx, 2 bl, x 14 cprs, 50 mg, cx, 2 bl, x 14 cprs, FR C/ 1,000 ML 60 mg, sol, inj, cx, FA vd, inc, x 1,5 ml + dil, x 4,5 ml Susp, inf, 30 ml 10 mg 30 drags, 5 mg 20 cprs, 10mg,poliof,inj, cx, FA 50 mg, po liof, inj, cx, FA 4 x 1026 ml 4 x 1440 ml 2 x 1920 ml 20 mg/g creme derm, bisn, 20 g 50 mg/g creme derm, bisn, 50 g 10 mg/1,0 ml 5 amps, 2 mg/0,2 ml 5 amps, Susp, 120 ml 12,5 mg cx, 15 cprs, 3,125 mg cx, 15 cprs, 6,250 mg cx, 15 cprs, 125mg, 2 bl,x10 caps, 10 mg/ml cx, 50 amps, 1 ml 1 g po inj, 25 FA vd, 250 mg, cx, 1 fr, 60 ml 500 mg, cx, 8 caps,

Laboratorio ROYTON HEXAL HEXAL HEXAL HEXAL EMS SIGMA PHARMA SIGMA PHARMA BIOLAB SANUS UCI-FARMA ROCHE MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME ABBOTT SANOFI-AVENTIS JOSPER CHIESI CHIESI MEIZLER MEIZLER FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI ACHE ACHE ROCHE ROCHE SIGMA PHARMA TORRENT TORRENT TORRENT SIGMA PHARMA CRISTALIA ABL ROYTON ROYTON

UNIDADE Pco Unt Base A CPR 2,81 CAPS 5,15 CPR 5,02 CPR 3,95 CPR 6,47 CAPS 4,80 CPR 3,79 CPR 5,91 CPR 6,60 CPR 5,43 CPR 0,98 CPR 5,16 CPR 5,16 CPR 1,29 CPR 2,58 FR 56,12 FA 14132,94 X ML 0,31 CPR 2,10 CPR 1,24 FA 58,19 FA 245,15 UNID 371,08 X UNID 399,51 X UNID 512,53 X GRAMA 14,83 GRAMA 28,20 AP 2,51 AP 1,80 ML 0,11 CPR 1,03 CPR 0,80 CPR 0,91 COMP 1,29 AMP 0,81 FA 24,21 ML 0,32 CPR 2,37

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7737 7738 7739 7740 7741 7742 7743 7744 7745 7746 7747 7748 7749 7750 7751 7752 7753 7754 7755 7756 7757 7758 7759 7760 7761 7762 7763 7764 7765 7766 7767 7768 7769 7770 7771 7772 7773 7774

CODIGO BENEFICIO 95084100 KEFALOTIN 95378618 KEFAZOL 95378634 KEFLAXINA 95378626 KEFLAXINA 95082859 KEFLEX 95082840 KEFLEX 95082867 KEFLEX 95082832 KEFLEX 95082824 KEFLEX 95082875 KEFLEX 95082816 KEFLEX 95999710 KEFLIN (Restrito Hosp.) 95066616 KEFLITIN 95999728 KEFORAL 95999736 KEFOX 95124322 KEFOZIL (Restrito Hosp,) 95124330 KEFOZIL (Restrito Hosp,) 95999752 KEFTRON 95124349 KEFTRON 95972560 KELAFER 95042067 KELLY 95899910 KEMOCARB 95899928 KEMOCARB 95899936 KEROXIME 95066624 KESINT 95378677 KETAMIN 95066632 KETAMIN-S 95378766 KETEK 95378758 KETEK 95391134 KETOMICOL

APRESENTAÇÃO 1 g cx, 50 frs, 1 g 50 FA 250 mg, susp, vd, 100 ml, 500 mg, cx, 8 caps, 1 g cx, 40 drags, 1 g cx, 8 drags, 250 mg, fr, 100 ml 500 mg, cx, 40 drags, 500 mg, cx, 8 drags, 500 mg, fr, 100 ml Gts, fr, 15 ml 1 g FA s/dil, cx, c/50 1 g po p/sol, inj, cx, 50 FA vd, 500 mg, cx, 20 bl, x 10 caps, 1 g po inj, 25 FA 1 g cx, 25 FA + dil 1 g cx, 50 FA + dil 1 g po inj, 25 FA 1 g po inj, 50 FA 250mg/mlgts,fr,30ml 75 mcg, bl, 28 cprs, 150mg,cx,FA15ml 450mg,cx,FA45ml 750 mg, IV/IM 25 FA 125 mg/ml po liof, inj, cx, FA 50 mg/ml 5 frs, 10 ml 50 mg/ml sol, inj, cx, 25 amps, vd, inc, x 2 ml 400 mg, bl, 10 cprs, rev, 400 mg, bl, 14 cprs, rev, Cr, bisn, 30 g

Laboratorio BIOCHIMICO ABL HEXAL HEXAL BAGO BAGO BAGO BAGO BAGO BAGO BAGO ABL NOVAFARMA ABL ABL BIOCHIMICO BIOCHIMICO ABL ABL BIOLAB SANUS SIGMA PHARMA BIOCHIMICO BIOCHIMICO ABL LIBRA CRISTALIA CRISTALIA SANOFI-AVENTIS SANOFI-AVENTIS LUPER

95830359 KETOMICOL 95391142 KETOMICOL (*) 95841040 KETONAZOL 95830375 KETONAZOL 95391177 KETONAZOL (*) 95270884 KIATRIUM 95270868 KIATRIUM 95270876 KIATRIUM

Shampoo fr, 100 ml Cx, 10 cprs, Creme tb, 30 g, Shampoo fr, 100 ml, Cx, 10 cprs, 10 mg, cx, 1 bl, x 20 cprs, 10 mg, cx, 1 bl, x 30 cprs, 5 mg, cx, 1 bl, x 20 cprs,

LUPER LUPER BUNKER BUNKER BUNKER GROSS GROSS GROSS

UNIDADE Pco Unt Base A UNID 3,58 FA 11,24 ML 0,22 CPR 1,40 DRAG 7,62 DRAG 7,74 ML 0,58 DRAG 3,99 DRAG 4,00 ML 1,04 Gota 0,06 F,A, 5,26 FA 3,28 CAPS 2,16 F,A, 28,70 FA 3,64 FA 3,64 F,A, 26,42 FA 27,92 GOTAS 0,03 COMP 0,88 FA 425,54 FA 1164,34 FA 21,50 FA 8,39 FA 53,91 FA 9,02 CPR 13,23 CPR 13,23 G 0,59 ML CPR G ML CPR CPR CPR CPR

0,38 2,51 0,57 0,37 2,05 0,40 0,39 0,29

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7775 7776 7777 7778 7779 7780 7781 7782 7783 7784 7785 7786 7787 7788 7789 7790 7791 7792 7793 7794 7795 7796 7797 7798 7799 7800 7801 7802 7803 7804 7805 7806 7807 7808 7809 7810 7811 7812

CODIGO BENEFICIO 95270892 KIATRIUM 95019588 KIDAZON 95019570 KIDAZON 95019561 KIDAZON 95378812 KLARICID 95378820 KLARICID 95019618 KLARICID 95378790 KLARICID 95378804 KLARICID 95038841 KLAROXIL 95038833 KLAROXIL 95019634 KOIDE 95011200 KOLAMPEPT 95011242 KOLANTYL 95011269 KOLANTYL 95011250 KOLANTYL 95056513 KOLANTYL DMP 95056521 KOLANTYL GEL 95860100 KOLLAGENASE 95860096 KOLLAGENASE 95860118 KOLLAGENASE 95056564 KOLLAGENASE C/CLORANF, 95111042 KOLLAGENASE C/CLORANF, 95056530 KOLLAGENASE C/CLORANF, 95056548 KOLLAGENASE C/CLORANF, 95056556 KOLLAGENASE C/CLORANF, 95124357 KOLLAGENASE C/CLORANF, (Restrito Hosp,) 95082883 KOLLAGENASE S/CLORANF, 95056580 KOLLAGENASE S/CLORANF, 95056572 KOLLAGENASE S/CLORANF, 95124365 KOLLAGENASE S/CLORANF, (Restrito Hosp,) 95111050 KOLPITRAT 95137904 KOMBIGLYZE XR 95137890 KOMBIGLYZE XR 95137874 KOMBIGLYZE XR 95137882 KOMBIGLYZE XR 95137866 KOMBIGLYZE XR 95090592 KOPLAN (Restrito Hosp,)

APRESENTAÇÃO 5 mg, cx, 1 bl, x 30 cprs, 1 mg, bl, x 2 cprs, 1 mg/ml inj, cx, amp, 3 ml 1mg/mlinj,cx, amp, 1 ml 125 mg/5 ml, gran, susp, ped, x 42,29 g (equiv, 60 ml) 250 mg/5 ml, gran, susp, ped, x 42,29 g (equiv, 60 ml) IV 500 mg, FA UD 500 mg, c/lib, prolong, cx, 10 cprs, UD 500 mg, c/lib, prolong, cx, 7 cprs, 500 mg, po liof, inj, 50 FA 500mg,poliof,inj, FA Elixir 120 ml Blister 20 cprs, Cx, 20 x 6 cprs, Cx, 5 x 6 cprs, DMP fr, 200 ml, Fr, 200 ml 200 ml C/cloranf, 10 bls, 30 g, C/cloranf, pom, bisn, 50 g S/cloranf, 10 bls, 30 g, Pom, 10 bisn, 30 g Pom, bisn, 15 g Pom, bisn, 30g Pom, bisn, 50 g Pom, bisn,15 g Pom, 10 bisn, 30 g 0,6 U/g pom, derm, Pom, 10 bisn, 30 g Pom, bisn, 30 g Pom, 10 bisn, 30 g Creme vag, bisn, 40 g + 10 aplic, 2,5 mg/1000 mg. 10 bl. x 6 cprs. 2,5 mg/1000 mg. 2 bl. x 7 cprs. 5 mg/1000 mg. 2 bl. x 7 cprs. 5 mg/1000 mg. 5 bl. x 6 cprs. 5 mg/500 mg. bl. xinj, 7 cprs. 200 mg, po liof,2 sol, IM/IV FA vd,+ dil, amp, vd, x 3 ml (hosp,)

Laboratorio GROSS CELLOFARM CELLOFARM CELLOFARM ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT BIOCHIMICO BIOCHIMICO EUROFARMA TEUTO BRAS, MEDLEY MEDLEY MEDLEY MEDLEY MEDLEY CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA MEDLEY B-MS B-MS B-MS B-MS B-MS NOVAFARMA

UNIDADE Pco Unt Base A CPR 0,28 COMP 29,89 AMP 107,90 AMP 54,14 ML 0,79 ML 1,49 FA 129,50 CPR 10,72 CPR 10,61 FA 102,65 FA 102,65 ML 0,08 CPR 0,29 CPR 0,64 CPR 0,75 ML 0,10 ML 0,10 ML 0,09 G 0,74 G 0,72 G 0,73 G 0,81 GRAMA 1,26 G 0,98 G 1,01 G 0,90 GRAMA 0,96 G 1,74 G 0,79 G 0,95 GRAMA 0,94 GRAMA 0,50 COMP 2,55 COMP 2,56 COMP 5,11 COMP 5,11 COMP 5,11 FA 197,48

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7813 7814 7815 7816 7817 7818 7819 7820 7821 7822 7823 7824 7825 7826 7827 7828 7829 7830 7831 7832 7833 7834 7835 7836 7837 7838 7839 7840 7841 7842 7843 7844 7845 7846 7847 7848 7849 7850

CODIGO BENEFICIO 95090606 KOPLAN (Restrito Hosp,) 95894420 KRONEL SABONETE 95170286 KYBERNIN P 1000 95124373 KYTRIL (Restrito Hosp,) 95124381 KYTRIL (Restrito Hosp,) 95030700 LABEL 95030670 LABEL 95030719 LABEL 95320873 LABIGERON 95320865 LABIGERON 95320890 LABIRIN 95038876 LABIRIN 95972609 LABIRIN 95894438 LABIRIN 95038884 LABIRIN 95320881 LABIRIN 95038868 LABIRIN 95972617 LABOPURINOL 95640347 LABOPURINOL 95124390 LABORHEX (Restrito Hosp,) 95124403 LABORHEX (Restrito Hosp,) 95042075 LABORIODINE 95042083 LABORIODINE 95042091 LABORIODINE 95042105 LABORIODINE 95042121 LABORSAN 95042113 LABORSAN 95850295 LABORSAN 95850309 LABORSAN 95972633 LAC-HYDRIN 95140611 LACIPIL 95972641 LACRIBELL 95029443 LACRIFILM 95740155 LACRIGEL A 95740163 LACRIL 95740180 LACRIMA PLUS 95111069 LACTO-PURGA 95111077 LACTULONA

APRESENTAÇÃO 400 mg, po liof, sol, inj, IM/IV FA vd,+ dil, amp, vd, x 3 ml (hosp,) Liq, fr, 250 ml 50 UI/ml po liof, inj, ct fr,+ dil, x 20 ml,+ disp, de tra Inj, 1 mg/ml, 1 amp, 1 ml Inj, 1 mg/ml, 1 amp, 3 ml 15 mg, liq, fr, 120 ml, Fr, 20 cprs, 150 mg, Fr, 20 cprs, 300 mg, 25 mg, cx, 30 cprs 75 mg, cx, 30 cprs, 16 mg, 30 cprs, 16 mg, cx, 60 cprs, 24 mg, 20 cprs, 24 mg, 30 cprs, 24 mg, cx, 60 cprs, 8 mg, 30 cprs, 8 mg, cx, 60 cprs, 100 mg, cx, 24 cprs, 300 cx, 16 cprs, 2% 1000 ml disp, 2,0% BAG 800 ml Degermante 1000 ml, c/ disp, Degermante 1000 ml, stander Tintura 1000 ml, Top, 1000 ml, 1000 ml 5000 ml Sab, liq, fr, 1000 ml, Sab, liq, fr, 5000 ml, 12% locao cart, fr, 225 g 4 mg, cx, 14 cprs, Fr, 15 ml 5 mg/ml sol, oft, fr, plast, got, 15 ml 10 g, 1/4% fr, plast, 15 ml, Fr, 15 ml, Fracao - 1 bl, x 6 cprs, rev, 667 mg/ml xpe, 10 sach, x 15 ml (sabor ameixa)

Laboratorio NOVAFARMA HEBRON CSL BEHRING ROCHE ROCHE ACHE ACHE ACHE TEUTO BRAS, TEUTO BRAS, APSEN APSEN APSEN APSEN APSEN APSEN APSEN EVOLABIS - SIF EVOLABIS - SIF EUROFARMA SEGMENTA EUROFARMA SEGMENTA SEGMENTA SEGMENTA SEGMENTA SEGMENTA GLICOLABOR GLICOLABOR BIOSINTETICA BIOSINTETICA B-MS GLAXOSMITHKLINE LATINOFARMA UNIAO QUIMICA NOVARTIS ALLERGAN ALCON COSMED DAIICHI SANKYO

UNIDADE Pco Unt Base A FA 395,05 ML 0,05 FA 1525,90 X AMP 63,23 AMP 127,04 ML 0,19 CPR 1,34 CPR 2,49 CPR 0,21 CPR 0,36 CPR 0,68 CP 0,63 CPR 0,81 COMP 0,91 CP 0,84 CPR 0,56 CP 0,52 CPR 0,25 CPR 0,50 ML 0,02 ML 0,30 ML 0,01 ML 0,01 ML 0,01 ML 0,01 ML 0,01 ML 0,01 ML 0,01 ML 0,01 G 0,18 CPR 3,13 GOTAS 0,04 GOTA 0,05 G 2,79 GOTAS 0,03 GOTAS 0,04 COMP 0,34 ML 0,21

205

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7851 7852 7853 7854 7855 7856 7857 7858 7859 7860 7861 7862 7863 7864 7865 7866 7867 7868 7869 7870 7871 7872 7873 7874 7875 7876 7877 7878 7879 7880 7881 7882 7883 7884 7885 7886 7887 7888

CODIGO BENEFICIO 95111085 LACTULONA 95056602 LACTULONA 95056610 LACTULONA 95019669 LADOGAL 95019677 LADOGAL 95019685 LADOGAL 95056637 LAMI 95340416 LAMICTAL 95340424 LAMICTAL 95340408 LAMICTAL 95111093 LAMICTAL 95111107 LAMICTAL 95111115 LAMICTAL 95111123 LAMICTAL 95841059 LAMISIL 95391185 LAMISIL 95391215 LAMISIL 95894446 LAMISIL 95841075 LAMISIL 95972692 LAMITOR 95972706 LAMITOR 95972714 LAMITOR 95894454 LAMIVUDINA - GENERICO (ICMS 0%) 95111131 LAMOCTRIL 95038892 LAMOTRIGINA - GENERICO 95999868 LAMOTRIGINA - GENERICO 95038906 LAMOTRIGINA - GENERICO 95999876 LAMOTRIGINA - GENERICO 95038914 LAMOTRIGINA - GENERICO 95999884 LAMOTRIGINA - GENERICO 95056645 LAMOTRIX 95056653 LAMOTRIX 95056661 LAMOTRIX 95300597 LANEXAT 95090304 LANITOP 95030727 LANOGASTRO 95111140 LANOGASTRO 95111158 LANOGASTRO

APRESENTAÇÃO 667 mg/ml xpe, 10 sach, x 15 ml (salada de frutas) 667 mg/ml xpe, fr, plast, (PET) x 120 ml (sabor ameixa) 667 mg/ml xpe, fr, plast, (PET) x 120 ml (salada de frutas) 100 mg, 50 caps, 200 mg,30 caps, 50 mg, vd, 50 caps, 10 mg/ml sol, or, ct, fr, plas, opc, x 240 ml+ ser, dos, 100 mg, cx, 3 bl, x 10 25 mg, cx, 30 cprs 50 mg, cx, 3 bl, x 10 Disp, 100 mg, x 30 cprs, Disp, 200 mg, x 30 cprs, Disp, 25 mg, x 30 cprs, Disp, 50 mg, x 30 cprs, 1% creme bisn, 20g 125 mg, bl, 14 cprs, 250 mg, bl, 28 cprs, Creme 7,5 g Spray 30 ml 100 mg cx, 30 cprs, 25 mg cx, 30 cprs, 50 mg cx, 30 cprs, Bl, 6 x 10 cprs, 100 mg, bl, pvc/pvdc inc, x 30 cprs, 100 mg, 30 cprs, 100 mg, 30 cprs, 25 mg, 30 cprs, 25 mg, 30 cprs, 50 mg, 30 cprs, 50 mg, 30 cprs, 100 mg, 30 cprs, 25 mg, 30 cprs, 50 mg, 30 cprs, 0,5 mg/5 ml, 5 amps, Cx, 30 cprs, 30 mg 7 caps, 30 mg, 14 caps, gel dura c/mcgran, lib, retard, 30 mg, 7 caps, gel dura c/mcgran, lib, retard,

Laboratorio DAIICHI SANKYO DAIICHI SANKYO DAIICHI SANKYO SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS CRISTALIA GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS TORRENT TORRENT TORRENT RANBAXY TEUTO BRAS, EUROFARMA ARROW EUROFARMA ARROW EUROFARMA ARROW UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA ROCHE EVOLABIS - SIF TEUTO BRAS, TEUTO BRAS, TEUTO BRAS,

UNIDADE Pco Unt Base A ML 0,21 ML 0,21 ML 0,21 COMP 2,34 CAPS 4,61 CAPS 1,23 ML 0,38 CPR 4,89 CPR 1,57 CPR 2,80 COMP 1,93 COMP 3,86 COMP 0,81 COMP 1,33 G 0,77 CPR 3,70 CPR 6,83 UND 6,08 DOSE 0,04 CPR 1,30 CPR 0,47 CPR 0,78 COMP 2,31 COMP 3,15 CP 2,99 COMP 1,73 CP 1,12 COMP 0,63 CP 1,87 COMP 1,03 COMP 1,26 COMP 0,46 COMP 0,76 AP 137,17 CPR 0,17 CPR 3,00 CAPS 3,50 CAPS 3,74

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7889 7890 7891 7892 7893 7894 7895 7896 7897 7898 7899 7900 7901 7902 7903 7904 7905 7906 7907 7908 7909 7910 7911 7912 7913 7914 7915 7916 7917 7918 7919 7920 7921 7922 7923 7924 7925 7926

CODIGO BENEFICIO 95972749 LANSODOM 95972757 LANSODOM 95972765 LANSOHEXAL 95972773 LANSOHEXAL 95894462 LANSOPRAZOL - GENERICO 95999892 LANSOPRAZOL - GENERICO 95030778 LANSOPRAZOL - GENERICO 95030786 LANSOPRAZOL - GENERICO 95894489 LANSOPRAZOL - GENERICO 95894497 LANSOPRAZOL - GENERICO 95999906 LANSOPRAZOL - GENERICO 95894500 LANSOPRAZOL - GENERICO 95894519 LANSOPRAZOL - GENERICO 95999914 LANSOPRAZOL - GENERICO 95894527 LANSOPRAZOL - GENERICO 95894535 LANSOPRAZOL - GENERICO 95999922 LANSOPRAZOL - GENERICO 95030751 LANSOPRAZOL - GENERICO 95030760 LANSOPRAZOL - GENERICO 95030743 LANSOPRAZOL - GENERICO 95972781 LANSOPRID 95972790 LANSOPRID 95999949 LANTUS 95999957 LANTUS 95972811 LANTUS OPTISET 95999930 LANTUS OPTISET 95072470 LANTUS SOLOSTAR 95152784 LANVIS 95972820 LANZ 95972838 LANZ 95972846 LANZ 95972854 LANZ 95056670 LANZACOR 95988424 LANZACOR 95988432 LANZACOR 95124411 LANZACOR (Restrito Hosp,) 95030840 LANZOL 95030824 LANZOL

APRESENTAÇÃO Laboratorio 15 - 15 mg, caps, micro desinteg, grad,+ 10 mg, cprs, c/2 b MEDLEY 30 - 30 mg, caps, micro desinteg, grad,+ 10 mg, cprs, c/2 b MEDLEY 30 mg, 14 caps, HEXAL 30 mg, 7 caps, HEXAL 15 mg, 14 caps, gel, dura EMS 15 mg, 2 bl, x 7 caps, GERMED 15 mg, cx, 14 caps, MEDLEY 15 mg, cx, 28 caps, MEDLEY 30 mg, 1 bl, x 7 cprs, GEN - LEGRAND 30 mg, 14 caps, gel, dura EMS 30 mg, 2 bl, x 7 caps, GERMED 30 mg, 2 bl, x 7 cprs, GEN - LEGRAND 30 mg, 28 caps, gel, dura EMS 30 mg, 4 bl, x 7 caps, GERMED 30 mg, 4 bl, x 7 cprs, GEN - LEGRAND 30 mg, 7 caps, gel, dura EMS 30 mg, bl, x 7 caps, GERMED 30 mg, cx, 14 caps, MEDLEY 30 mg, cx, 28 caps, MEDLEY 30 mg, cx, 7 caps, MEDLEY 15 mg,+ 10 mg, 2 bl, x 7+ 21 caps, gel, dura MEDLEY 30 mg,+ 10 mg, 2 bl, x 7+ 21 caps, gel, dura MEDLEY 100 UI/ml sol, inj, 5 carp, vd, x 3 ml SANOFI-AVENTIS 100 UI/ml sol, inj, FA vd, x 10 ml SANOFI-AVENTIS 100 UI/ml sol, inj, 1 carp, vd, x 3 ml+ 1 sist, aplic, PL SANOFI-AVENTIS 100 UI/ml sol, inj, 5 carp, vd, x 3 ml+ 5 sist, aplic, PL SANOFI-AVENTIS 100 UI/ml sol, inj, 1 carp, vd, inc,x3 ml+1 sist,aplic,plas, SANOFI-AVENTIS 40 mg. fr. vd. amb. x 25 cprs. ASPEN PHARMA 15 mg, caps, 2 bl, x 7 SIGMA PHARMA 30 mg caps, gel dura fr, 14 SIGMA PHARMA 30 mg, caps, gel dura 4 bl, x 7 SIGMA PHARMA 30 mg, caps, gelatinosa 1 bl, x 7 SIGMA PHARMA 50 mg, cx, 49 bl, x 10 cprs, rev, (hosp,) NEO QUIMICA 50 mg, cx,1bl,14cprs, NEO QUIMICA 50 mg, cx,2bl,14cprs, NEO QUIMICA 50 mg, cx, 49 bl, x 10 cprs, rev, (hosp,) NEO QUIMICA 15 mg, 14 caps, ACHE 30 mg, 7 caps, ACHE

UNIDADE Pco Unt Base A CPR 17,73 CPR 30,01 CPR 2,76 CPR 2,95 CAPS 1,87 CAPS 1,63 CPR 1,88 CPR 1,85 COMP 2,34 CAPS 3,65 CAPS 2,79 COMP 1,39 CAPS 3,47 CAPS 5,12 COMP 1,38 CAPS 3,87 CAPS 3,25 CPR 3,69 CPR 3,51 CPR 3,65 CPR 1,62 CPR 1,89 UNID 80,53 F,A, 258,61 AP 88,94 UNID 88,93 UI 0,31 CPRS 5,51 CPR 1,35 CPR 2,23 CPR 1,90 CPR 2,27 COMP 1,12 COMP 1,39 COMP 2,78 COMP 1,28 CPR 1,88 CPR 3,83

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7927 7928 7929 7930 7931 7932 7933 7934 7935 7936 7938 7939 7940 7941 7942 7943 7944 7945 7946 7947 7948 7949 7950 7951 7952 7953 7954 7955 7956 7957 7958 7959 7960 7961 7962 7963 7964 7965

CODIGO BENEFICIO 95072497 LANZOPRAN 95072489 LANZOPRAN 95007784 LANZOPRAZOL - GENERICO 95000011 LANZOPRAZOL - GENERICO 95972870 LARINGEX 95972889 LARINGEX 95894543 LASILACTONA 95100482 LASIX 95100490 LASIX 95111166 LATANOPROSTA - GENERICO 95066640 LECTRUM 95066659 LECTRUM 95137858 LEFLUNOMIDA - GENERICO 95972900 LEGALON - FITOTERAPICO 95000100 LEGIFOL (FOLINATO DE CALCIO) 95011277 LEITE DE MAGNESIA PHILLIPS 95280324 LEPONEX 95280332 LEPONEX 95124420 LEPONEX (Restrito Hosp,) 95180184 LESCOL 95180192 LESCOL 95180230 LESCOL 95038922 LESTAMIL 95894551 LESTAMIL 95894560 LESTAMIL 95042156 LETROZOL - GENERICO 95111174 LETROZOL - GENERICO (ICMS 0%) 95090614 LEUCIN (Restrito Hosp,) 95550097 LEUCOCITIM - MOLGRAMOSTIMA 95550100 LEUCOCITIM - MOLGRAMOSTIMA 95550119 LEUCOCITIM - MOLGRAMOSTIMA 95550135 LEUCOGEN 95550127 LEUCOGEN 95541730 LEUKERAN 95541764 LEUSTATIN 95152881 LEUSTATIN (Restrito Hosp.) 95378898 LEVAFLOX (LEVOFLOXACINA) 95378901 LEVAQUIN

APRESENTAÇÃO Laboratorio 30 mg, cx, 14 caps, ROYTON 30 mg, cx, 7 caps, ROYTON 30 mg, 2 bl, x 7 cprs, GEN - LEGRAND 30 mg, 28 caps, gel, dura EMS Cx, 20 past, CAZI Sol, oro-faringeo fr, 150 ml CAZI 100 mg,+ 20 mg, ct, 5 str, al, x 6 caps, gel, dura SANOFI-AVENTIS Cx, 20 cprs, SANOFI-AVENTIS Cx, 5 x 2 ml, SANOFI-AVENTIS 0,05 mg, sol, 2,5 ml EMS 3,75mg, poliof, inj,FAvd, inc,amp,dil, x 1,5 ml+ser,+ 2 ag, SANDOZ 7,50 mg, po liof, inj, FA vd, inc, amp, dil, x 1,5 ml+ ser,+ 2 ag, SANDOZ 20 mg. bl. al/al. x 30 cprs. rev. BIOSINTETICA Cx, 30 drags, 70 mg, NYCOMED PHARMA 50 mg, sol, inj, cx, 10 FA PFIZER Liq, fr, 350 ml, GLAXOSMITHKLINE 100 mg, cx, 3 bl, x 10 cprs, NOVARTIS 25 mg, cx, 20 cprs, NOVARTIS 100 mg, 450 cp, NOVARTIS 20 mg, str, x 14 caps, NOVARTIS 40 mg, str, x 14 caps, NOVARTIS XL 80 mg 30 cp, NOVARTIS 2 mg/5 ml+ 0,25 mg/5 ml xpe, fr, pet 120 ml cp, med, TEUTO BRAS, Cx, 15 cprs, TEUTO BRAS, Xpe, fr, 120 ml TEUTO BRAS, 2,5 mg, bl, 28 cprs, rev, EUROFARMA 2,5 mg, bl, 30 cprs, rev, EUROFARMA 300 mcg/ml cx, 5 FA 1 ml, BERGAMO 150 mcg, c/ dil, 1 ml BLAUSIEGEL 300 mcg, c/ dil, 1 ml BLAUSIEGEL 400 mcg, c/ dil, 1 ml BLAUSIEGEL Caps, gel 2 bl, x 10 ACHE Xpe, 120 ml, ACHE Cx, 25 cprs, 2 mg, GLAXOSMITHKLINE Cx, 1 FA 10 ml, JANSSEN - CILAG 1 mg. FA inj. 8 ml JANSSEN - CILAG 500 mg bolsa 100 ml HALEX ISTAR 500 mg, 10 cprs, JANSSEN - CILAG

UNIDADE Pco Unt Base A CAPS 1,78 CAPS 2,14 COMP 1,39 CAPS 3,47 CPR 0,45 ML 0,08 CAPS 1,23 CPR 0,51 AP 1,18 GOTAS 1,21 FA 389,11 FA 1006,52 COMP 6,08 CPR 1,61 F,A, 43,57 ML 0,02 CPR 5,62 CPR 1,40 COMP 4,88 CPR 2,03 CPR 2,47 CPR 3,72 ML 0,11 COMP 0,64 ML 0,11 COMP 10,33 COMP 12,02 FA 314,28 AP 167,70 AP 293,34 AP 403,77 CAPS 4,40 ML 0,58 CPR 0,89 FA 1230,83 X FA 984,66 UND 129,11 CPR 15,39

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 7966 7967 7968 7969 7970 7971 7972 7973 7974 7975 7976 7977 7978 7979 7980 7981 7982 7983 7984 7985 7986 7987 7988 7989 7990 7991 7992 7993 7994 7995 7996 7997 7998 7999 8000 8001 8002 8003

CODIGO BENEFICIO 95124438 LEVAQUIN (Restrito Hosp,) 95056696 LEVCIN 95056688 LEVCIN 95111182 LEVCIN 95111190 LEVCIN 95056700 LEVCIN 95056718 LEVCIN 95972927 LEVEDURA DE CERVEJA 95972935 LEVEL 95111204 LEVEL 95111212 LEVEMIR 95111220 LEVEMIR 95072500 LEVERCTIN 95072519 LEVERCTIN 95972943 LEVITRA 95894594 LEVITRA 95972951 LEVITRA 95000143 LEVITRA 95972960 LEVITRA 95894608 LEVITRA 95972978 LEVITRA 95378995 LEVOFLOXACINO - GENERICO 95972994 LEVOFLOXACINO - GENERICO 95111239 LEVOFLOXACINO - GENERICO 95111247 LEVOFLOXACINO - GENERICO 95047093 LEVOFLOXACINO - GENERICO 95972986 LEVOFLOXACINO - GENERICO 95029460 LEVOFLOXACINO - GENERICO 95379002 LEVOFLOXACINO - GENERICO 95973028 LEVOFLOXACINO - GENERICO 95894616 LEVOFLOXACINO - GENERICO 95894624 LEVOFLOXACINO - GENERICO 95894632 LEVOFLOXACINO - GENERICO 95029494 LEVOFLOXACINO - GENERICO 95973036 LEVOFLOXACINO - GENERICO 95973044 LEVOFLOXACINO - GENERICO 95894640 LEVOFLOXACINO - GENERICO 95894659 LEVOFLOXACINO - GENERICO

APRESENTAÇÃO 500 mg, mini-bag 100 ml 250 mg, bl, 7 cprs, rev, 500 mg, bl, 10 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 7 cprs, rev, 500 mg,bl,3cprs,rev, 500 mg,bl,7cprs,rev, Fr, 100 cprs, 0,1/0,02 mg, bl, 21 cprs, rev, 100 mcg + 20 mcg 3 bl, x 21 cprs, rev, FlexPen cx, c/5 Penfill 3 ml cx, c/5 6 mg, 1 bl, x 2 cprs, 6 mg, 2 bl, x 2 cprs, 10 mg, 1 cpr, 10 mg, 2 cprs, 10 mg, 4 cprs, 20 mg, 2 cprs, 20 mg, 4 cprs, 20 mg, 8 cprs, 5 mg, 4 cprs, 250 mg est, bl, 7 cprs, 250 mg, 7 cprs, 250 mg, bl, 7 cprs, rev, 250 mg, bl, pvc/pvdc x 7 cprs, 250mg,bl,7 cprs,rev, 250mg,bl,7cprs,rev, 5 mg/ml bolsa 100 ml 500 mg est, bl, 7 cprs, 500 mg, 10 cprs, 500 mg, 10 cprs, rev, 500 mg, 10 cprs, rev, 500 mg, 10 cprs, rev, 500 mg, 7 bl, x 6 cprs, rev, 500 mg, 7 cprs, 500 mg, 7 cprs, 500 mg, 7 cprs, rev, 500 mg, 7 cprs, rev,

Laboratorio JANSSEN - CILAG SANDOZ SANDOZ SANDOZ SANDOZ SANDOZ SANDOZ OSORIO DE MORAES BIOLAB SANUS BIOLAB SANUS NOVO NORDISK PROD, NOVO NORDISK PROD, EMS EMS BAYER BAYER BAYER BAYER BAYER BAYER BAYER RANBAXY RATIOPHARM SANDOZ ZYDUS SANDOZ BRAINFARMA HALEX ISTAR RANBAXY EUROFARMA EMS GERMED GEN - LEGRAND EMS EUROFARMA MEPHA-RATIOPHARM EMS GERMED

UNIDADE Pco Unt Base A UND 131,08 COMP 3,36 COMP 6,72 COMP 6,72 COMP 6,72 COMP 5,66 COMP 4,80 CPR 0,07 CPR 0,55 COMP 0,52 UND 60,94 UND 57,52 COMP 5,41 COMP 4,36 CPR 17,79 COMP 27,71 CPR 26,30 COMP 36,98 CPR 36,97 COMP 36,72 CPR 28,11 CPR 3,20 CPR 3,63 COMP 3,09 COMP 2,34 COMP 2,33 CPR 3,63 UND 69,20 CPR 7,55 CPR 6,53 COMP 6,52 COMP 5,84 COMP 6,33 CPR 6,52 CPR 6,53 CPR 5,48 COMP 6,52 COMP 5,93

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8004 8005 8006 8007 8008 8009 8010 8011 8012 8013 8014 8015 8016 8017 8018 8019 8020 8021 8022 8023 8024 8025 8026 8027 8028 8029 8030 8031 8032 8033 8034 8035 8036 8037 8038 8039 8040 8041

CODIGO BENEFICIO 95894667 LEVOFLOXACINO - GENERICO 95047115 LEVOFLOXACINO - GENERICO 95019693 LEVOFLOXACINO - GENERICO 95019723 LEVOFLOXACINO - GENERICO 95082891 LEVOFLOXACINO - GENERICO 95111255 LEVOFLOXACINO - GENERICO 95111263 LEVOFLOXACINO - GENERICO 95111271 LEVOFLOXACINO - GENERICO 95111280 LEVOFLOXACINO - GENERICO 95111298 LEVOFLOXACINO - GENERICO 95047085 LEVOFLOXACINO - GENERICO 95047107 LEVOFLOXACINO - GENERICO 95973010 LEVOFLOXACINO - GENERICO 95124446 LEVOFLOXACINO - GENERICO (Restrito Hosp,) 95124454 LEVOFLOXACINO - GENERICO (Restrito Hosp,) 95124462 LEVOFLOXACINO - GENERICO (Restrito Hosp,) 95111301 LEVOGEN 95038973 LEVOID 95038981 LEVOID 95038990 LEVOID 95039007 LEVOID 95039015 LEVOID 95039023 LEVOID 95038930 LEVOID 95089659 LEVOID 95038949 LEVOID 95038957 LEVOID 95038965 LEVOID 95075283 LEVOPHED 95125949 LEVOPHED (BITARTARATO DE NOREPINEFRINA) 95985565 LEVORDIOL 95571256 LEVORIN - LEUCOVORINA CALCICA 95082930 LEVOTIROXINA SODICA - GENERICO 95082972 LEVOTIROXINA SODICA - GENERICO 95082948 LEVOTIROXINA SODICA - GENERICO 95082956 LEVOTIROXINA SODICA - GENERICO 95082980 LEVOTIROXINA SODICA - GENERICO 95082999 LEVOTIROXINA SODICA - GENERICO

APRESENTAÇÃO 500 mg, 7 cprs, rev, 500 mg, bl, 10 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 3 cprs, rev, 500 mg, bl, 7 cprs, rev, 500 mg, bl, pvc/pvdc x 7 cprs, 500mg, bl, 3 cprs,rev, 500mg, bl,7cprs,rev, 500mg,bl,7cprs,rev, 5 mg/ml bolsa 100 ml 5 mg/ml bolsa poliet, 100 ml 5 mg/ml sol, inj, 6 bolsas plast, x 100 ml 0,150 mg, + 0,030 mg, bl, 21 cprs, rev, 100 mcg, bl, 30 cprs, 112 mcg, bl, 30 cprs, 125 mcg, bl, 30 cprs, 150 mcg, bl, 30 cprs, 175 mcg, bl, 30 cprs, 200 mcg, bl, 30 cprs, 25 mcg, bl, 30 cprs, 38 mcg bl, 30 cprs, 50 mcg, bl, 30 cprs, 75 mcg, bl, 30 cprs, 88 mcg, bl, 30 cprs, 1 mg/ml 4 ml (cx, 10 FA) 4 MG - CX C/ 10 AMP x 4 ML Cx, 28 cprs 15 mg, bl, 10 cprs, 100 mcg cart, bl, al, al, x 30 cprs, 112 mcg cart, bl, al, al, x 30 cprs, 125 mcg crt, bl, al, al, x 30 cprs, 150 mcg cart, bl, al, al, x 30 cprs, 175 mcg cart, bl, al, al, x 30 cprs, 200 mcg cart, bl, al, al, x 30 cprs,

Laboratorio GEN - LEGRAND SANDOZ EMS EUROGENUS - LEGRAND EUROFARMA EMS GERMED SANDOZ BRAINFARMA ZYDUS SANDOZ SANDOZ BRAINFARMA HALEX ISTAR ISOFARMA EUROFARMA EUROFARMA ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE ACHE HOSPIRA HOSPIRA SIGMA PHARMA BLAUSIEGEL MERCK MERCK MERCK MERCK MERCK MERCK

UNIDADE Pco Unt Base A COMP 6,33 COMP 6,51 COMP 5,48 COMP 4,51 COMP 6,51 COMP 6,51 COMP 4,89 COMP 6,52 COMP 6,53 COMP 4,98 COMP 4,67 COMP 6,50 CPR 4,66 UNID 79,35 UNID 71,49 COMP 69,96 COMP 0,19 CP 0,24 CP 0,47 CP 0,36 CP 0,39 CP 0,49 CP 0,59 CP 0,26 COMP 0,21 CP 0,29 CP 0,31 CP 0,38 FA 16,23 AMP 16,23 COMP 0,42 CPR 8,26 COMP 0,15 COMP 0,29 COMP 0,22 COMP 0,24 COMP 0,30 COMP 0,51

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Orde Geral 8042 8043 8044 8045 8046 8047 8048 8049 8050 8051 8052 8053 8054 8055 8056 8057 8058 8059 8060 8061 8062 8063 8064 8065 8066 8067 8068 8069 8070 8071 8072 8073 8074 8075 8076 8077 8078 8079

CODIGO BENEFICIO 95082905 LEVOTIROXINA SODICA - GENERICO 95082913 LEVOTIROXINA SODICA - GENERICO 95082921 LEVOTIROXINA SODICA - GENERICO 95082964 LEVOTIROXINA SODICA - GENERICO 95379070 LEVOXIN 95379053 LEVOXIN 95379061 LEVOXIN 95973052 LEVOXIN 95894675 LEVOXIN 95973060 LEVOXIN 95043772 LEVOZINE 95043780 LEVOZINE 95280375 LEVOZINE 95056769 LEXAPRO 95111328 LEXAPRO 95111336 LEXAPRO 95111344 LEXAPRO 95111352 LEXAPRO 95039031 LEXAPRO 95072527 LEXAPRO 95111360 LEXAPRO 95899987 LEXATO 95899979 LEXATO 95973095 LEXFAST 95973109 LEXFAST 95973117 LEXFAST 95072535 LEXIN 95379088 LEXIN 95270930 LEXOTAN 95270949 LEXOTAN 95973133 LEXOTAN 95056777 LEZEPAN 95056785 LEZEPAN 95530428 LIBERAN 95530410 LIBERAN 95530436 LIBERAN 95530444 LIBERAN 95541780 LIBOXAL

APRESENTAÇÃO 25 mcg cart, bl, al, al, x 30 cprs, 50 mcg cart, bl, al, al, x 30 cprs, 75 mcg cart, bl, al, al, x 30 cprs, 88 mcg cart, bl, al, al, x 30 cprs, 250 mg 3 cprs, rev, 250 mg 7 cprs, rev, 500 mg 7 cprs, rev, 500 mg, 10 cprs, rev, 500 mg, 14 cprs, rev, 500 mg, 3 cprs, rev, 100 mg, 20 bl, 10 cps, 25 mg, 20 bl, 10 cps, 40 mg/ml cx, 10 frs, 20 ml 10 mg, 15 ml 10 mg, 28 cprs, 10 mg, 7 cprs, 15 mg, 14 cprs, 15 mg, 28 cprs, 20 mg, 14 cprs, 20 mg, 28 cprs, 20 mg/ml 15 ml Sol, inj, 50 mg, cx, FA Sol,inj,500 mg,cx, FA 3 mg, bl, 20 cprs, 6 mg, bl, 20 cprs, 6 mg/ml sol, oral fr, 20 ml 50 mg/ml po susp, oral fr, vd, amb, x 100 ml+ cp, med, 500 mg, 10 cprs 3 mg, cx, 20 cprs, 6 mg, cx, 20 cprs, Gotas 20 ml 3 mg, cx, 20 cprs, 6 mg, cx, 20 cprs, 10 mg, 30 cprs, 25 mg, 30 cprs, 5 mg, 30 cprs, 5 mg/ml inj, 1 ml x 6 amps, 100 mg, po liof, FA x1000 mg,

Laboratorio MERCK MERCK MERCK MERCK APSEN APSEN APSEN APSEN APSEN APSEN CRISTALIA CRISTALIA CRISTALIA LUNDBECK LUNDBECK LUNDBECK LUNDBECK LUNDBECK LUNDBECK LUNDBECK LUNDBECK DARROW DARROW SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA TEUTO BRAS, TEUTO BRAS, ROCHE ROCHE ROCHE NEO QUIMICA NEO QUIMICA APSEN APSEN APSEN APSEN LIBRA

UNIDADE Pco Unt Base A COMP 0,16 COMP 0,18 COMP 0,19 COMP 0,23 CPR 3,84 CPR 3,40 CPR 6,79 CPR 6,79 COMP 6,53 CPR 6,79 CP 0,56 CP 0,28 GOTAS 0,02 GOTA 0,22 COMP 5,29 COMP 5,28 COMP 6,34 COMP 6,34 CP 10,56 COMP 10,04 GOTAS 0,53 FA 15,54 FA 96,74 CPR 0,61 CPR 1,03 GOTAS 0,03 ML 0,25 CPR 2,14 CPR 0,69 CPR 1,16 GOTAS 0,02 COMP 0,42 COMP 0,64 CPR 1,04 CPR 1,33 CPR 0,58 AP 8,09 FA 829,49 X

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8080 8081 8082 8083 8084 8085 8086 8087 8088 8089 8090 8091 8092 8093 8094 8095 8096 8097 8098 8099 8100 8101 8102 8103 8104 8105 8106 8107 8108 8109 8110 8111 8112 8113 8114 8115 8116 8117

CODIGO BENEFICIO 95541772 LIBOXAL 95066667 LIBRACTAM 95066675 LIBRACTAM 95066683 LIBRATECAM 95072543 LICOR DE CACAU VERMIFUGO DE XAVIER 95072560 LICOR DE CACAU VERMIFUGO DE XAVIER 95072551 LICOR DE CACAU VERMIFUGO DE XAVIER 95920072 LIDOCAINA - GENERICO 95056793 LIDOCAINA - GENERICO 95056823 LIDOCAINA - GENERICO 95056815 LIDOCAINA - GENERICO 95056807 LIDOCAINA - GENERICO 95081488 LIDOCAINA - GENERICO 95056831 LIDOCAINA - GENERICO 95111379 LIDOCAINA - GENERICO (Restrito Hosp,) 95920080 LIDOGEL 95124470 LIDOGEL (Restrito Hosp,) 95000216 LIDOSPORIN 95780262 LIDOSPRAY 95780270 LIDOSTON S/VASO 95124489 LIFOLIN (Restrito Hosp,) 95066713 LIFOS 95973150 LIMA C 95270990 LIMBITROL 95894683 LINATIS 95894691 LINATRON 95379150 LINCOFLAN 95379169 LINCOFLAN 95124497 LINCOMIRAL 95124500 LINCOMIRAL 95124519 LINCOVAX 95072586 LINURIN 95072578 LINURIN 95271007 LIORAM 95650113 LIORESAL 95180249 LIPANON 95894705 LIPANON RETARD 95894713 LIPANON RETARD

APRESENTAÇÃO 50 mg, po liof, FA x 500 mg, 1 g+ 2 g FA vd, 500 mg,+ 1000 mg, po inj, cx, FA 1,5 g 20 mg/ml sol, inj, FA vd, x 5,0 ml 100 mg, bl, 6 cprs, 20 mg/ml susp, oral fr, 30 ml 500 mg, bl, 1 cpr, 2% s/v cx, 25 x 20 ml, 40 mg/g creme derm, bisn, 30 g 40 mg/g creme derm, bisn, 30 g 50 mg/g pom, derm, bisn, 25 g 50 mg/g pom, derm, bisn, 25 g (laranja) 50 mg/g pom, derm, ct, bg, al, x 25 g 50 mg/g pom, derm, sabor laranja bisn, 25 g 2% s/v cx, 25 x 20 ml, Gel 30 g c/aplic, 2% gel top, cx, 50 bisn, 30 g (hosp,) Sol, otol, fr, 10 ml 10% fr, 50 ml, 2% 12 FA20 ml 50 mg, po liof, cx, FA 1 g po liof, inj, FA vd, Cx, 12 past, Cx, bl, x 20 caps, 0,35 mg, cx, 5 bl, x 7 600 mg, cx, 50 amps, 2 ml 300 mg, cx,1 amp, 1ml 600 mg, cx,1 amp,2 ml Inj, 300 mg, cx, 1 amp, 1 ml Inj, 600 mg, cx, 1 amp, 2 ml Cx, 1 amp, 2 ml 600 mg, 20 cprs, Susp, 100 ml 10 mg, 1 bl, 10 cprs, 10 mg, bl, 20 cprs, Retard 30 caps, 250 mg, bl, 15 caps, gel, microg, 250 mg, bl, 30 caps, gel, microg,

Laboratorio LIBRA LIBRA LIBRA LIBRA COSMED COSMED COSMED HYPOFARMA EMS GERMED EMS EMS PRATI DONADUZZI GERMED HYPOFARMA NEO QUIMICA NEO QUIMICA FARMOQUIMICA APSEN ARISTON LIBRA LIBRA CAZI VALEANT EUROFARMA ARISTON BUNKER BUNKER DUCTO DUCTO DELTA DOVALLE DOVALLE MANTECORP NOVARTIS FARMASA FARMASA FARMASA

UNIDADE Pco Unt Base A FA 412,67 X FA 40,05 FA 9,55 FA 1320,60 COMP 1,44 ML 0,29 COMP 7,19 ML 0,13 G 1,52 G 1,37 G 0,31 G 0,30 G 0,29 G 0,30 UND 2,54 G 0,35 GRAMA 0,29 GOTA 0,04 DOSE 0,04 ML 0,12 FA 6,21 FA 94,77 CPR 0,54 CPR 0,32 COMP 0,18 AMP 6,36 AP 6,84 AP 11,08 AMP 4,77 AMP 6,09 AMP 7,01 COMP 0,63 ML 0,10 CPR 2,23 CPR 1,27 CPR 1,65 CAPS 1,91 CAPS 1,91

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8118 8119 8120 8121 8122 8123 8124 8125 8126 8127 8128 8129 8130 8131 8132 8133 8134 8135 8136 8137 8138 8139 8140 8141 8142 8143 8144 8145 8146 8147 8148 8149 8150 8151 8152 8153 8154 8155

CODIGO BENEFICIO 95180265 LIPIDIL 95042164 LIPIODOL ULTRA-FLUIDO 95180290 LIPITOR 95111387 LIPITOR 95072594 LIPITOR 95111395 LIPITOR 95111409 LIPITOR 95072608 LIPITOR 95180273 LIPITOR 95379282 LIPITOR 95111417 LIPITOR 95379312 LIPITOR 95066764 LIPLATIN 95310126 LIPLESS 95111433 LIPOTEX 95581065 LIPOVENOS 95581073 LIPOVENOS 95581057 LIPOVENOS 95581081 LIPOVENOS 95000259 LIPOVENOS 95581090 LIPOVENOS 20% 95894721 LIPTRAT 95160477 LIQUEMINE 95039058 LISADOR 95083014 LISADOR 95019774 LISADOR 95039066 LISADOR 95581839 LISADOR 95056840 LISADOR 95973249 LISAFLEX 95973257 LISAFLEX 95000275 LISAFLEX 95431314 LISAGLUCON 95133356 LISAPRES 95662693 LISEDEMA 95662707 LISEDEMA 95973281 LISINOPRIL + HIDROCLOTIAZIDA - GEN 95973273 LISINOPRIL + HIDROCLOTIAZIDA - GEN

APRESENTAÇÃO 3 bl, x 10 caps, Amp, 10 ml x 1 10 cprs, rev, 10 mg, 10 mg, 30 cprs, rev, 10 mg, 90 cprs, rev, 20 mg, 10 cprs, rev, 20 mg, 30 cprs, rev, 20 mg, 90 cprs, rev, 30 cprs, rev, 20 mg, 40 mg 30 cprs, 40 mg, 10 cprs, rev, 80 mg 30 cprs, 150 mg, po inj, cx, FA 100 mg 30 cprs, 20 mg, bl, 30 cprs, rev, 20% 1 x 100 ml 20% 1 x 500 ml MCT 10% 1 x 500 ml MCT 20% 1 x 500 ml PLR 10% 1 x 100 ml 1 x 1000 ml 10 mg, 30 cprs, rev, Cx, 25 amps, (subcutanea) 5000 UI/0,25 ml, 375 mg,+ 12,5 mg,+ 12,5 mg/ml sol, inj, 50 amps, vd, 500 mg, 25 bl, x 8 cprs, 500 mg,+ 5 mg,+ 10 mg, 25 bl, x 4 cprs, 500 mg,+ 5 mg,+ 10 mg/1,5 ml sol, oral fr, 20 ml Inj, cx, 3 amps, Sol, oral ct, fr, vd, amb, x 15 ml Cx, 3 bl, x 4 cprs, Gts, fr,15 ml Sol, inj,50amps,x2ml, Cx, 20 cprs, 4 mg, 30 cprs, 10 mg, 16 drags 20 mg, 16 drags, 20 mg,+ 12,5 mg, 3 bl, al, plast, x 10 cprs, 20 mg+ 12,5 mg 3 bl, al plast, x 10 cprs,

Laboratorio CHIESI GUERBET PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER LIBRA BIOLAB SANUS MEDLEY FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI UNIAO QUIMICA ROCHE FARMASA FARMASA FARMASA FARMASA FARMASA FARMASA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA FARMASA LIBBS CLIMAX CLIMAX MERCK BIOSINTETICA

UNIDADE Pco Unt Base A CPR 2,64 AMP 122,61 CPR 4,22 COMP 3,94 COMP 3,94 COMP 4,83 COMP 4,83 COMP 4,83 CPR 5,47 CPR 6,16 COMP 7,10 CPR 7,10 FA 57,50 CPR 1,79 COMP 1,49 ML 1,31 ML 0,49 ML 0,35 ML 0,56 ML 0,60 ML 0,57 COMP 1,07 AP 1,77 AMP 2,26 COMP 0,78 COMP 0,80 GOTA 0,06 AP 2,19 GOTA 0,06 CPR 0,36 GOTAS 0,03 AMP 1,33 CPR 0,22 CPR 0,41 CPR 0,58 CPR 0,93 CPR 4,41 CPR 5,40

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8156 8157 8158 8159 8160 8161 8162 8163 8164 8165 8166 8167 8168 8169 8170 8171 8172 8173 8174 8175 8176 8177 8178 8179 8180 8181 8182 8183 8184 8185 8186 8187 8188 8189 8190 8191 8192 8193

CODIGO BENEFICIO 95120777 LISINOPRIL - GENERICO 95120750 LISINOPRIL - GENERICO 95000283 LISINOPRIL - GENERICO 95111441 LISINOPRIL - GENERICO 95973303 LISINOPRIL - GENERICO 95973311 LISINOPRIL - GENERICO 95019790 LISINOPRIL - GENERICO 95000291 LISINOPRIL - GENERICO 95056866 LISINOPRIL - GENERICO 95894756 LISINOPRIL - GENERICO 95000305 LISINOPRIL - GENERICO 95056882 LISINOPRIL - GENERICO 95973354 LISINOPRIL - GENERICO 95120734 LISINOPRIL - GENERICO 95120769 LISINOPRIL - GENERICO 95000313 LISINOPRIL - GENERICO 95111450 LISINOPRIL - GENERICO 95973389 LISINOPRIL - GENERICO 95111468 LISINOPRIL - GENERICO 95973400 LISINOPRIL - GENERICO 95019804 LISINOPRIL - GENERICO 95056858 LISINOPRIL - GENERICO 95120815 LISINOPRIL - GENERICO 95894764 LISINOPRIL - GENERICO 95056890 LISINOPRIL - GENERICO 95111476 LISINOPRIL - GENERICO 95973362 LISINOPRIL - GENERICO 95973451 LISINOPRIL - GENERICO 95019812 LISINOPRIL - GENERICO 95120785 LISINOPRIL - GENERICO 95111484 LISINOPRIL - GENERICO 95000330 LISINOPRIL - GENERICO 95973478 LISINOPRIL - GENERICO 95019782 LISINOPRIL - GENERICO 95056874 LISINOPRIL - GENERICO 95120866 LISINOPRIL - GENERICO 95894772 LISINOPRIL - GENERICO 95029540 LISINOPRIL - GENERICO

APRESENTAÇÃO 10 mg cx, 10 cprs, 10 mg cx, 30 cprs, 10 mg, 2 bl, x 15 cprs, 10 mg, 2 bl, x 15 cprs, 10 mg, 2 bl, x 15 cprs, 10 mg, 3 bl, x 10 cprs, 10 mg, 9 bl, x 10 cprs, 10 mg, bl, 30 cprs, 10 mg, bl, 30 cprs, 10 mg, bl, 30 cprs, 10 mg, bl, al, pvc x 30 cprs, 10 mg, bl, plas,x 30 cprs, 10 mg, cx, 30 cprs, 20 mg 2 bl, al, plast, x 15 cprs, 20 mg cx, 30 cprs, 20 mg, 2 bl, x 15 cprs, 20 mg, 2 bl, x 15 cprs, 20 mg, 2 bl, x 15 cprs, 20 mg, 3 bl, x 10 cprs, 20 mg, 3 bl, x 10 cprs, 20 mg, 6 bl, x 10 cprs, 20 mg, bl, 30 cprs, 20 mg, bl, 30 cprs, 20 mg, bl, 30 cprs, 20 mg, bl, plas,x 30 cprs, 20 mg, cx, 10 cprs, 20mg,cx,30cprs, 30 mg, 2 bl, x 15 cprs, 30 mg, 6 bl,x10 cprs, 5 mg cx, 30 cprs, 5 mg, 2 bl, al, plast, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 9 bl, x 10 cprs, 5 mg, bl, 30 cprs, 5 mg, bl, 30 cprs, 5 mg, bl, 30 cprs, 5 mg, c/30

Laboratorio MEDLEY MEDLEY GEN - LEGRAND EMS GERMED CRISTALIA EMS MERCK AUROBINDO PHARMA BRAINFARMA BIOSINTETICA SANDOZ TEUTO BRAS, BIOSINTETICA MEDLEY GEN - LEGRAND EMS GERMED CRISTALIA MERCK EMS AUROBINDO PHARMA RANBAXY BRAINFARMA SANDOZ MEDLEY TEUTO BRAS, GERMED EMS MEDLEY BIOSINTETICA EMS GERMED EMS AUROBINDO PHARMA RANBAXY BRAINFARMA SANDOZ

UNIDADE Pco Unt Base A CPR 0,86 CPR 0,94 COMP 0,72 COMP 0,94 CPR 0,69 CPR 0,97 COMP 0,85 COMP 0,90 COMP 0,65 COMP 0,74 COMP 0,87 COMP 0,93 CPR 0,70 CPR 1,77 CPR 1,65 COMP 1,14 COMP 1,65 CPR 1,49 COMP 1,85 CPR 1,38 COMP 1,27 COMP 2,02 CPR 1,41 COMP 1,28 COMP 1,62 COMP 1,44 CPR 1,34 CPR 2,12 COMP 2,07 CPR 0,59 COMP 0,68 COMP 0,59 CPR 0,51 COMP 0,53 COMP 0,45 CPR 0,45 COMP 0,46 CPR 0,60

214

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8194 8195 8196 8197 8198 8199 8200 8201 8202 8203 8204 8205 8206 8207 8208 8209 8210 8211 8212 8213 8214 8215 8216 8217 8218 8219 8220 8221 8222 8223 8224 8225 8226 8227 8228 8229 8230 8231

CODIGO BENEFICIO 95973532 LISINOPRIL - GENERICO 95120874 LISINOPRIL + HIDROCLOTIAZIDA - GENERICO 95000348 LISINORETIC 95973540 LISINORETIC 95973559 LISINOVIL 95111492 LISINOVIL 95973567 LISINOVIL 95973575 LISINOVIL 95973583 LISOCLOR 95541837 LISODREN 95973591 LISONOTEC 95988483 LISOPRIL 95973605 LISTRIL 95973613 LISTRIL 95530495 LITOCIT 95530487 LITOCIT 95066772 LITREXATE 95111506 LIVGAS 95973621 LIVOLON 95111514 LIVOLON 95460691 LIVOLON 95133364 LODIPEN 95030867 LOGAT 95030883 LOGAT 95030875 LOGAT 95973630 LOMDOR 95332936 LOMDOR 95894780 LOMFER 95000356 LOMFER 95571280 LOMFER 95571272 LOMFER 95124527 LOMFER (Restrito Hosp,) 95973648 LOMICINA 95140638 LOMIR 95133372 LONCORD 95133380 LONCORD 95056912 LONGACTIL 95056920 LONGACTIL

APRESENTAÇÃO 5 mg, cx, 30 cprs, 20 mg+ 12,5 mg 3 bl, al plast, x 10 cprs, 10/12,5 mg, cx, 30 cprs, 20/12,5 mg, cx, 30 cprs, 10 mg, cx, 30 cprs, 20 mg, cx, 30 cprs, 20mg,cx,30cprs, 5 mg, cx, 30 cprs, 20 mg/12,5 mg cx, 3 bl, x 10 cprs, 500 mg, fr, 100 cprs, 20 mg/12,5 mg, cx, 30 cprs, 10 mg, cx, 30 cprs, 10 mg cx, 30 cprs, 5 mg cx, 30 cprs, 10 mEq 60 cprs, 5 mEq 60 cprs, 25 mg/ml sol, inj, cx, FA 20 ml 75 mg/ml fr, 15 ml 1,25 mg, bl, 30 cprs, 1,25 mg, bl, 90 cprs, 2,5 mg, cx, 30 cprs, 5 mg cx, c/20 cprs, 150 mg, 20 cprs, 300 cx, 16 cprs, Inj, cx, 5 amps, Cx, c/50 fr, c/10 ml Fr, 10 ml, Cart, 5 bl, x 10 drags, Cx, c/50 fr, c/30 ml Fr, 100 ml, Fr, 30 ml, Cx, 250 bl, x 10 drags, 5 mg/g bisn, 10 g SRO 5 mg, cap, str, x 14 20 mg, 20 caps, 40 mg, 20 caps, 100 mg, 20bl,10cps, 25 mg, 20 bl, 10 cps,

Laboratorio TEUTO BRAS, MERCK HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL NEO QUIMICA B-MS TEUTO BRAS, NEO QUIMICA TORRENT TORRENT APSEN APSEN LIBRA MEDQUIMICA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS ROYTON LIBBS LIBBS LIBBS OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES NOVARTIS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS CRISTALIA CRISTALIA

UNIDADE Pco Unt Base A CPR 0,44 CPR 1,47 COMP 0,71 CPR 1,20 CPR 0,85 COMP 1,40 CPR 1,13 CPR 0,50 CPR 1,27 CPR 9,92 CPR 1,05 COMP 0,88 CPR 0,76 CPR 0,47 CPR 0,62 CPR 0,50 FA 47,89 GOTAS 0,02 CPR 1,02 COMP 0,79 CPR 1,63 CPR 0,41 CPR 0,70 CPR 2,03 AP 2,25 GOTAS 0,01 GOTAS 0,01 DRAG 0,15 GOTA 0,01 ML 0,07 GOTAS 0,01 COMP 0,14 G 0,57 CPR 3,35 CPR 0,60 CPR 1,39 COMP 0,26 COMP 0,16

215

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8232 8233 8234 8235 8236 8237 8238 8239 8240 8241 8242 8243 8244 8245 8246 8247 8248 8249 8250 8251 8252 8253 8254 8255 8256 8257 8258 8259 8260 8261 8262 8263 8264 8265 8266 8267 8268 8269

CODIGO BENEFICIO 95066780 LONGACTIL 95124535 LONGACTIL (Restrito Hosp,) 95133399 LONITEN 95894810 LONIUM 95894802 LONIUM 95894829 LOPERIN 95056939 LOPERIN 95111522 LOPID 95180346 LOPID 95056947 LOPIGREL 95056955 LOPIGREL 95030930 LOPRAZOL 95133402 LOPRESSOR 95133410 LOPRIL D 95391240 LOPROX 95973702 LORADINE 95230866 LORALERG 95973737 LORALERG D 95973745 LORALERG D 95230890 LORANIL 95230904 LORANIL 95230920 LORANIL 95056980 LORANIL D 95056963 LORANIL D 95056971 LORANIL D 95973753 LORAPAN 95973761 LORAPAN 95231005 LORATADINA - GENERICO 95894845 LORATADINA - GENERICO 95057013 LORATADINA - GENERICO 95230955 LORATADINA - GENERICO 95894870 LORATADINA - GENERICO 95029567 LORATADINA - GENERICO 95894896 LORATADINA - GENERICO 95000372 LORATADINA - GENERICO 95056998 LORATADINA - GENERICO 95973770 LORATADINA - GENERICO 95089667 LORATADINA - GENERICO

APRESENTAÇÃO 25 mg, 50 amps, 5 ml 40 mg/ml 10 frs, 20 ml 10 mg, fr, 30 cprs 40 mg, cx, 30 cprs, rev, 40mg,cx,10cprs,rev, 2 mg, 200 cprs, 2 mg, bl, x 12 cprs, 600 mg, 2 bl, x 12 cprs, rev, 900 mg, bl, 12 cprs, 75 mg, x 14 75 mg, x 28 10 mg, cx, 14 caps, 100 mg, 20 cprs, 50/25 mg, cprs, ct,c/2 blister x 8 Sol, fr, 15 ml, 10 mg, cx, 12 cprs, 10 mg, bl, 10 cprs, Cx, 10cprs, Xpe, fr,60 ml 10 mg, 20 cprs, 10 mg, cx, c/6 cprs, Xpe 100 ml, 24h 6 cprs, 6 cprs, Xarope fr, 60 ml, 1 mg, 20 cprs, 2 mg, 20 cprs, 0,2 mg/ml xpe fr, vd, ambar 100 ml 1 mg/ml cx, 50 fr, plast, opc x 100 ml (hosp,) 1 mg/ml xpe, 100 ml 1 mg/ml xpe, 100 ml, 1 mg/ml xpe, fr, plast, opc x 100 ml 1 mg/ml xpe, fr, vd, 100 ml+ cp, med, 1 mg/ml xpe, fr, vd, x 100 ml 1 mg/ml xpe, fr, vd, x 100 ml+ cp, med, 1,0 mg/ml xpe, fr, vd, amb, x 100 ml+ cp, med, 10 mg, 12 cprs, 10 mg, 2 bl, al, plast, x 6 cprs, rev,

Laboratorio CRISTALIA CRISTALIA PFIZER APSEN APSEN TEUTO BRAS, TEUTO BRAS, PFIZER PFIZER MEDLEY MEDLEY TEUTO BRAS, NOVARTIS B-MS SANOFI-AVENTIS TEUTO BRAS, FARMASA FARMASA FARMASA LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS NEO QUIMICA NEO QUIMICA ATIVUS PRATI DONADUZZI MEPHA-RATIOPHARM UNIAO QUIMICA PRATI DONADUZZI BIOSINTETICA BRAINFARMA MERCK NEO QUIMICA RANBAXY BIOSINTETICA

UNIDADE Pco Unt Base A AMP 1,63 GOTAS 0,01 CPR 1,07 COMP 1,14 COMP 1,07 COMP 0,22 COMP 0,35 COMP 3,58 CPR 5,26 COMP 2,88 COMP 2,85 CPR 0,90 CPR 0,81 CPR 2,05 GOTAS 0,07 CPR 1,59 CPR 1,94 CPR 1,84 ML 0,32 CPR 1,84 CPR 2,16 ML 0,21 COMP 3,87 COMP 2,02 ML 0,37 CPR 0,36 CPR 0,53 ML 0,13 ML 5,10 ML 0,15 ML 0,14 ML 0,15 GOTA 0,01 ML 0,12 ML 0,16 ML 0,15 CPR 1,39 COMP 1,58

216

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8270 8271 8272 8273 8274 8275 8276 8277 8278 8279 8280 8281 8282 8283 8284 8285 8286 8287 8288 8289 8290 8291 8292 8293 8294 8295 8296 8297 8298 8299 8300 8301 8302 8303

CODIGO BENEFICIO 95973800 LORATADINA - GENERICO 95057005 LORATADINA - GENERICO 95894900 LORATADINA - GENERICO 95057021 LORATADINA - GENERICO 95057030 LORATADINA - GENERICO 95894837 LORATADINA - GENERICO 95230971 LORATADINA - GENERICO 95894926 LORATADINA - GENERICO 95894918 LORATADINA - GENERICO 95083022 LORATADINA - GENERICO 95230980 LORATADINA - GENERICO 95124543 LORATADINA - GENERICO (Restrito Hosp,) 95973826 LORATADINA + PSEUDOEFEDRINA - GENERICO 95029605 LORATADINA + PSEUDOEFEDRINA - GENERICO 95029591 LORATADINA + PSEUDOEFEDRINA - GENERICO 95000402 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95029613 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95000399 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95894934 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95894942 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95000410 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95973834 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95000429 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95039112 LORATADINA + SULF, PSEUDOEFEDRINA - GENE 95000437 LORAX 95000445 LORAX 95973842 LORAZEFAST 95973850 LORAZEFAST 95271058 LORAZEPAM - GENERICO 95000461 LORAZEPAM - GENERICO 95894969 LORAZEPAM - GENERICO 95973877 LORAZEPAM - GENERICO 95000470 LORAZEPAM - GENERICO 95271066 LORAZEPAM - GENERICO

APRESENTAÇÃO Laboratorio 10 mg, 2 bl, al, plast, x 6 cprs, rev, MERCK 10 mg, 6 cprs, MEPHA-RATIOPHARM 10 mg, bl, al, plast, x 12 cprs, BRAINFARMA 10 mg, bl, x 10 cprs, SANDOZ 10 mg, bl, x 12 cprs, SANDOZ 1mg/mlxpe,fr,vd,60 ml FARMASA 5 mg/5 ml xpe, fr, 100 ml EMS 5 mg/5 ml xpe, fr, 100 ml GEN - LEGRAND 5mg/mlxpe,fr,100 ml GERMED Xarope 100 ml MULTILAB Xpe, fr, 100 ml,+ cp, med, MEDLEY 1 mg/ml, xpe, cx, 50 fr, plas, opc, x 100 ml + cp, med, (hosp,) PRATI DONADUZZI 1 mg/ml+ 12 mg/ml xpe, fr, 60 ml EMS 1 mg/ml+ 12 mg/ml xpe, fr, vd, 60 ml+ cp, med, BIOSINTETICA 1+12mg/mlxpe, 60 ml TEUTO BRAS, 1 mg/ml xpe, fr, 60 ml GEN - LEGRAND 1 mg/ml+ 12 mg/ml xpe, 60 ml,+ cp, med, SANDOZ 1 mg/ml+ 12 mg/ml xpe, fr, vd, 60 ml+ dos, MEDLEY 1 mg/ml+ 12 mg/ml xpe, fr, vd, x 60 ml BRAINFARMA 5 mg,+ 120 mg, bl, 12 drags, BRAINFARMA Xpe, 60 ml NOVARTIS Xpe, 60 ml EUROFARMA Xpe, fr, 60 ml GERMED Xpe, fr, 60 ml NEO QUIMICA 1 mg, ct, 1 bl, x 30 cprs, WYETH 2 mg, ct, 1 bl, x 30 cprs, WYETH 1 mg, bl, 20 cprs, SIGMA PHARMA 2 mg, bl, 20 cprs, SIGMA PHARMA 1 mg cx, 20 cprs, EMS 1 mg, 20 cprs, GEN - LEGRAND 1 mg, bl, 20 cprs, MERCK 1 mg, bl, x 20 MEDLEY 1 mg, fr, c/20 ARROW 2 mg cx, 20 cprs, EMS

UNIDADE Pco Unt Base A CPR 1,59 COMP 2,83 COMP 1,19 COMP 1,58 COMP 1,43 ML 0,02 ML 0,12 ML 0,14 ML 0,09 ML 0,13 ML 0,15 ML 0,05 ML 0,26 GOTA 0,01 GOTA 0,01 ML 0,24 GOTA 0,01 ML 0,26 ML 0,22 DRAG 1,22 ML 0,20 ML 0,22 ML 0,24 ML 0,25 COMP 0,49 COMP 0,69 CPR 0,49 CPR 0,69 CPR 0,24 COMP 0,20 COMP 0,27 CPR 0,28 COMP 0,21 CPR 0,41

8304 95057056 LORAZEPAM - GENERICO 8305 95000496 LORAZEPAM - GENERICO

2 mg, 100 cprs, 2 mg, 20 cprs,

TEUTO BRAS, GEN - LEGRAND

COMP COMP

0,32 0,34

8306 95271074 LORAZEPAM - GENERICO 8307 95057048 LORAZEPAM - GENERICO

2 mg, 20 cprs, 2 mg, 30 cprs,

RANBAXY TEUTO BRAS,

CPR COMP

0,29 0,41

217

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8308 8309 8310 8311 8312 8313 8314 8315 8316 8317 8318 8319 8320 8321 8322 8323 8324 8325 8326 8327 8328 8329 8330 8331 8332 8333 8334 8335 8336 8337 8338 8339 8340 8341 8342 8343 8344 8345

CODIGO BENEFICIO 95894977 LORAZEPAM - GENERICO 95973907 LORAZEPAM - GENERICO 95000500 LORAZEPAM - GENERICO 95124551 LORAZEPAM - GENERICO (Restrito Hosp,) 95000518 LORAZEPAM (B1) - GENERICO 95000534 LORAZEPAM (B1) - GENERICO 95000542 LORELIN 95894985 LORELIN DEPOT 95231056 LOREMIX 95231064 LOREMIX 95231072 LOREMIX D 95231080 LOREMIX D 95133445 LORSACOR 95133437 LORSACOR 95039120 LORSACOR 95057064 LORSACOR 95111530 LORSACOR 95030956 LORSAR + HCT 95039139 LORSAR HCT 95780289 LOSALEN 95973966 LOSAPRIN 95973974 LOSAPRIN 95030964 LOSAPROL 95030980 LOSAPROL 95030972 LOSAPROL 95084134 LOSAR 95066799 LOSAR 95973982 LOSARTAN POTASSICO - GENERICO 95974008 LOSARTAN POTASSICO - GENERICO 95974016 LOSARTAN POTASSICO - GENERICO 95974024 LOSARTAN POTASSICO - GENERICO 95974032 LOSARTAN POTASSICO - GENERICO 95974040 LOSARTAN POTASSICO - GENERICO 95974059 LOSARTAN POTASSICO - GENERICO 95974067 LOSARTAN POTASSICO - GENERICO 95974075 LOSARTAN POTASSICO - GENERICO 95974083 LOSARTAN POTASSICO - GENERICO 95043799 LOSARTANA + HIDROCLOROTIAZIDA - GENERICO

APRESENTAÇÃO 2 mg, bl, 20 cprs, 2 mg, bl, x 20 2 mg, fr, c/20 2 mg, 100 cprs, (hosp,) 1 mg, 2 blist, x 10 cprs, 2 mg, 2 blist, x 10 cprs, 3,75 mg, po liof, inj, FA+ amp, dil, 7,50 mg, po liof, inj, FA+ amp, dil, x 2 ml 10 mg, 12 cprs, Xpe, fr, 100 ml 12 cprs, rev, Xpe fr, 60 ml, 50 mg, 14 cprs, 50 mg, 28 cprs, 50 mg, 60 cprs, rev, 50 mg, bl, 30 cprs, rev, 50 mg, bl, 30 cprs, rev, 50/12,5 mg 30 cprs, 50 mg,+ 12,5 mg, bl, 28 cprs, rev, Pom, 30 g, 50 mg, cx, 14 cprs, 50 mg, cx, 28 cprs, 10 mg, 14 caps, 20 mg, 14 caps, 20 mg, 7 caps, 40 mg, inj, cx, 1 amp, 40 mg, po liof, cx, 50 FA+ 50 amps, x 10 ml 12,5 mg, 21 cprs, 50 mg, 1 bl, x 14 cprs, 50 mg, 1 bl, x 14 cprs, rev, 50 mg, 1 bl, x 15 cprs, rev, 50 mg, 14 cprs, 50 mg, 2 bl, x 14 cprs, 50 mg, 2 bl, x 14 cprs, rev, 50 mg, 2 bl, x 15 cprs, rev, 50 mg, 28 cprs, 50 mg, 4 bl, x 15 cprs, rev, 100+ 25 mg, bl, 30 cprs,

Laboratorio MERCK MEDLEY ARROW TEUTO BRAS, GERMED GERMED BERGAMO BERGAMO ATIVUS ATIVUS ATIVUS ATIVUS HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL NOVARTIS ROYTON ROYTON LUPER LUPER LUPER BIOCHIMICO BIOCHIMICO RATIOPHARM RANBAXY BRAINFARMA MEDLEY MEPHA-RATIOPHARM RANBAXY BIOSINTETICA MEDLEY MEPHA-RATIOPHARM MEDLEY EUROFARMA

UNIDADE Pco Unt Base A COMP 0,37 CPR 0,41 COMP 0,31 COMP 0,36 COMP 0,23 COMP 0,39 F,A, 301,47 UNID 698,81 CPR 1,57 ML 0,15 CPR 1,98 ML 0,36 CPR 1,51 CPR 1,35 CP 1,04 COMP 0,92 COMP 1,15 CPR 1,17 CP 1,17 G 1,19 CPR 0,82 CPR 0,66 CPR 1,25 CPR 2,41 CPR 2,45 AMP 10,94 FA 10,95 CPR 0,96 CPR 0,73 CPR 0,86 CPR 0,79 CPR 0,84 CPR 0,61 CPR 0,70 CPR 0,79 CPR 0,84 CPR 0,77 CP 1,64

218

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8346 8347 8348 8349 8350 8351 8352 8353 8354 8355 8356 8357 8358 8359 8360 8361 8362 8363 8364 8365 8366 8367 8368 8369 8370 8371 8372 8373 8374 8375 8376 8377 8378 8379 8380 8381 8382 8383

CODIGO BENEFICIO 95043802 LOSARTANA + HIDROCLOROTIAZIDA - GENERICO 95000550 LOSARTANA POTASSICA - GENERICO 95974091 LOSARTANA POTASSICA - GENERICO 95974105 LOSARTANA POTASSICA - GENERICO 95895019 LOSARTANA POTASSICA - GENERICO 95895027 LOSARTANA POTASSICA - GENERICO 95974113 LOSARTANA POTASSICA - GENERICO 95000569 LOSARTANA POTASSICA - GENERICO 95000577 LOSARTANA POTASSICA - GENERICO 95974121 LOSARTANA POTASSICA - GENERICO 95974130 LOSARTANA POTASSICA - GENERICO 95894993 LOSARTANA POTASSICA - GENERICO 95895000 LOSARTANA POTASSICA - GENERICO 95895051 LOSARTANA POTASSICA + HIDROCLOROTIAZID 95895035 LOSARTANA POTASSICA + HIDROCLOROTIAZID 95895043 LOSARTANA POTASSICA + HIDROCLOROTIAZID 95895086 LOSARTANA POTASSICA + HIDROCLOROTIAZID 95895060 LOSARTANA POTASSICA + HIDROCLOROTIAZID 95895078 LOSARTANA POTASSICA + HIDROCLOROTIAZID 95043810 LOSARTANA POTASSICA - GENERICO 95043845 LOSARTANA POTASSICA - GENERICO 95043861 LOSARTANA POTASSICA - GENERICO 95111549 LOSARTANA POTASSICA - GENERICO 95111557 LOSARTANA POTASSICA - GENERICO 95111565 LOSARTANA POTASSICA - GENERICO 95111573 LOSARTANA POTASSICA - GENERICO 95043837 LOSARTANA POTASSICA - GENERICO 95057102 LOSARTANA POTASSICA - GENERICO 95111581 LOSARTANA POTASSICA - GENERICO 95029621 LOSARTANA POTASSICA - GENERICO 95043829 LOSARTANA POTASSICA - GENERICO 95043853 LOSARTANA POTASSICA - GENERICO 95043870 LOSARTANA POTASSICA - GENERICO 95057099 LOSARTANA POTASSICA - GENERICO 95111590 LOSARTANA POTASSICA - GENERICO 95083030 LOSARTANA POTASSICA - GENERICO 95111603 LOSARTANA POTASSICA - GENERICO 95057072 LOSARTANA POTASSICA - GENERICO

APRESENTAÇÃO 50+ 12,50 mg, bl, 30 cprs, 50 mg, 1 bl, x 14 cprs, rev, 50 mg, 1 bl, x 14 cprs, rev, 50 mg, 1 bl, x 28 cprs, rev, 50 mg, 14 cp, 50 mg, 28 cp, 50 mg, bl, 30 cprs, rev, 50 mg, ct, 15 cprs, 50 mg, ct, 30 cprs, 50 mg, x 20 cprs, 50 mg, x 30 cprs, 50mg,bl,15cprs,rev, 50mg,bl,30 cprs,rev, 100 mg,+ 25 mg, 30 cprs, rev, 100+ 25 mg, 30 cprs, rev, 100+ 25 mg, 30 cprs, rev, 50 mg,+ 12,5 mg, 30 cprs, rev, 50+ 12,5 mg, 30 cprs, rev, 50+ 12,5 mg, 30 cprs, rev, 100 mg, 2 bl, x 15 cprs, rev, 100 mg, 2 bl, x 15 cprs, rev, 100 mg, 2 bl, x 15 cprs, rev, 100 mg, 3 bl, x 10 cprs, rev, 100 mg, bl, 30 cprs, rev, 100 mg, cprs, rev, bl, al, x 30 100 mg, cprs, rev, ct, bl, al, plas, inc, x 100 (frac,) 2 bl, x 10 cps, 3 bl x 10 cprs, 50 mg, 2 bl, x 15 cprs, rev, 50 mg, 3 bl, x 10 cprs, 50 mg, 3 bl, x 10 cprs, rev, 50 mg, 3 bl, x 10 cprs, rev, 50 mg, 3 bl, x 10 cprs, rev, 50 mg, 60 cprs, rev, 50 mg, 60 cprs, rev, 50 mg, bl, 30 cprs, rev, 50 mg, bl, al, plas, inc, x 30 cprs, rev, 50 mg, bl, plas, bco opc, x 30 cprs, rev,

Laboratorio EUROFARMA BIOSINTETICA BRAINFARMA BRAINFARMA NOVARTIS NOVARTIS MERCK EUROFARMA EUROFARMA CRISTALIA CRISTALIA FARMASA FARMASA GEN - LEGRAND EMS GERMED GEN - LEGRAND EMS GERMED EMS GERMED GEN - LEGRAND NEO QUIMICA MEDLEY PRATI DONADUZZI PRATI DONADUZZI CRISTALIA ZYDUS NEO QUIMICA RANBAXY EMS GERMED GEN - LEGRAND TEUTO BRAS, RANBAXY FARMASA SANDOZ TEUTO BRAS,

UNIDADE Pco Unt Base A CP 1,03 COMP 0,74 CPR 0,86 CPR 0,86 COMP 0,99 COMP 0,94 CPR 0,78 COMP 0,65 COMP 0,79 CPR 1,26 CPR 1,60 COMP 0,62 COMP 0,65 COMP 1,32 COMP 1,34 COMP 1,42 COMP 0,80 COMP 0,81 COMP 0,86 CP 1,16 CP 1,16 CP 1,16 COMP 1,16 COMP 1,16 COMP 1,16 COMP 0,85 CP 1,60 COMP 0,82 COMP 0,79 CPR 0,73 CP 0,79 CP 0,79 CP 0,79 COMP 0,35 COMP 0,25 COMP 0,75 COMP 1,12 COMP 0,35

219

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8384 8385 8386 8387 8388 8389 8390 8391 8392 8393 8394 8395 8396 8397 8398 8399 8400 8401 8402 8403 8404 8405 8406 8407 8408 8409 8410 8411 8412 8413 8414 8415 8416 8417 8418 8419 8420 8421

CODIGO BENEFICIO APRESENTAÇÃO 95057080 LOSARTANA POTASSICA - GENERICO 50 mg, bl, plas, bco, opc, x 75 cprs, rev, (hosp,) 95111611 LOSARTANA POTASSICA - GENERICO 50 mg, cprs, rev, ct, bl, al, plas, inc, x 200 (frac,) 95111620 LOSARTANA POTASSICA - GENERICO 50 mg, cprs, rev, ct, bl, al, plas, inc, x 30 95057129 LOSARTANA POTASSICA - GENERICO 50mg, bl,28cprs,rev, 95057110 LOSARTANA POTASSICA - GENERICO 50mg,bl,14 cprs,rev, 95111638 LOSARTANA POTASSICA - GENERICO (Restrito Hosp,) 100 mg, com, rev, ct, bl, al, plas, inc, x 300 (hosp,) 95111646 LOSARTANA POTASSICA - GENERICO (Restrito Hosp,) 50 mg, bl, plas, bco, opc, x 75 cprs, rev, (hosp,) 95111654 LOSARTANA POTASSICA - GENERICO (Restrito Hosp,) 50 mg, cprs, rev, bl, al, x 300 (hosp,) 95111662 LOSARTANA POTASSICA + HIDROCLOROTIAZIDA - GENERICO 100 mg, + 25 mg, bl, 30 cprs, rev, 95111670 LOSARTANA POTASSICA + HIDROCLOROTIAZIDA - GENERICO 100 mg, + 25 mg, bl, 60 cprs, rev, 95111689 LOSARTANA POTASSICA + HIDROCLOROTIAZIDA - GENERICO 50 mg, + 12,5 mg, bl, 30 cprs, rev, 95111697 LOSARTANA POTASSICA + HIDROCLOROTIAZIDA - GENERICO 50 mg, + 12,5 mg, bl, 60 cprs, rev, 95133488 LOSARTEC 25 mg, cx, 10 cprs, 95133453 LOSARTEC 25 mg, cx, 30 cprs, 95133461 LOSARTEC 50 mg, cx, 10 cprs, 95133470 LOSARTEC 50 mg, cx, 30 cprs, 95019847 LOSARTION 50mg,bl,30cprs, rev, 95000585 LOSEC Infusao 40 mg, 5 amps, 95030999 LOSEC MUPS 10 mg, cx, 14 cprs, 95031006 LOSEC MUPS 20 mg, cx, 7 cprs, 95031022 LOSEC MUPS 40 mg, cx, 7 cprs, 95974148 LOTAR 2,5 mg/50 mg, c/30 caps, 95974156 LOTAR 5 mg/100 mg c/30 caps, 95133526 LOTENSIN (Fr, Plast,) 10 mg, cprs, rev, x 14 95133534 LOTENSIN (Fr, Plast,) 5 mg, cprs, rev, x 30 95133585 LOTENSIN (Fr, Plast,) H 10 mg,+ 12,5 mg, 30 cprs, rev, 95133577 LOTENSIN (Fr, Plast,) H 5 mg,+ 6,25 mg, 30 cprs, rev, 95057145 LOTENSIN H 10 mg,+ 12,5 mg, 30ce 95057137 LOTENSIN H 5 mg,+ 6,25 mg, 30ce 95042172 LOVASTATINA - GENERICO 10 mg, 30 cprs, 95029630 LOVASTATINA - GENERICO 20 mg, 30 cprs, 95029648 LOVASTATINA - GENERICO 40 mg, 10 cprs, 95111700 LOVATON 20 mg cx, 30 cprs, 95180460 LOVATON 20 mg cx, c/10 cprs, 95039147 LOVAX 10 mg, 30 cprs, 95630112 LOVAX 20 mg cx, 30 cprs, 95662740 LOXAM 7,5 mg vd, 10 cprs, 95057153 LOXONIN 60 mg cx, 30 cprs,

Laboratorio TEUTO BRAS, PRATI DONADUZZI PRATI DONADUZZI SANDOZ SANDOZ PRATI DONADUZZI TEUTO BRAS, PRATI DONADUZZI MEDLEY MEDLEY MEDLEY MEDLEY MARJAN MARJAN MARJAN MARJAN MERCK ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA BIOSINTETICA BIOSINTETICA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS SANDOZ SANDOZ SANDOZ ROYTON ROYTON CELLOFARM CELLOFARM NEO QUIMICA DAIICHI SANKYO

UNIDADE Pco Unt Base A COMP 0,60 COMP 1,24 COMP 0,79 COMP 0,96 COMP 1,02 COMP 0,46 COMP 0,68 COMP 0,31 COMP 1,34 COMP 1,34 COMP 0,81 COMP 0,81 CPR 1,45 CPR 1,14 CPR 2,33 CPR 1,77 COMP 0,60 AMP 29,16 CPR 4,14 CPR 8,04 CPR 14,15 CPR 1,23 CPR 1,52 CPR 2,21 CPR 1,35 CPR 1,64 CPR 1,04 COMP 1,70 COMP 1,08 COMP 0,95 CPR 1,45 CPR 2,64 COMP 0,70 CPR 0,77 CP 0,83 CPR 0,88 CPR 1,71 COMP 1,01

220

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8422 8423 8424 8425 8426 8427 8428 8429 8430 8431 8432 8433 8434 8435 8436 8437 8438 8439 8440 8441 8442 8443 8444 8445 8446 8447 8448 8449 8450 8451 8452 8453 8454 8455 8456 8457 8458 8459

CODIGO BENEFICIO 95662790 LOXONIN 95111727 LOXONIN 95057161 LOXONIN 95000615 LOZAN (*) 95000623 LOZAN (*) 95988491 LOZIL 95019855 LOZIX 95138161 LUCENTIS 95974300 LUCRETIN 95290850 LUDIOMIL 95290869 LUDIOMIL 95111735 LUFISAN 95111743 LUFISAN 95020837 LUFTAL 95020870 LUFTAL 95000658 LUMIGAN 95039155 LUMIGAN 95000666 LUMIREM 95662847 LUPAREN 95662839 LUPAREN 95019871 LUPRON 95019901 LUPRON 95019910 LUPRON 95019880 LUPRON 95019898 LUPRON 95000674 LURANTAL 95895094 LUTAMIDAL 95895108 LUTAMIDAL 95125957 LUVERIS 95000682 LUVOX 95000690 LUVOX 95000704 LYMIUM 95084622 LYRICA 95084614 LYRICA 95084630 LYRICA 95974326 MAALOX PLUS 95974334 MAALOX PLUS 95974342 MAALOX PLUS

APRESENTAÇÃO Laboratorio 60 mg cx, 30 cprs, SANKYO PHARMA 60 mg, bl, al/al x 8 cprs, DAIICHI SANKYO 60 mg, cx, 15 cprs, DAIICHI SANKYO 200 mg, cx, 10 cprs, TEUTO BRAS, 200 mg, cx, 30 cprs, TEUTO BRAS, 900 mg, cx, 12 cprs, NEO QUIMICA 20 mg, cx, 28 caps, CELLOFARM 0,23 ml solucao NOVARTIS Cx, 20 envs, x 4 g FARMASA 25 mg, 20 cprs, NOVARTIS 75 mg, 20 cprs, NOVARTIS 40 mg, bl, 20 cprs, SANDOZ 75 mg/ml emul, oral fr, plast, got, opc, x 15 ml SANDOZ Cprs, ct, c/2 bl x 10 B-MS Gts, fr, NF 15 ml B-MS 3 ml ALLERGAN Fr, 5 ml ALLERGAN 3 x fr, 300 ml GUERBET 50 mg, cx, 20 drags, LUPER 75 mg, cx, 50 amps, 3,0 ml LUPER 5 mg/ml inj, cx, fr, amp, 2,8 ml ABBOTT Depot 11,25 mg/ml inj, cx, 1 fr, amp,+ dil,+ 2 ser,+ 2 ag ABBOTT Depot 22,5 mg/ml po liof, inj, cx, 1 FA+ dil,+ ser,+ 2 ag ABBOTT Depot 3,75 mg/ml inj, cx, 1 fr, amp,+ dil, 2 ml,+ ser, ABBOTT Depot 7,5 mg/ml inj, cx, 1 fr, amp,+ dil, ABBOTT 20mg,1 blc/30caps, SCHERING 150 mg, cx, 1 bl, x 14 cprs, ZODIAC 150 mg, cx, 2 bl, x 14 cprs, ZODIAC 75 UI cx, 1 FA po liof, p/inj,+ 1 FA solv, MERCK 100 mg, 15 cprs, SOLVAY FARMA 100 mg, 30 cprs, SOLVAY FARMA 30 cprs, rev, ATIVUS 150 mg, 28 caps, PFIZER 75 mg, 14 caps, PFIZER 75 mg, 28 caps, PFIZER 153 mg,+ 200 mg,+ 25 mg, cx, 3 bl, x 10 cprs, mast, menta,SANOFI-AVENTIS 153 mg,+ 200 mg,+ 25 mg, cx, 30 bl, x 10 cprs, mast, mentaSANOFI-AVENTIS Cx, 8 strip, x 6 cprs, rev,-sabor creme-limao AVENTIS PHARMA

UNIDADE Pco Unt Base A CPR 0,89 COMP 1,01 COMP 1,06 COMP 2,05 COMP 1,65 COMP 3,12 CAPS 1,45 AMP 2819,25 x ENV 1,23 CPR 1,30 CPR 3,33 COMP 0,40 GOTAS 0,03 CPR 0,53 GOTAS 0,04 GOTA 1,36 GOTA 1,22 ML 0,23 CPR 0,59 AP 1,31 FA 20,05 FA 761,61 FA 2943,74 FA 471,83 FA 1312,69 CAPS 3,43 COMP 42,31 COMP 42,31 FA 121,17 COMP 2,38 COMP 8,83 CPR 0,93 CAPS 4,48 CAPS 2,92 CAPS 2,92 CPR 0,49 CPR 0,32 CPR 0,28

221

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8460 8461 8462 8463 8464 8465

CODIGO BENEFICIO 95760385 MAALOX PLUS 95541870 MABTHERA 95541861 MABTHERA 95974377 MAC AZI 95974385 MAC AZI 95000712 MACRODANTINA

APRESENTAÇÃO Susp, oral 240 ml creme-limao 100 mg, 2 FA 500 mg, 1 FA 1200 mg, cx, 4 cprs, 600 mg, cx, 8 cprs, 100 mg, 28 caps,

Laboratorio SANOFI-AVENTIS ROCHE ROCHE SIGMA PHARMA SIGMA PHARMA MANTECORP

8466 95332995 MAGNOPYROL

300 mg, cx, 5 supos,

FARMASA

8467 8468 8469 8470 8471 8472 8473 8474 8475 8476 8477 8478 8479 8480 8481 8482 8483 8484 8485 8486 8487 8488 8489 8490 8491 8492 8493 8494 8495 8496 8497

500 mg, 25 bl, x 8 cprs, Gts, fr,10 ml Gts,fr,20ml Xpe, fr, 100 ml 2 mg, cx, 12 cprs, 10% cx, 100 x 10 ml 50% cx, 100 x 10 ml 130 mg bl, 15 cprs, 130 mg,2 bl,x15cprs, 10 mg, cx, 30 cprs, 20 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 0,4 mg/ml sol, oral fr, plast, x 120 ml+ cp, med, 0,4 mg/ml sol, oral, fr, vd, 120 ml+ cp, med, 10 ml 0,4 mg/ml xpe,fr,120ml 0,4 mg/ml, sol, or, ct, fr, vd, amb, x 120 ml,+ cp, med, 0,4 mg/ml, sol, or, cx, 50 fr, vd, amb, x 100 ml,+ cp, med, 0,4 mg/mlsol, oralcx, 50 fr,plast,x100 ml+cp, 0,4mg/mlsol, oralcx, 50 fr, plast,x120 ml+ cp, me 10 mg/g creme bisn, 30 g 10mg, cremebisn,30g 2 mg, 2 bl, x 10 cprs, 2 mg, 2 bl, x 10 cprs, 2 mg, 2 bl, x 10 cprs, 2 mg, bl, x 20 cprs, Sol, oral fr, 120 ml Sol, oral fr, 120 ml 0,4 mg/ml sol, 100 ml c/50 0,4 mg/ml xpe, ct, 50 frs, plas, amb, x 120 ml 10 mg/g creme bisn, 30 g 10 mg/g creme derm, bisn, x 30 g

FARMASA FARMASA FARMASA FARMASA NEO QUIMICA ARISTON ARISTON SIGMA PHARMA SIGMA PHARMA GALLIA GALLIA GALLIA PRATI DONADUZZI MERCK BRAINFARMA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GERMED EMS GERMED GEN - LEGRAND EMS BRAINFARMA GERMED GEN - LEGRAND TEUTO BRAS, HIPOLABOR GERMED NEO QUIMICA

95000739 MAGNOPYROL 95974415 MAGNOPYROL 95974407 MAGNOPYROL 95332979 MAGNOPYROL 95974423 MAGNOSTASE 95011331 MAGNOSTON 95011323 MAGNOSTON 95974431 MAG-TAB 95974440 MAG-TAB 95019928 MALEAPRIL 95019944 MALEAPRIL 95019936 MALEAPRIL 95019960 MALEATO DE DEXCLORFENIRAMINA 95000747 MALEATO DE DEXCLORFENIRAMINA 95974458 MALEATO DE DEXCLORFENIRAMINA 95039163 MALEATO DE DEXCLORFENIRAMINA 95039171 MALEATO DE DEXCLORFENIRAMINA 95019952 MALEATO DE DEXCLORFENIRAMINA 95019979 MALEATO DE DEXCLORFENIRAMINA 95046747 MALEATO DE DEXCLORFENIRAMINA 95045058 MALEATO DE DEXCLORFENIRAMINA 95000755 MALEATO DE DEXCLORFENIRAMINA 95000763 MALEATO DE DEXCLORFENIRAMINA 95988505 MALEATO DE DEXCLORFENIRAMINA 95974466 MALEATO DE DEXCLORFENIRAMINA 95019987 MALEATO DE DEXCLORFENIRAMINA 95019995 MALEATO DE DEXCLORFENIRAMINA 95057200 MALEATO DE DEXCLORFENIRAMINA 95072624 MALEATO DE DEXCLORFENIRAMINA 95057218 MALEATO DE DEXCLORFENIRAMINA 95072616 MALEATO DE DEXCLORFENIRAMINA

GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENERICO GENERICO GENERICO GENERICO

UNIDADE Pco Unt Base A ML 0,08 FA 965,68 X FA 4821,07 X CPR 16,85 CPR 5,31 CAPS 0,26 UND

2,45

COMP CPR GOTAS ML CPR AP AP CPR CPR COMP COMP COMP ML ML ML ML ML ML ML G G COMP COMP COMP CPR ML ML ML ML G G

0,65 0,02 0,03 0,15 0,39 0,68 0,72 0,98 0,92 0,66 1,22 0,38 0,07 0,07 0,06 0,05 0,02 0,02 0,92 0,20 0,20 0,29 0,28 0,29 0,25 0,04 0,06 0,05 0,02 0,20 0,20

222

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8498 8499 8500 8501 8502 8503 8504 8505 8506 8507 8508 8509 8510 8511 8512 8513 8514 8515 8516 8517 8518 8519 8520 8521 8522 8523 8524 8525 8526 8527 8528 8529 8530 8531 8532 8533 8534 8535

CODIGO BENEFICIO 95057170 MALEATO DE 95057188 MALEATO DE 95057226 MALEATO DE 95057234 MALEATO DE 95057196 MALEATO DE 95039180 MALEATO DE 95895116 MALEATO DE 95021116 MALEATO DE 95021108 MALEATO DE 95895132 MALEATO DE 95895140 MALEATO DE 95895124 MALEATO DE 95895159 MALEATO DE 95895167 MALEATO DE 95000771 MALEATO DE 95895175 MALEATO DE 95895183 MALEATO DE 95974474 MALEATO DE 95895191 MALEATO DE 95895205 MALEATO DE 95000801 MALEATO DE 95000798 MALEATO DE 95000810 MALEATO DE 95029656 MALEATO DE 95000828 MALEATO DE 95043926 MALEATO DE 95043942 MALEATO DE 95029664 MALEATO DE 95974490 MALEATO DE 95974504 MALEATO DE 95029672 MALEATO DE 95029680 MALEATO DE 95974512 MALEATO DE 95974520 MALEATO DE 95974539 MALEATO DE 95974547 MALEATO DE 95045252 MALEATO DE 95045244 MALEATO DE

DEXCLORFENIRAMINA - GENERICO DEXCLORFENIRAMINA - GENERICO DEXCLORFENIRAMINA - GENERICO DEXCLORFENIRAMINA - GENERICO DEXCLORFENIRAMINA - GENERICO DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + BETAM DEXCLORFENIRAMINA + SULF, DEXCLORFENIRAMINA + SULF, DEXCLORFENIRAMINA + SULF, DEXCLORFENIRAMINA + SULF, DEXCLORFENIRAMINA + SULF, DEXCLORFENIRAMINA + SULF, ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER ENALAPRIL GENER

APRESENTAÇÃO 10mg, cremebisn,30g 2,8 mg/ml gts, fr, 20 ml 2,8 mg/ml sol, oral fr, 20 ml 2,8 mg/ml sol, oral fr, 20 ml Xpe,2 mg/mlfr,100ml 0,4 mg/ml,+ 0,05 mg/ml, xpe, ct, fr, vd, amb, x 120 ml, 0,4 mg/ml+ 0,05 mg/ml xpe fr, vd, x 120 ml+ cp, med, 0,4 mg/ml+ 0,05 mg/ml xpe, fr, plast, x 120 ml 0,4 mg/ml+0,05 mg/ml xpe, cx, 50 fr, plast,x100 ml ( 2,0/0,25 mg, 20 cprs, 2,0/0,25 mg, 20 cprs, 2,0+ 0,25 mg, 20 cprs, Xpe, 120 ml Xpe, cx, 50 fr, 100 ml Xpe, fr, 120 ml Xpe, fr, 120 ml Xpe, fr, 120 ml Xpe, fr, 120 ml+ copo med, Xpe, fr, 120 ml+ cp, med, Xpe, fr, plast, 120 ml+ cp, dos, 0,4 mg/ml+ 4,0 mg/ml+ 20 mg/ml fr, vd, 120 ml+ dos, 0,4+ 4,0+20 mg/ml fr, 120 ml Fr, 100 ml Fr, 120 ml Sol, oral 0,4+ 4,0+ 20 mg/ml fr, x 120 ml Xpe, 120 ml 10 mg, 3 bl, 10 cps, 10 mg, 3 bl, x 10 cprs, 10 mg, 3 bl, x 10 cprs, 10 mg, 3 bl, x 10 cprs, 10 mg, 30 cprs, 10 mg, 30 cprs, 10 mg, 30 cprs, 10 mg, 30 cprs, 10 mg, 30 cprs, 10 mg, 30 cprs, 10 mg, 30 cprs, alu-alu 10 mg, cx, 10 envs, x 10 cprs, (hosp,)

Laboratorio EMS EMS GERMED GEN - LEGRAND TEUTO BRAS, PRATI DONADUZZI FARMASA PRATI DONADUZZI PRATI DONADUZZI GERMED GEN - LEGRAND EMS PRATI DONADUZZI PRATI DONADUZZI UNIAO QUIMICA GERMED GEN - LEGRAND TEUTO BRAS, MERCK BRAINFARMA MEDLEY EMS GERMED GERMED GEN - LEGRAND BRAINFARMA CRISTALIA GEN - LEGRAND CRISTALIA RANBAXY NEO QUIMICA SANDOZ BIOSINTETICA TEUTO BRAS, HEXAL BRAINFARMA TEUTO BRAS, TEUTO BRAS,

UNIDADE Pco Unt Base A G 0,20 GOTA 0,02 GOTA 0,02 GOTA 0,02 ML 0,05 ML 0,10 ML 0,14 ML 0,13 ML 0,03 COMP 0,37 COMP 0,49 COMP 0,49 ML 0,09 ML 0,03 ML 0,13 ML 0,11 ML 0,13 ML 0,12 ML 0,14 ML 0,11 ML 0,08 ML 0,12 ML 0,08 GOTA 0,00 ML 0,09 ML 0,06 CP 0,58 CPR 0,67 CPR 0,54 CPR 0,54 CPR 0,63 CPR 0,73 CPR 0,68 CPR 0,46 CPR 0,65 CPR 0,75 COMP 0,42 COMP 0,48

223

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8536 8537 8538 8539 8540 8541 8542 8543 8544 8545 8546 8547 8548 8549 8550 8551 8552 8553 8554 8555 8556 8557 8558 8559 8560 8561 8562 8563 8564 8565 8566 8567 8568 8569 8570 8571 8572 8573

CODIGO BENEFICIO 95974555 MALEATO DE 95000836 MALEATO DE 95043950 MALEATO DE 95029699 MALEATO DE 95000844 MALEATO DE 95029702 MALEATO DE 95029710 MALEATO DE 95974580 MALEATO DE 95974598 MALEATO DE 95974601 MALEATO DE 95974610 MALEATO DE 95045260 MALEATO DE 95974563 MALEATO DE 95029729 MALEATO DE 95974636 MALEATO DE 95974644 MALEATO DE 95045309 MALEATO DE 95000852 MALEATO DE 95029737 MALEATO DE 95029745 MALEATO DE 95974652 MALEATO DE 95974660 MALEATO DE 95974679 MALEATO DE 95974687 MALEATO DE 95045279 MALEATO DE 95043934 MALEATO DE 95000860 MALEATO DE 95974695 MALEATO DE 95057285 MALEATO DE 95072640 MALEATO DE 95057323 MALEATO DE 95057242 MALEATO DE 95057250 MALEATO DE 95057293 MALEATO DE 95057269 MALEATO DE 95072632 MALEATO DE 95057331 MALEATO DE 95057307 MALEATO DE

ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL

GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENER GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO GENERICO

APRESENTAÇÃO 10 mg, cx, 28 cprs, 10mg,3stp,x10cprs, 20 mg, 3 bl, 10 cps, 20 mg, 3 bl, x 10 cprs, 20 mg, 3 stp, x 10 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, alu-alu 20mg,3bl,x10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 3 envs, al, x 10 cprs, 5 mg, 3 stp, x 10 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, 30 cprs, alu-alu 5 mg, cprs, ct, 3 bl, al/al x 10 5 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 10 mg, 3 envs, al, x 10 cprs, 10 mg, bl, 30 cprs, 10 mg, com, ct, bl, al,/al, x 30 10 mg, cx, 10 envs, x 10 cprs, (hosp,) 10 mg,30cprs,alu-alu 20 mg, 3 envs, al, x 10 cprs, 20 mg, 30 cprs, alu-alu 20 mg, bl, 30 cprs, 20 mg, com, ct, bl, al,/al, x 30 5 mg, 3 envs, al, x 10 cprs,

Laboratorio RATIOPHARM GERMED CRISTALIA GEN - LEGRAND GERMED NEO QUIMICA SANDOZ BIOSINTETICA TEUTO BRAS, HEXAL BRAINFARMA TEUTO BRAS, RANBAXY GEN - LEGRAND CRISTALIA RANBAXY TEUTO BRAS, GERMED NEO QUIMICA SANDOZ BIOSINTETICA TEUTO BRAS, HEXAL BRAINFARMA TEUTO BRAS, CRISTALIA EMS RATIOPHARM TEUTO BRAS, AUROBINDO PHARMA PRATI DONADUZZI TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, AUROBINDO PHARMA PRATI DONADUZZI TEUTO BRAS,

UNIDADE Pco Unt Base A CPR 0,61 COMP 0,59 CP 0,82 CPR 0,92 COMP 0,80 CPR 0,94 CPR 1,04 CPR 1,16 CPR 0,90 CPR 0,93 CPR 0,82 COMP 0,79 CPR 0,77 CPR 0,40 CPR 0,36 CPR 0,30 COMP 0,25 COMP 0,37 CPR 0,35 CPR 0,41 CPR 0,50 CPR 0,26 CPR 0,37 CPR 0,39 COMP 0,32 CP 0,39 COMP 0,45 CPR 0,36 COMP 0,50 COMP 0,63 COMP 0,59 COMP 0,48 COMP 0,42 COMP 0,50 COMP 0,79 COMP 0,63 COMP 0,84 COMP 0,25

224

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8574 8575 8576 8577 8578 8579 8580 8581 8582 8583 8584 8585 8586 8587 8588 8589 8590 8591 8592 8593 8594 8595 8596 8597 8598 8599 8600 8601 8602 8603 8604 8605 8606 8607 8608 8609 8610 8611

CODIGO BENEFICIO 95057277 MALEATO DE ENALAPRIL GENERICO 95072659 MALEATO DE ENALAPRIL GENERICO 95057315 MALEATO DE ENALAPRIL GENERICO 95974709 MALEATO DE ENALAPRIL + HIDROCL 95000887 MALEATO DE ENALAPRIL + HIDROCL 95974717 MALEATO DE ENALAPRIL + HIDROCL 95000879 MALEATO DE ENALAPRIL + HIDROCL 95029753 MALEATO DE ENALAPRIL + HIDROCL 95974725 MALEATO DE ENALAPRIL + HIDROCL 95000895 MALEATO DE ENALAPRIL + HIDROCL 95000909 MALEATO DE ENALAPRIL + HIDROCL 95000917 MALEATO DE ENALAPRIL + HIDROCL 95029761 MALEATO DE ENALAPRIL + HIDROCL 95974733 MALEATO DE ENALAPRIL + HCT - GENER 95974741 MALEATO DE ENALAPRIL + HCT - GENER 95974750 MALEATO DE ENALAPRIL + HCT - GENER 95000925 MALEATO DE ENALAPRIL + HCTZ - GENE 95000933 MALEATO DE ENALAPRIL + HCTZ - GENE 95974768 MALEATO DE TIMOLOL GENERIC 95029770 MALEATO DE TIMOLOL GENERIC 95895213 MALEATO DE TIMOLOL GENERIC 95895221 MALEATO DE TIMOLOL GENERIC 95895230 MALEATO DE TIMOLOL GENERIC 95974776 MALEATO DE TIMOLOL GENERIC 95021124 MALEATO DE TIMOLOL GENERIC 95895248 MALEATO DE TIMOLOL GENERIC 95895256 MALEATO DE TIMOLOL GENERIC 95895264 MALEATO DE TIMOLOL GENERIC 95029788 MALEATO DE TIMOLOL GENERIC 95072667 MALEATO DE TIMOLOL GENERICO 95231110 MALEATO DE DEXCLORF,+BETAMET, - GENERICO 95231102 MALEATO DE DEXCLORF,+BETAMET, - GENERICO 95111751 MALEATO DE DEXCLORFENIRAMINA - GENERICO 95111760 MALEATO DE DEXCLORFENIRAMINA - GENERICO 95111778 MALEATO DE DEXCLORFENIRAMINA - GENERICO 95083049 MALEATO DE DEXCLORFENIRAMINA - GENERICO 95084142 MALEATO DE DEXCLORFENIRAMINA - GENERICO 95125965 MALEATO DE DEXCLORFENIRAMINA - GENERICO

APRESENTAÇÃO Laboratorio 5 mg, 30 cprs, alu-alu TEUTO BRAS, 5 mg, bl, 30 cprs, AUROBINDO PHARMA 5 mg, com, ct, bl, al,/al, x 30 PRATI DONADUZZI 10 mg+ 25 mg c/30 cprs, BIOSINTETICA 10/25 mg, 2 bl, x 15 cprs, GERMED 10/25 mg, 2 bl, x 15 cprs, EMS 10/25mg, 2 bl,x 15 cprs, EUROGENUS - LEGRAND 10+ 25 mg, 9 bl, x 10 cprs, rev, EMS 20 mg+ 12,5 mg c/30 cprs, BIOSINTETICA 20/12,5 mg, 2 bl, x 15 cprs, EMS 20/12,5 mg, 2 bl, x 15 cprs, GERMED 20/12,5 mg, 2 bl, x 15 cprs, GEN - LEGRAND 20+ 12,5 mg, 9 bl, x 10 cprs, rev, EMS 10 mg/25 mg, 3 str, x 10 cprs, MEDLEY 20 mg/12,5 mg, 3 str, x 10 cprs, MEDLEY 20/12,5 mg, 30 cp, NOVARTIS 10 mg,+ 25 mg, 30 cprs, MERCK 20 mg,+ 12,5 mg, 30 cprs, MERCK 0,25 pcc sol, oft, ct, fr, plast, opc, gts, x 5 ml BIOSINTETICA 0,25% sol, oft, fr, 5 ml RANBAXY 0,25% sol, oft, fr, 5 ml EMS 0,25% sol, oft, fr, 5 ml GERMED 0,25% sol, oft, fr, 5 ml GEN - LEGRAND 0,5 pcc sol, olf, fr, plast, gts, 5 ml BIOSINTETICA 0,5% sol, oft, fr, 5 ml TEUTO BRAS, 0,5% sol, oft, fr, 5 ml EMS 0,5% sol, oft, fr, 5 ml GERMED 0,5% sol, oft, fr, 5 ml GEN - LEGRAND 0,50% sol, oft, fr, 5 ml RANBAXY 5 mg/ml sol, oft, fr, plast, got, x 5 ml NEO QUIMICA Xpe fr, 120 ml+ cp, med, MEDLEY Xpe, fr, 120 ml+ copo EUROFARMA 0,4 mg/ml 100 ml (hosp,) - cx, c/60 frs, FARMACE 0,4 mg/ml 120 ml (hosp,) - cx, c/60 frs, FARMACE 0,4 mg/ml CT 100 ml - frasco FARMACE 0,4 mg/ml sol, oral ct, fr, plast, x 100 ml+ cp, med, TEUTO BRAS, 0,4 mg/ml sol, oral cx, 50 frs, plast, x 100 ml+ 50 cp, med, (hosp,) TEUTO BRAS, 0,4 mg/ml xpe, fr, 120 ml + dos PRATI DONADUZZI

UNIDADE Pco Unt Base A COMP 0,32 COMP 0,32 COMP 0,40 CPR 0,76 COMP 0,52 CPR 0,76 COMP 0,36 CPR 0,68 CPR 1,21 COMP 1,29 COMP 1,17 COMP 1,21 CPR 1,17 CPR 0,82 CPR 1,30 CPR 0,95 COMP 0,75 COMP 1,21 GOTAS 0,04 GOTA 0,04 GOTA 4,32 GOTA 4,13 GOTA 4,31 GOTAS 0,06 GOTA 0,06 GOTA 5,75 GOTA 5,21 GOTA 5,73 GOTA 0,05 GOTA 0,06 ML 0,14 ML 0,10 ML 0,05 ML 0,05 ML 0,06 ML 0,06 ML 0,06 ML 0,06

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8612 8613 8614 8615 8616 8617 8618 8619 8620 8621 8622 8623 8624 8625 8626 8627 8628 8629 8630 8631 8632 8633 8634 8635 8636 8637 8638 8639 8640 8641 8642 8643 8644 8645 8646 8647 8648 8649

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95083057 MALEATO DE DEXCLORFENIRAMINA - GENERICO 10 mg/g creme derm, bisn, 30 g MEDLEY 95111786 MALEATO DE DEXCLORFENIRAMINA - GENERICO 10 mg/g creme derm, bisn, 30 g TEUTO BRAS, 95231188 MALEATO DE DEXCLORFENIRAMINA - GENERICO 100 ml c/50 frs, PRATI DONADUZZI 95231200 MALEATO DE DEXCLORFENIRAMINA - GENERICO 120 ml c/50 frs, PRATI DONADUZZI 95111794 MALEATO DE DEXCLORFENIRAMINA - GENERICO 2 mg, bl, 20 cprs, NEO QUIMICA 95111808 MALEATO DE DEXCLORFENIRAMINA - GENERICO Creme 30 g MULTILAB 95231161 MALEATO DE DEXCLORFENIRAMINA - GENERICO Cx, 1 fr, 120 ml, CRISTALIA 95111816 MALEATO DE DEXCLORFENIRAMINA - GENERICO Sol, oral - 0,4 mg/ml - fr, 120 ml MULTILAB 95231137 MALEATO DE DEXCLORFENIRAMINA - GENERICO Sol, oral fr, 120 ml EMS 95231153 MALEATO DE DEXCLORFENIRAMINA - GENERICO Sol, oral fr, 120 ml+ cp, med, MEDLEY 95231170 MALEATO DE DEXCLORFENIRAMINA - GENERICO Xpe, 2 mg/5 ml fr, vd, 120 ml NEO QUIMICA 95124578 MALEATO DE DEXCLORFENIRAMINA - GENERICO (Restrito Hosp,) 0,4 mg/ml sol, oral cx, 50 frs, plast, x 100 ml + 50 cp, med, (hosp,) TEUTO BRAS, 95124586 MALEATO DE DEXCLORFENIRAMINA - GENERICO (Restrito Hosp,) 0,4 mg/ml, sol, or, cx, 50 fr, plas, opc, x 100 ml, + cp, med, (hosp,) PRATI DONADUZZI 95124594 MALEATO DE DEXCLORFENIRAMINA - GENERICO (Restrito Hosp,) 0,4 mg/ml, sol, or, cx, 50 fr, plas, opc, x 120 ml, + cp, med, (hosp,) PRATI DONADUZZI 95111824 MALEATO DE DEXCLORFENIRAMINA + BETAM, - GENERICO0,4 mg/ml + 0,05 mg/ml xpe fr, x 120 ml + dosad, BIOSINTETICA 95111832 MALEATO DE DEXCLORFENIRAMINA + BETAM, - GENERICOXpe, fr, 120 ml EMS 95111840 MALEATO DE DEXCLORFENIRAMINA + SULF, PSEUDO + GUAIF, 0,4 mg/ml - GENERICO + 4 mg/ml + 20 mg/ml sol, or, fr, plast, x 120 ml COSMED 95133690 MALEATO DE ENALAPRIL - GENERICO 10 mg, 3 str, x 10 cp, MEDLEY 95133593 MALEATO DE ENALAPRIL - GENERICO 10 mg, 30 cprs, TEUTO BRAS, 95133747 MALEATO DE ENALAPRIL - GENERICO 10 mg, 30 cprs, BRAINFARMA 95133658 MALEATO DE ENALAPRIL - GENERICO 10 mg, cx, 30 cprs, EMS 95133704 MALEATO DE ENALAPRIL - GENERICO 20 mg, 3 str, x 10 cp, MEDLEY 95133615 MALEATO DE ENALAPRIL - GENERICO 20 mg, 30 cprs, TEUTO BRAS, 95133763 MALEATO DE ENALAPRIL - GENERICO 20 mg, 30 cprs, BRAINFARMA 95111859 MALEATO DE ENALAPRIL - GENERICO 20 mg, cx, 30 cprs, EMS 95133682 MALEATO DE ENALAPRIL - GENERICO 5 mg, 3 str, x 10 cp, MEDLEY 95133607 MALEATO DE ENALAPRIL - GENERICO 5 mg, 30 cprs, TEUTO BRAS, 95133844 MALEATO DE ENALAPRIL - GENERICO 5 mg, 30 cprs, BRAINFARMA 95124608 MALEATO DE ENALAPRIL - GENERICO (Restrito Hosp,) 10 mg, cx, 10 envs, x 10 cprs, (hosp,) TEUTO BRAS, 95111867 MALEATO DE MIDAZOLAM - GENERICO 15 mg, bl, 20 cprs, rev, MEDLEY 95895272 MALEATO DE MIDAZOLAM - GENERICO 15 mg, bl, 20 cprs, rev, FARMASA 95083065 MALEATO DE MIDAZOLAM - GENERICO 15 mg, bl, 30 cprs, rev, MEDLEY 95111875 MALEATO DE MIDAZOLAM - GENERICO 15 mg, bl, 30 cprs, rev, EUROFARMA 95895280 MALEATO DE MIDAZOLAM - GENERICO 15 mg, bl, 30 cprs, rev, FARMASA 95000941 MALEATO DE MIDAZOLAM - GENERICO 15mg,bl,20cprs,rev, EUROFARMA 95000950 MALEATO DE MIDAZOLAM - GENERICO 15mg,bl,30cprs,rev, EUROFARMA 95083073 MALEATO DE MIDAZOLAM - GENERICO 7,5 mg, bl, 20 cprs, rev, MEDLEY 95083081 MALEATO DE MIDAZOLAM - GENERICO 7,5 mg, bl, 30 cprs, rev, MEDLEY

UNIDADE Pco Unt Base A G 0,20 GRAMA 0,20 ML 0,02 ML 0,02 COMP 0,29 GRAMA 0,19 ML 0,06 ML 0,06 ML 0,07 ML 0,07 ML 0,05 ML 0,06 ML 0,02 ML 0,02 ML 0,11 ML 0,15 ML 0,08 CPR 0,77 CPR 0,37 CPR 0,75 CPR 0,77 CPR 1,17 CPR 0,69 CPR 0,82 COMP 1,15 CPR 0,56 CPR 0,28 CPR 0,39 COMP 0,56 COMP 1,25 COMP 1,21 COMP 1,25 COMP 1,17 COMP 0,11 COMP 1,09 COMP 1,13 COMP 0,63 COMP 0,62

226

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8650 8651 8652 8653 8654 8655 8656 8657 8658 8659 8660 8661 8662 8663 8664 8665 8666 8667 8668 8669 8670 8671 8672 8673 8674 8675 8676 8677 8678 8679 8680 8681 8682 8683 8684

CODIGO BENEFICIO 95720219 MALEATO DE TIMOLOL - GENERICO 95720197 MALEATO DE TIMOLOL - GENERICO 95720200 MALEATO DE TIMOLOL - GENERICO 95083090 MALEATO DE TIMOLOL - GENERICO 95720227 MALEATO DE TIMOLOL - GENERICO 95720235 MALEATO DE TIMOLOL - GENERICO 95720243 MALEATO DE TIMOLOL - GENERICO 95124616 MALEATO DE TIMOLOL - GENERICO (Restrito Hosp,) 95111883 MALEATO DE TIMOLOL - GENERICO (Restrito Hosp,) 95057358 MALENA 95057366 MALENA 95057340 MALENA 95042199 MALENA HCT 95042202 MALENA HCT 95021132 MALTENS 95581847 MANITOL 20% 95581863 MANITOL 3% 95140646 MANIVASC 95000968 MANIVASC 95140662 MANIVASC 95000976 MANIVASC 95420690 MANSIL 95420681 MANSIL 95200975 MARAX 95160493 MARCOUMAR 95057374 MAREVAN 95974822 MAREVAN 95000984 MAREVAN 95160507 MAREVAN 95895302 MARFARIM 95974830 MATER FOLIC 95890106 MATERGAM 95271155 MAX PAX 95333010 MAXALT 95333029 MAXALT

8685 95039201 MAXAPRAN 8686 95039198 MAXAPRAN 8687 95379479 MAXCEF INJ,

APRESENTAÇÃO 0,25% 5 ml 0,5% fr, 5 ml, 0,5% sol, oft, fr, 5 ml 0,5% sol, oft, fr, c/50 0,50% 10 ml 0,50% 5 ml Sol, oft, 0,5% fr, plast, 5 ml 0,5% sol, oft, 50 frs, x 5 ml 0,5% sol, oft, fr, c/50 (hosp,) 10 mg, 3 bl, x 10 cprs, 20 mg, 3 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, 10 mg,+ 25 mg, 7 bl, x 10 cprs, 20 mg,+ 12,5 mg, 7 bl, x 10 cprs, Fr, plast, cx, 30 cprs, rev, Fr com 250 ml Fr com 2000 ml 10 mg, cx, 14 cprs, 10 mg, cx, 28 cprs, 20 mg, cx, 14 cprs, 20 mg, cx, 28 cprs, 250 mg, 6 caps Xpe, 12 ml, 20 cprs, Vd, 25 cprs, 3 mg, 2,5 mg, bl, 60 cprs, 5 mg, 30 cprs, 7,5 mg, 30 cprs, Cx, 10 cprs, 5mg, 5 mg, bl, 10 cprs, 30 cprs, 300 mcg - 200 mcg/ml inj. ct amp. vd. incolor x 1,5 ml. Cx, 20 cprs, 2 mg, 10 mg, cx, 1 bl, 2 cprs, RPD 10 mg, cx, 1 bl, 2 cprs,

Laboratorio ALLERGAN ALCON CRISTALIA TEUTO BRAS, ALLERGAN ALLERGAN APOTEX CRISTALIA TEUTO BRAS, SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA GALLIA B, BRAUN B, BRAUN CHIESI CHIESI CHIESI CHIESI PFIZER PFIZER PFIZER ROCHE FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA TEUTO BRAS, FARMOQUIMICA ZLB BEHRING BIOLAB SANUS MERCK SHARP & DOHME MERCK SHARP & DOHME

20 mg, cx, 14 cprs, 20 mg, cx, 28 cprs, 1 g, 1 FA+ dil,

BIOSINTETICA BIOSINTETICA B-MS

UNIDADE Pco Unt Base A GOTAS 0,06 GOTAS 0,06 GOTAS 0,06 UNID 4,85 GOTAS 0,04 GOTAS 0,15 GOTAS 0,05 GOTAS 2,12 UNID 4,73 COMP 0,66 COMP 0,93 COMP 0,37 COMP 0,40 COMP 0,53 COMP 1,28 FR 6,61 FR 17,10 CPR 2,94 COMP 2,83 CPR 5,43 COMP 5,22 CPR 7,23 ML 2,25 CPR 0,37 CPR 0,27 COMP 0,24 CPR 0,48 COMP 0,72 CPR 0,48 COMP 0,46 CPR 0,59 AP 174,38 x CPR 0,43 CPR 7,86 CPR 18,43 CP CP FA

1,61 1,63 58,74

227

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8688 8689 8690 8691 8692 8693 8694 8695 8696 8697 8698 8699 8700 8701 8702 8703 8704 8705 8706 8707 8708 8709 8710 8711 8712 8713 8714 8715 8716 8717 8718 8719 8720 8721 8722 8723 8724 8725

CODIGO BENEFICIO 95379487 MAXCEF INJ, 95084150 MAXCEF INJ, 95000992 MAXCEF SOL, INJ, SIST, FECHADO 95001000 MAXCEF SOL, INJ, SIST, FECHADO 95974849 MAXIBELL 95740210 MAXICROM 95740228 MAXICROM 95700161 MAXIDEX 95700170 MAXIDEX 95895310 MAXIDRATE 95057382 MAXIFEN 95021140 MAXIFEN 95057390 MAXIFEN 95974857 MAXIFLOX 95974865 MAXIFLOX 95974873 MAXIFLOX-D 95974881 MAXIFLOX-D 95974890 MAXILERG 95333045 MAXILIV 95039210 MAXINOM 95039228 MAXINOM 95680020 MAXITROL 95680039 MAXITROL 95021159 MAXSULID 95039236 MEBENDAZOL + TIABENDAZOL - GENERICO 95001018 MEBENDAZOL + TIABENDAZOL - GENERICO 95895329 MEBENDAZOL + TIABENDAZOL - GENERICO 95001026 MEBENDAZOL + TIABENDAZOL - GENERICO 95420843 MEBENDAZOL - GENERICO 95420851 MEBENDAZOL - GENERICO 95985700 MEBENDAZOL - GENERICO 95420800 MEBENDAZOL - GENERICO 95111891 MEBENDAZOL - GENERICO 95420860 MEBENDAZOL - GENERICO 95021167 MEBENDAZOL - GENERICO 95057412 MEBENDAZOL - GENERICO 95420789 MEBENDAZOL - GENERICO 95057404 MEBENDAZOL - GENERICO

APRESENTAÇÃO Laboratorio 2 g, 1 FA s/dil, B-MS 500 mg, 1 FA+ dil, B-MS 1 g 10 FA+ 10 bolsas flex, c/100 ml dil, B-MS 2 g 10 FA+ 10 bolsas flex, c/100 ml dil, B-MS Fr, 10 ml LATINOFARMA 2% sol, oft, 5 ml, ALCON 4% sol, oft, 5 ml, ALCON Pom, bg, 3,5 g, ALCON Susp, fr, 5 ml, ALCON 0,45% x 30 g LIBBS 40 mg/ml 15 ml sus, or, ct, fr, trans, JANSSEN - CILAG/J&J 40 mg/ml susp, oral fr, 15 ml JANSSEN - CILAG 50 mg/ml susp, 30 ml or, ct, fr, plas, opc gts, x 30 ml (sabor JANSSEN framboesa)- CILAG/J&J Bisn, 3,5 g LATINOFARMA Fr, 5 ml LATINOFARMA Bisn, 3,5 g LATINOFARMA Fr, 5 ml LATINOFARMA Fr, 5 ml LATINOFARMA 500 mg, 20 cprs, ACHE Pom, oft, bisn, 3,5 g UNIAO QUIMICA Susp, oft, fr, got, x 5 ml UNIAO QUIMICA Pom, bg, 3,5 g, ALCON Susp, fr, 5 ml, ALCON 400 mg, bl, x 10 FARMASA 20 mg/ml,+ 33,2 mg/ml, sus, or, ct, fr, vd, amb, x 30 ml, PRATI DONADUZZI 200+ 332 mg, 6 cprs, mast, GEN - LEGRAND 200+ 332 mg, 6 cprs, mast, GERMED 200+ 332 mg, mast, 6 cprs, EMS 100 mg 300 cprs, PRATI DONADUZZI 100 mg 6 cprs, ABBOTT 100 mg 6 cprs, PRATI DONADUZZI 100 mg cx, 1 bl, x 6 cprs, NEO QUIMICA 100 mg, 6 cprs, CIFARMA 100 mg, bl, 6 cprs, EMS 100 mg, bl, plast, x 120 cprs, (emb, mult,) PRATI DONADUZZI 100 mg, cx, 300 cprs, TEUTO BRAS, 100 mg, cx, 6 cprs, TEUTO BRAS, 20 mg, susp, oral fr, 30 ml BIOSINTETICA

UNIDADE Pco Unt Base A FA 106,82 FA 32,07 UNID 57,20 UNID 99,97 GOTAS 0,04 GOTAS 0,05 GOTAS 0,06 G 4,90 GOTAS 0,05 GRAMA 16,85 GOTA 0,35 ML 0,22 GOTA 0,01 G 5,20 GOTAS 0,14 G 6,38 GOTAS 0,20 GOTAS 0,18 CPR 0,58 GOTA 4,34 GOTA 0,09 G 4,82 GOTAS 0,10 COMP 2,09 ML 0,17 COMP 1,06 COMP 0,82 COMP 1,09 CPR 0,08 CPR 0,62 COMP 0,58 CPR 0,36 COMP 0,31 CPR 0,58 COMP 0,28 COMP 0,05 CPR 0,41 ML 0,16

228

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8726 8727 8728 8729 8730 8731 8732 8733 8734 8735 8736 8737 8738 8739 8740 8741 8742 8743 8744 8745 8746 8747 8748 8749 8750 8751 8752 8753 8754 8755 8756 8757 8758 8759 8760 8761 8762 8763

CODIGO BENEFICIO 95420754 MEBENDAZOL - GENERICO 95057439 MEBENDAZOL - GENERICO 95057447 MEBENDAZOL - GENERICO 95895337 MEBENDAZOL - GENERICO 95111905 MEBENDAZOL - GENERICO 95420738 MEBENDAZOL - GENERICO 95895345 MEBENDAZOL - GENERICO 95895353 MEBENDAZOL - GENERICO 95001034 MEBENDAZOL - GENERICO 95111913 MEBENDAZOL - GENERICO 95039244 MEBENDAZOL - GENERICO 95111921 MEBENDAZOL - GENERICO 95057420 MEBENDAZOL - GENERICO 95420770 MEBENDAZOL - GENERICO 95420819 MEBENDAZOL - GENERICO 95029800 MEBENDAZOL - GENERICO 95029818 MEBENDAZOL - GENERICO 95420797 MEBENDAZOL - GENERICO 95039287 MEBENDAZOL - GENERICO (*) 95039295 MEBENDAZOL - GENERICO (*) 95039260 MEBENDAZOL - GENERICO (*) 95039325 MEBENDAZOL - GENERICO (*) 95039309 MEBENDAZOL - GENERICO (*) 95039317 MEBENDAZOL - GENERICO (*) 95039279 MEBENDAZOL - GENERICO (*) 95111930 MEBENDAZOL - GENERICO (Restrito Hosp,) 95111948 MEBENDAZOL - GENERICO (Restrito Hosp,) 95111956 MEBENDAZOL - GENERICO (Restrito Hosp,) 95420908 MEBENDAZOL + TIABENDAZOL - GENERICO 95420878 MEBENDAZOL + TIABENDAZOL - GENERICO 95420924 MEBENTAL 95420916 MEBENTAL 95662855 MEBRON 95974920 MECLIN 95001042 MECLIN 95066829 MEDAT 95066810 MEDAT 95379517 MEDCEF

APRESENTAÇÃO Laboratorio 20 mg/ml fr, 30 ml, EMS 20 mg/ml sus, or, ct, fr, plas, opc, x 30 ml+ CP med, PRATI DONADUZZI 20 mg/ml sus, or, cx, 200 fr, plas, opc, x 30 ml+ 200 CP med, PRATI (emb,DONADUZZI hosp,) 20 mg/ml susp, fr, vd, 30 ml PRATI DONADUZZI 20 mg/ml susp, or, fr, 30 ml + cp, med, MARIOL 20 mg/ml susp, oral fr, 30 ml, ABBOTT 20 mg/ml susp, oral fr, plast, 30 ml c/200 frs, PRATI DONADUZZI 20 mg/ml susp, oral fr, plast, x 30 ml PRATI DONADUZZI 20 mg/ml susp, oral fr, vd, 30 ml+ dos, MEDLEY 20 mg/ml x 30 ml CIFARMA 500 mg, bl, 50 cprs, (mult,) MEDLEY Fracao de venda MEDLEY Susp, 100 mg/5 ml cx, 100 fr, x 30 ml TEUTO BRAS, Susp, 100 mg/5 mlfr, 30 ml, TEUTO BRAS, Susp, 20 mg/ml vd, 30 ml, NEO QUIMICA Susp, fr, 30 ml GERMED Susp, fr, 30 ml GEN - LEGRAND Susp, oral cx, 1 fr, 30 ml, CRISTALIA 100 mg, com, ct, bl, al, plas, inc, x 300 (emb, hosp,) PRATI DONADUZZI 100 mg, com, ct, bl, al, plas, inc, x 6 PRATI DONADUZZI 100 mg, cx, 6 cprs, EMS 20 mg/ml, sus, or, ct, fr, plas, opc, x 30 ml, PRATI DONADUZZI 20 mg/ml, sus, or, ct, fr, vd, amb, x 30 ml, PRATI DONADUZZI 20 mg/ml, sus, or, cx, 200 fr, plas, opc,x30ml,(emb, PRATI DONADUZZI 20 mg/ml, sus, or, cx, 200 fr, vd, amb, x30ml,(emb,h PRATI DONADUZZI 100 mg, com, ct, bl, al, plas, inc, x 300 (hosp,) PRATI DONADUZZI 100 mg, cx, 300 cprs, (hosp,) TEUTO BRAS, Susp, 100 mg/5 ml cx, 100 fr, x 30 ml (hosp,) TEUTO BRAS, Comp, c/6 PRATI DONADUZZI Susp, 30 ml PRATI DONADUZZI 100 mg, cx, 6 cprs, ROYTON Susp, cx, 1 fr, 30 ml ROYTON 20 cprs, NIKKHO 25 mg, x 15 cprs, APSEN 50 mg, x 15 cprs, APSEN 2500 mcg/ml sol, inj, IM 50 amps, vd, x 2 ml NOVAFARMA 500 mcg/ml sol, inj, IM 50 amps, vd, x 2 ml NOVAFARMA 750 mg+ dil, cx, 1 FA BERGAMO

UNIDADE Pco Unt Base A ML 0,14 ML 0,11 COMP 0,92 ML 0,10 UND 4,12 ML 0,13 ML 1,06 ML 0,12 GOTA 0,01 GOTAS 0,01 CP 3,98 UND 3,83 ML 0,04 ML 0,14 ML 0,13 GOTA 0,00 GOTA 0,01 ML 0,13 CP 0,07 CP 0,50 CP 0,66 ML 0,11 ML 0,11 ML 0,03 ML 0,03 UND 0,08 COMP 0,07 UND 1,41 CPR 0,91 ML 0,15 CPR 0,52 ML 0,21 CPR 0,78 CPR 0,86 COMP 1,54 AMP 3,71 AMP 1,93 FA 29,92

229

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8764 8765 8766 8782 8783 8784 8785 8786 8787 8788 8789 8790 8791 8792 8793 8794 8795 8796 8797 8798 8799 8800 8801 8802 8803 8804 8805 8806 8807 8808 8809 8810 8811 8812 8813 8814 8815 8816

CODIGO BENEFICIO 95988513 MEDGERON 95988521 MEDGERON 95057455 MEDICAINA 95072675 MEDPRAZOL 95001050 MEDPRESS 95001069 MEDPRESS 95001077 MEDTRIM 95001093 MEDTRIM 95001085 MEDTRIM 95001107 MEDTRIM 95001115 MEDXIL 95988530 MEDXIL 95988548 MEDXIL 95001123 MEDXIL 95974938 MEFENAN 95021175 MEFLOX 95021183 MEFLOX 95048774 MEGALOTECT 95048782 MEGALOTECT 95048766 MEGALOTECT 95985719 MEGESTAT 95550186 MEGESTAT 95001131 MEGUANIN 95001158 MEGUANIN 95124624 MEGUANIN (Restrito Hosp,) 95072691 MELHORAL 95072705 MELHORAL ADULTO 95072713 MELHORAL INFANTIL 95124632 MELIDRONATO (Restrito Hosp,) 95124640 MELIDRONATO (Restrito Hosp,) 95124659 MELIDRONATO (Restrito Hosp,) 95057498 MELLERIL 95057463 MELLERIL 95057471 MELLERIL 95057501 MELLERIL 95057510 MELLERIL 95057480 MELLERIL 95124667 MELOCOX

APRESENTAÇÃO 25 mg, cx, 30 cprs, 75 mg, cx, 30 cprs, 25 mg/g+ 25 mg/g crem derm, ct, bg, al, x 5 g 20 mg, fr, 60 caps, 250 mg, cx, 30 cprs, 500 mg, cx, 30 cprs, 250mg, susp,vd,100ml 400 mg, cx, 20 cprs, 400mg,susp,vd,100ml 800 mg, cx, 16 cprs, 250 mg, po susp, vd, 150 ml 250 mg, po susp, vd, 80 ml 500 mg, cx, 12 caps, 500 mg, cx, 21 caps, 500 mg, cx, 20 cprs, 400 mg, cx, 3 cprs, 400 mg, cx, 7 cprs, 1000 UI fr, 20 ml 2500 UI fr, 50 ml 500 UI fr, 10 ml 160 mg, fr, 30 cprs, Susp, 40 mg/ml fr, 240 ml, 500 mg, cx, 30 cprs, 850 mg, cx, 30 cprs, 850 mg, bl, 200 cprs, (hosp,) C eferv, 30 envs, x 2 cprs, fracao de venda 25 bl, x 8 cprs, fracao de venda 25 str, x 8 cprs, fracao de venda 30 mg, po liof, p/sol, inj, FA vd, 60 mg, po liof, p/sol, inj, FA vd, 90 mg, po liof, p/sol, inj, FA vd, 10 mg, bl, 20 drags, 100 mg, fr, 20 drags, 200 mg, retard fr, c/20 25 mg, bl, 20 drags, 3% sol, oral fr, vd, 50 ml 50 mg, bl, 20 drags, 10 mg/ml sol, inj, amp, vd, x 1,5 ml

Laboratorio MEDQUIMICA MEDQUIMICA CRISTALIA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA ROYTON GLENMARK GLENMARK MARCOS PEDRILSON MARCOS PEDRILSON MARCOS PEDRILSON B-MS B-MS UCI-FARMA UCI-FARMA UCI-FARMA COSMED COSMED COSMED MEIZLER MEIZLER MEIZLER VALEANT VALEANT VALEANT VALEANT VALEANT VALEANT EUROFARMA

UNIDADE Pco Unt Base A COMP 0,19 COMP 0,30 G 2,44 CAPS 0,63 COMP 0,46 COMP 0,90 ML 0,09 COMP 0,39 ML 0,14 COMP 0,70 ML 0,14 ML 0,19 COMP 1,27 CAPS 1,08 CPR 0,46 COMP 8,10 COMP 6,95 F,A, 1222,61 F,A, 3024,44 F,A, 602,65 COMP 6,11 ML 1,29 COMP 0,37 COMP 0,43 COMP 0,38 COMP 0,15 COMP 0,49 COMP 0,32 FA 213,84 FA 396,22 FA 617,06 DRAG 0,31 DRAG 1,21 DRAG 2,23 DRAG 0,55 ML 0,41 DRAG 0,67 AMP 3,20

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8817 8818 8819 8820 8821 8822 8823 8824 8825 8826 8827 8828 8829 8830 8831 8832 8833 8834 8835 8836 8837 8838 8839 8840 8841 8842 8843 8844 8845 8846 8847 8848 8849 8850 8851 8852 8853 8854

CODIGO BENEFICIO 95066837 MELOCOX 95057536 MELOCOX 95111972 MELOCOX 95057528 MELOCOX 95039341 MELOTEC 95662880 MELOTEC 95039333 MELOTEC 95895361 MELOXICAM - GENERICO 95895370 MELOXICAM - GENERICO 95974946 MELOXICAM - GENERICO 95001166 MELOXICAM - GENERICO 95001174 MELOXICAM - GENERICO 95021213 MELOXICAM - GENERICO 95001182 MELOXICAM - GENERICO

APRESENTAÇÃO 15 mg, sol, inj, 5 amps, x 1,5 ml 15 mg, str, 10 cprs, 15 mg, str, x 5 cprs, 7,5 mg/ml str, 10 cprs, 15 mg, 1 bl, x 10 cprs, 15 mg, 10 cprs, 7,5 mg, 1 bl, x 10 cprs, 10 mg/ml sol, inj, 5 amps, vd, x 1,5 ml 10 mg/ml sol, inj, ct, 5 amps, vd, amb, x 1,5 ml 15 mg bl, 10 cprs, 15 mg, 1 bl, x 10 cprs, 15 mg, 1 bl, x 10 cprs, 15 mg, 1 x 10 cprs, 15 mg, 10 cprs,

Laboratorio EUROFARMA EUROFARMA EUROFARMA EUROFARMA SIGMA PHARMA EMS SIGMA PHARMA FARMASA ATIVUS MERCK GERMED GEN - LEGRAND ZYDUS BIOSINTETICA

95111980 MELOXICAM - GENERICO 95895388 MELOXICAM - GENERICO 95021191 MELOXICAM - GENERICO 95111999 MELOXICAM - GENERICO 95974954 MELOXICAM - GENERICO 95057595 MELOXICAM - GENERICO 95057560 MELOXICAM - GENERICO 95974962 MELOXICAM - GENERICO 95895396 MELOXICAM - GENERICO 95974970 MELOXICAM - GENERICO 95001190 MELOXICAM - GENERICO 95001204 MELOXICAM - GENERICO 95021205 MELOXICAM - GENERICO 95001212 MELOXICAM - GENERICO 95895400 MELOXICAM - GENERICO 95974989 MELOXICAM - GENERICO 95057587 MELOXICAM - GENERICO 95057544 MELOXICAM - GENERICO 95057552 MELOXICAM - GENERICO 95974997 MELOXICAM - GENERICO 95895418 MELOXICAM - GENERICO 95029826 MELOXICAM - GENERICO 95001220 MELOXICAM - GENERICO 95124675 MELOXICAM - GENERICO (Restrito Hosp,)

15 mg, 10 cprs, 15 mg, 10 cprs, 15 mg, 6 bl,x10 cprs, 15 mg, bl, 10 cprs, 15 mg, bl, 10 cprs, 15 mg, bl,10cprs,rev, 15 mg, com, ct, bl, al, plas, inc, x 10 15 mg, ct, 10 cprs, 15 mg, fr, 10 cprs, 7,5 mg bl, 10 cprs, 7,5 mg, 1 bl, x 10 cprs, 7,5 mg, 1 bl, x 10 cprs, 7,5 mg, 1 x 10 cprs, 7,5 mg, 10 cprs, 7,5 mg, 10 cprs, 7,5 mg, bl, 10 cprs, 7,5 mg, bl, 10 cprs, rev, 7,5 mg, com, ct, bl, al, plas, inc, x 10 7,5 mg, com, ct, bl, al, plas, inc, x 500 (hosp,) 7,5 mg, ct, 10 cprs, 7,5 mg, fr, 10 cprs, 7,5mg,6bl, x 10 cprs, Inj, 10 mg, ct, 5 amps, 15 mg, com, ct, bl, al, plas, inc, x 500 (hosp,)

NEO QUIMICA RANBAXY EMS TEUTO BRAS, MEDLEY MEPHA-RATIOPHARM PRATI DONADUZZI EUROFARMA EMS MERCK GERMED GEN - LEGRAND ZYDUS BIOSINTETICA RANBAXY MEDLEY MEPHA-RATIOPHARM PRATI DONADUZZI PRATI DONADUZZI EUROFARMA EMS EMS EUROFARMA PRATI DONADUZZI

UNIDADE Pco Unt Base A AMP 3,39 COMP 1,31 COMP 1,75 COMP 1,06 CP 1,51 CPR 1,51 CP 0,81 AMP 3,25 AMP 3,01 CPR 2,00 COMP 1,71 COMP 1,71 COMP 1,67 COMP 1,75 COMP COMP COMP COMP CPR COMP COMP CPR COMP CPR COMP COMP COMP COMP COMP CPR COMP COMP COMP CPR COMP CPR AP COMP

1,98 1,28 2,39 2,39 1,99 2,03 2,38 1,84 2,39 1,07 0,81 0,96 0,96 0,94 0,69 1,20 1,28 1,28 0,39 0,99 1,30 1,28 3,34 0,49

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8855 8856 8857 8858 8859 8860 8861 8862 8863 8864 8865 8866 8867 8868 8869 8870 8871 8872 8873 8874 8875 8876 8877 8878 8879 8880 8881 8882 8883 8884 8885 8886 8887 8888 8889 8890 8891 8892

CODIGO BENEFICIO 95112006 MELOXIGRAN 95662901 MELOXIGRAN 95662910 MELOXIGRAN 95662928 MELOXIL 95662936 MELOXIL 95662944 MELOXIL 95066845 MENADION 95057609 MENELAT 95057617 MENELAT 95895426 MENOCALM 95895434 MENOGON 95490370 MENOGON 95895442 MENOPUR 95039368 MENOSTRESS 95039350 MENOSTRESS 95045023 MENOXITON 95045031 MENOXITON 95001255 MEPENOX 95075305 MEPENOX 95001263 MEPENOX 95075291 MEPENOX 95066861 MEPENOX MONOVIAL 95066870 MEPENOX MONOVIAL 95066853 MEPENOX MONOVIAL 95066888 MEPENOX MONOVIAL 95075348 MEPENOX SIST, FECH, 95075356 MEPENOX SIST, FECH, 95075313 MEPENOX SIST, FECH, 95075321 MEPENOX SIST, FECH, 95057625 MEPRAMIN 95112014 MEPRAMIN 95057633 MEPRAMIN 95112022 MEPRAMIN 95124683 MEPRAMIN (Restrito Hosp,) 95124691 MEPRAMIN (Restrito Hosp,) 95975020 MEPRAZAN 95975039 MEPRAZAN 95975047 MEPRAZAN

APRESENTAÇÃO 15 mg, bl, 10 cprs, 15 mg, fr, 10 cprs, 7,5 mg, fr, 10 cprs, 15 mg, 10 cprs, 7,5 mg, 10 cprs, Inj, 15 mg, 5 amps, 10 mg/ml 50 amps, x 0,2 ml 30 mg, cx, 30 cprs, 45 mg, cx, 30 cprs, 40 mg, cx, 30 cprs, rev, 75 UI cart, 1 amp, po liof,+ 1 amp, dil, 75 UI cart, 5 amps, po liof,+ 5 amps, dil, 75 UI cart, 1 amp, po liof,+ 1 amp, dil, 10 mg, cx, 200 cprs, 5 mg, cx, 200 cprs, 15 mg, cx, 10 cprs, 7,5 mg, cx, 10 cprs, 1 g cx, 10 FA 1gcx,50FA 500 mg, cx, 10 FA 500 mg, cx, 50 FA 1 g cx, 1 FA 1 g cx, 10 FA 500 mg, cx, 1 FA 500 mg, cx, 10 FA 1 g cx, 1 FA+ bolsa 1 gcx,10FA+bolsa 500 mg, cx, 1 FA+ bolsa 500 mg, cx, 10 FA+ bolsa 10 mg, cx, 20 cprs, 10 mg, cx, 20 drags, 25 mg, cx, 20 cprs, 25 mg, cx, 20 drags, 10 mg, bl, 200 drags, (hosp,) 25 mg, bl, 200 drags, (hosp,) 10 mg, cx, 14 caps, 20 mg, cx, 14 caps, 20 mg, cx, 7 caps,

Laboratorio LEGRAND LEGRAND LEGRAND ATIVUS ATIVUS ATIVUS CELLOFARM TORRENT TORRENT BUNKER FERRING FERRING FERRING ARROW ARROW ROYTON ROYTON BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA CAZI CAZI CAZI

UNIDADE Pco Unt Base A COMP 2,86 CPR 2,05 CPR 1,18 CPR 2,81 CPR 1,39 AP 5,45 AMP 1,98 COMP 3,01 COMP 4,28 COMP 0,97 AMP 68,18 AP 72,33 AMP 93,68 CP 0,27 CP 0,23 COMP 0,91 COMP 0,67 F,A, 19,38 FA 193,76 F,A, 111,70 FA 111,70 FA 193,76 FA 193,77 FA 111,69 FA 111,70 FA 193,76 FA 193,77 FA 111,72 FA 111,74 COMP 0,29 COMP 0,33 COMP 0,35 COMP 0,35 COMP 0,26 COMP 0,30 CPR 1,53 CPR 2,68 CPR 2,41

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8893 8894 8895 8896 8897 8898 8899 8900 8901 8902 8903 8904 8905 8906 8907 8908 8909 8910 8911 8912 8913 8914 8915 8916 8917 8918 8919 8920 8921 8922 8923 8924 8925 8926 8927 8928 8929 8930

CODIGO BENEFICIO 95988564 MEPRAZOL 95988572 MEPRAZOL 95988580 MEPRAZOL 95988599 MEPRAZOL 95057650 MEPROZIN 95057641 MEPROZIN 95124705 MEPROZIN (Restrito Hosp,) 95124713 MEPROZIN (Restrito Hosp,) 95379606 MERACILINA 95075372 MEROMAX 95899995 MERONEM 95900586 MERONEM 95384685 MERONEM IV 95384715 MERONEM IV

APRESENTAÇÃO 10 mg, fr, 14 caps, 20 mg, fr, 14 caps, 20 mg, fr, 28 caps, 20 mg, fr, 7 caps, 100 mg, com ct, 2 bl, al, plas, amb, x 20 25 mg, com ct, bl, al, plas, amb, x 20 100 mg, 200 cprs, (hosp,) 25 mg, 200 cprs, (hosp,) 500,000 UI 25 str, x 10 cprs, (emb, mult,) 2 g po sol, inj, IV 5 fr, vd, x 30 ml IV 1 g - sistema fechado cx, 10 FA IV 500 mg, - sistema fechado cx, 10 FA 500 MG - CX C/ 10 FA 1g frasco (cx 10)

95900594 MEROPENEM - GENERICO 95900616 MEROPENEM - GENERICO 95124721 MEROPENEM - GENERICO (Restrito Hosp,) 95124730 MEROPENEM - GENERICO (Restrito Hosp,) 95124748 MEROPENEM - GENERICO (Restrito Hosp,) 95124756 MEROPENEM - GENERICO (Restrito Hosp,) 95124764 MEROPENEM - GENERICO (Restrito Hosp,) 95124772 MEROPENEM - GENERICO (Restrito Hosp,) 95975055 MERTHIOLATE 95001310 MESACOL 95001328 MESACOL 95001336 MESACOL 95001344 MESACOL 95112030 MESALAZINA - GENERICO 95112049 MESALAZINA - GENERICO 95895450 MESALAZINA - GENERICO 95895469 MESALAZINA - GENERICO 95895477 MESALAZINA - GENERICO 95895493 MESALAZINA ENEMA - GENERICO 95895485 MESALAZINA ENEMA - GENERICO 95895507 MESALAZINA ENEMA - GENERICO 95081496 MESIDOX 95081500 MESIDOX 95112057 MESIGYNA

1 g 1 FA c/bolsa 500 mg, 1 FA c/bolsa 1 g 10 FA 1 g po sol, inj, 25 frs, vd, x 30 ml 1 g po sol, inj, IV cx, 10 FA vd, inc, x 50 ml (hosp,) 500 mg, 10 FA 500 mg, po sol, inj, 25 frs, vd, x 30 ml 500 mg, po sol, inj, IV cx, 10 FA vd, inc, x 30 ml (hosp,) Fr, x 30 ml fracao 250 mg sup, ret, ct berco x 10 400 mg bl, al, x 30 cprs, rev, 500 mg sup, ret, ct berco x 10 800 mg bl, al, x 30 cprs, rev, 400 mg, 30 cprs, rev, 800 mg, 30 cprs, rev, 800 mg, 30 cprs, rev, 800 mg, 30 cprs, rev, 800 mg, 30 cprs, rev, 3 g 3 envs, x 100 ml 3 g 3 envs,+ fr, 100 ml dil, Env, 3 g x 100 ml dil, 2 mg, fr, plast, opc, x 30 cprs, 4 mg, fr, plast, opc, x 30 cprs, Sol, inj, ser, vd, x 1 ml

Laboratorio MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA ACHE EUROFARMA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ABL ABL ABL EUROFARMA NOVAFARMA ABL EUROFARMA NOVAFARMA COSMED NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA COSMED COSMED EMS GERMED GEN - LEGRAND EMS GERMED GEN - LEGRAND MERCK MERCK BAYER

UNIDADE Pco Unt Base A CAPS 0,80 CAPS 0,88 CAPS 0,62 CAPS 1,64 COMP 0,29 COMP 0,28 COMP 0,54 COMP 0,24 CPR 10,66 FA 284,16 X FA 192,14 FA 110,76 FA 110,76 FA 192,14 FA 122,99 FA 70,89 FA 122,99 FA 122,98 FA 97,61 FA 70,89 FA 70,89 FA 70,89 ML 0,26 UNID 2,27 COMP 2,39 UNID 4,54 COMP 3,37 COMP 1,39 COMP 1,93 COMP 2,29 COMP 2,05 COMP 2,20 ENV 5,91 ENV 17,68 ENV 17,71 COMP 0,58 COMP 1,15 AMP 18,70

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8931 8932 8933 8934 8935 8936 8937 8938 8939 8940 8941 8942 8943 8944 8945 8946 8947 8948 8949 8950 8951 8952 8953 8954 8955 8956 8957 8958 8959 8960 8961 8962 8963 8964 8965 8966 8967 8968

CODIGO BENEFICIO 95029850 MESILATO DE DOXAZOSINA - GENERICO 95029869 MESILATO DE DOXAZOSINA - GENERICO 95039376 MESILATO DE DOXAZOSINA - GENERICO 95895515 MESILATO DE DOXAZOSINA - GENERICO 95895523 MESILATO DE DOXAZOSINA - GENERICO 95895531 MESILATO DE DOXAZOSINA - GENERICO 95895540 MESILATO DE DOXAZOSINA - GENERICO 95021256 MESILATO DE DOXAZOSINA - GENERICO 95021248 MESILATO DE DOXAZOSINA - GENERICO 95072721 MESILATO DE DOXAZOSINA - GENERICO 95975063 MESILATO DE DOXAZOSINA - GENERICO 95029877 MESILATO DE DOXAZOSINA - GENERICO 95029885 MESILATO DE DOXAZOSINA - GENERICO 95029893 MESILATO DE DOXAZOSINA - GENERICO 95470131 MESILATO DE BROMOCRIPTINA - GENERICO 95089675 MESILATO DE CODERGOCRINA - GENERICO 95089683 MESILATO DE CODERGOCRINA - GENERICO 95133917 MESILATO DE DOXAZOSINA - GENERICO 95112065 MESILATO DE DOXAZOSINA - GENERICO 95112073 MESILATO DE DOXAZOSINA - GENERICO 95133879 MESILATO DE DOXAZOSINA - GENERICO 95133925 MESILATO DE DOXAZOSINA - GENERICO 95133887 MESILATO DE DOXAZOSINA - GENERICO 95271201 MESMERIN 95271198 MESMERIN 95066918 MESNA - GENERICO 95530509 MESNA - GENERICO 95124780 MESNA - GENERICO (Restrito Hosp,) 95124799 MESNA - GENERICO (Restrito Hosp,) 95124802 MESNA - GENERICO (Restrito Hosp,) 95112081 MESOPRAN 95031103 MESOPRAN 95650164 MESTINON 95975071 METADEX 95975080 METADEX 95975098 METADON 95333100 METADON 95975101 METADON

APRESENTAÇÃO 2 mg 10 cprs, 2 mg 30 cprs, 2 mg, 2 bl, x 15 cprs, 2 mg, 2 bl, x 15 cprs, 2 mg, 2 bl, x 15 cprs, 2 mg, 2 bl, x 16 cprs, 2 mg, 30 cprs, 2 mg, bl, 10 cprs, 2 mg, bl, 30 cprs, 2 mg, bl, 30 cprs, 2mg,fr,plast,10cprs, 4 mg 30 cprs, 4 mg, 10 cprs, 4 mg, 20 cprs, 2,5 mg fr, plast, 14 cprs, 1 mg/ml 30 ml gt, sol, or, fr, vd, amb, 4,5 mg/1,5 ml gts, sol, or, fr, vd, amb, 2 mg 10 cprs, 2 mg, bl, 30 cprs, 2 mg, bl, 30 cprs, 2 mg, fr, 30 cprs, 4 mg 10 cprs, 4 mg, fr, 30 cprs, 1 mg, cx, 20 cprs, 2 mg, cx, 20 cprs, 100 mg/ml sol, inj, 50 amps, vd, x 4 ml 400 mg cx, 10 amp, 4 ml, 100 mg/ml sol, inj, 50 amps, vd, x 4 ml 100 mg/ml sol, inj, 50 amps, vd, x 4 ml 100 mg/ml sol, inj, IV cx, 10 amps, vd, inc, x 4 ml (hosp,) 10 mg, cx, 14 caps, 20 mg, cx, 14 caps, Fr, 60 cprs, 60 mg, Bisn, c/10 g Cart, c/2 bl, c/10 cprs, 10 mg, 2 bl, 10cprs, 10 mg, cx, 10 amps, 1 ml 5 mg, 2 bl, 10 cprs,

Laboratorio SANDOZ SANDOZ GERMED EMS GEN - LEGRAND GERMED MEDLEY RANBAXY RANBAXY BRAINFARMA APOTEX SANDOZ SANDOZ SANDOZ APOTEX BIOSINTETICA BIOSINTETICA HEXAL EUROFARMA TEUTO BRAS, MERCK HEXAL MERCK SIGMA PHARMA SIGMA PHARMA EUROFARMA EUROFARMA BLAUSIEGEL EUROFARMA NOVAFARMA ROYTON ROYTON VALEANT OSORIO DE MORAES OSORIO DE MORAES CRISTALIA CRISTALIA CRISTALIA

UNIDADE Pco Unt Base A CPR 2,11 CPR 1,50 CP 1,26 COMP 1,51 COMP 1,43 COMP 0,79 COMP 1,51 COMP 1,57 COMP 1,14 COMP 1,21 CPR 1,90 CPR 1,68 CPR 3,00 CPR 1,76 CPR 1,25 GOTAS 0,03 GOTAS 0,07 CPR 1,42 COMP 1,62 COMP 1,08 CPR 1,49 CPR 2,01 CPR 2,82 CPR 0,32 CPR 0,48 AMP 7,09 AP 7,22 AMP 7,64 AMP 7,09 AMP 6,80 COMP 0,76 CPR 1,04 CPR 0,39 G 0,78 CPR 0,15 CPR 0,87 AP 2,85 CPR 0,50

234

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 8969 8970 8971 8972 8973 8974 8975 8976 8977 8978 8979 8980 8981 8982 8983 8984 8985 8986 8987 8988 8989 8990 8991 8992 8993 8994 8995 8996 8997 8998 8999 9000 9001 9002 9003 9004 9005 9006

CODIGO BENEFICIO 95057676 METADOXIL 95001352 METALYSE 95001360 METALYSE 95050361 METAMUCIL 95050370 METAMUCIL 95900632 METAXON 95112090 METCORT 95047344 METFORGEN 95021264 METFORM 95112103 METFORMIX 95072730 METFORMIX 95021272 METFORMIX 95112111 METFORMIX 95072748 METFORMIX 95021280 METFORMIX 95500138 METHERGIN 95500146 METHERGIN 95450904 METICORTEN 95450890 METICORTEN 95133933 METILCORD 95133941 METILCORD 95975110 METILDOPA - GENERICO 95001379 METILDOPA - GENERICO 95975136 METILDOPA - GENERICO 95029907 METILDOPA - GENERICO 95001387 METILDOPA - GENERICO 95975160 METILDOPA - GENERICO 95029915 METILDOPA - GENERICO 95133984 METILDOPA - GENERICO 95975179 METILDOPA - GENERICO 95001395 METILDOPA - GENERICO 95895558 METILPRESS 95895566 METILPRESS 95975187 METIOCOLIN B12 95975195 METIOCOLIN COMPOSTO 95975209 METIOCOLIN COMPOSTO 95320911 METOCLOPRAMIDA 95320938 METOCLOPRAMIDA - GENERICO

APRESENTAÇÃO 500 mg, cx, 30 cprs, 40 mg po liof, inj, fr,+ ser, inj, dil, x 8 ml, 50 mg, po liof, inj, fr,+ ser, inj, dil, x 10 ml Laranja - sachet 10 un, Laranja fr, 174 g 4 mg/ml cx, 50 FA 2,5 ml Creme bisn, 10 g 850 mg, cx, 30 cprs, 850 mg, cx, 30 cprs, 500 mg, 12 cp, 500 mg, 24 cp, 500 mg, 48 cp, 850 mg, 12 cp, 850 mg, 24 cp, 850 mg, 48 cp, Amps, 50 x 1 ml, Blister c/12 drags, 20 mg, 10 cprs, 5 mg, 20 cprs, 250 mg, 30 cprs, 500 mg, 30 cprs, 250 mg cx, 30 cprs, 250 mg, 2 bl, x 15 cprs, rev, 250 mg, 2 bl, x 15 cprs, rev, 250 mg, 9 bl, x 10 cprs, rev, 250 mg, fr, 30 cprs, 500 mg cx, 30 cprs, 500 mg, 15 bl, x 6 cprs, rev, 500 mg, 2 bl, x 15 cprs, rev, 500 mg, 2 bl, x 15 cprs, rev, 500 mg, fr, 30 cprs, 250 mg, cx, 30 cprs, 500mg,3bl,x10 cprs, 100 mg, cx, 40 drags, Cx, c/100flac,x10 ml Cx, c/12 flac, x 10 ml Inj, 10 mg, cx, 100 amps, x 2 ml, Inj, 10 mg cx, 100 amps, 2 ml,

Laboratorio BALDACCI BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM PROCTER & GAMBLE PROCTER & GAMBLE ARISTON DELTA MILIAN BRASTERAPICA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS MANTECORP MANTECORP LUPER LUPER EMS BIOSINTETICA MEDLEY EMS LUPER EMS EMS MEDLEY BIOSINTETICA LUPER SIGMA PHARMA SIGMA PHARMA FARMASA FARMASA FARMASA NEO QUIMICA NEO QUIMICA

UNIDADE Pco Unt Base A COMP 1,09 F,A, 3415,23 F,A, 4220,79 ENV 1,87 G 0,22 FA 2,65 GRAMA 1,06 COMP 0,45 COMP 0,40 COMP 0,25 COMP 0,25 COMP 0,25 COMP 0,43 COMP 0,43 COMP 0,42 AP 1,54 CPR 0,45 CPR 1,42 CPR 0,53 CPR 0,68 CPR 1,30 CPR 0,41 COMP 0,38 CPR 0,36 CPR 0,37 COMP 0,32 CPR 0,76 CPR 0,69 CPR 0,73 CPR 0,73 COMP 0,62 COMP 0,34 COMP 0,62 CPR 0,29 UND 1,19 UND 1,31 AP 0,50 AP 0,55

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9007 9008 9009 9010 9011 9012 9013 9014 9015 9016 9017 9018 9019 9020 9021 9022 9023 9024 9025 9026 9027 9028 9029 9030 9031 9032 9033 9034 9035 9036 9037 9038 9039 9040 9041 9042 9043 9044

CODIGO BENEFICIO 95057684 METOCLOPRAMIDA - GENERICO 95124810 METOCLOPRAMIDA - GENERICO (Restrito Hosp,) 95057692 METOCLOPRAMIDA HCL - GENERICO 95021299 METOCLOPRAMIDA HCL - GENERICO 95124829 METOCLOPRAMIDA HCL - GENERICO (Restrito Hosp,) 95057706 METOCLOPRAMIDA, CLORIDRATO DE - GENERICO 95124837 METOCLOSANTISA (Restrito Hosp,) 95021302 METOPLAMIN 95895574 METREXATO - METOTREXATO 95895582 METREXATO - METOTREXATO 95895590 METREXATO - METOTREXATO 95001409 METRI 95057714 METRI 95112120 METRI 95001417 METRI 95001425 METRI 95039384 METRIZOL 95410279 METRODAX 95410260 METRODAX 95057722 METRODAX 95124845 METROFARMA 95895604 METROFARMA 95039392 METRONIDAZOL + NISTATINA - GENERICO 95021329 METRONIDAZOL + NISTATINA - GENERICO 95057730 METRONIDAZOL + NISTATINA - GENERICO 95021310 METRONIDAZOL + NISTATINA - GENERICO 95001433 METRONIDAZOL + NISTATINA - GENERICO 95057773 METRONIDAZOL - GENERICO 95057765 METRONIDAZOL - GENERICO 95112138 METRONIDAZOL - GENERICO 95043969 METRONIDAZOL - GENERICO 95043977 METRONIDAZOL - GENERICO 95975225 METRONIDAZOL - GENERICO 95410295 METRONIDAZOL - GENERICO 95410309 METRONIDAZOL - GENERICO 95057757 METRONIDAZOL - GENERICO 95001450 METRONIDAZOL - GENERICO 95083103 METRONIDAZOL - GENERICO

APRESENTAÇÃO Laboratorio Sol, inj, 10 mg/2 ml cx, 100 ampx, x 2 ml TEUTO BRAS, Sol, inj, 10 mg/2 ml cx, 100 amps, x 2 ml (hosp,) TEUTO BRAS, 5 mg/ml sol, inj, 2 ml c/120 TEUTO BRAS, Sol, oral gts, 4 mg/ml fr, 10 ml TEUTO BRAS, 5 mg/ml sol, inj, 2 ml c/120 (hosp,) TEUTO BRAS, 10 mg, bl, 20 cprs, SANOFI-AVENTIS 10 mg, sol, inj, cx, 100 amps, vd, amb, x 2 ml SANTISA 10 mg, 20 cprs, CIFARMA 2,5 mg, ct, 3 bl, x 3 cprs, BLAUSIEGEL 2,5 mg, ct, 8 bl, x 3 cprs, BLAUSIEGEL 2,5 mg, ct, 80 bl, x 3 cprs, BLAUSIEGEL 1000 mg, 30 cprs, LIBBS 250 mg, 30 cprs, rev, LIBBS 500 mg, 30 cprs, LIBBS 500 mg, 30cprs, LIBBS 750 mg, 30 cprs, LIBBS 100 mg/g gel vag, bisn, 50 g+ 10 aplic, CELLOFARM 200 mg/5 ml, cx, 1 fr, 80 ml, susp, ROYTON 250 mg, cx, 20 cprs, ROYTON Susp, fr, 80 ml ROYTON 10 mg/2 ml cx, 100 amps, vd, FARMACE 5 mg/ml amp, 2 ml FARMACE 100 mg,+ 20,000 UI/g crem, vag, ct, bg, al, x 50 g+ aplic, PRATI DONADUZZI 100 mg/g+ 20,000 UI/g creme vag, bisn, 50 g+ 10 aplic, PRATI DONADUZZI 100 mg/g+ 20,000 UI/g creme vag, ct, bisn, al, x 50 g+ 10 aplic, SANOFI-AVENTIS 100 mg/g+ 20,000 UI/g creme vag, cx, 50 bisn, x 50 g+ 500PRATI DONADUZZI Creme vag, 50 g c/50 PRATI DONADUZZI 100 mg/g bisn, gel vag, 50 g+ 10 aplic, MEPHA-RATIOPHARM 100 mg/g gel vag, bisn, 50 g+ 10 aplic, desc, SANOFI-AVENTIS 100 mg/g gel, vag, ct, bg, al x 50 g + 10 aplic, PRATI DONADUZZI 250 mg, com, rev, ct, bl, al, pvc Leit x 20 PRATI DONADUZZI 250 mg, com, rev, ct, bl, al, pvc Leit x 600 (emb, hosp,) PRATI DONADUZZI 250 mg, cx, 2 bl, x 10 cprs, NEO QUIMICA 250 mg, cx, 20 cprs, EMS 400 mg, cx, 24 cprs, EMS 400 mg,bl,24cprs,rev, SANOFI-AVENTIS 5 mg/ml bolsa 100 ml HALEX ISTAR 5 mg/ml bolsa polietileno 100 ml ISOFARMA

UNIDADE Pco Unt Base A AMP 0,28 AMP 0,33 AMP 0,28 GOTA 0,01 AMP 0,33 COMP 0,35 AMP 0,28 COMP 0,23 COMP 0,17 COMP 0,67 COMP 0,56 COMP 1,60 COMP 0,53 COMP 1,20 COMP 1,07 COMP 1,44 G 0,18 ML 0,08 CPR 0,33 ML 0,09 AMP 0,46 AMP 0,38 G 0,25 GRAMA 0,35 G 0,40 GRAMA 5,89 G 0,05 G 0,20 G 0,26 GRAMA 0,28 CP 0,34 CP 0,09 CPR 0,29 CPR 0,26 CPR 0,30 COMP 0,39 UNID 7,02 UNID 7,36

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9045 9046 9047 9048 9049 9050 9051 9052 9053 9054 9055 9056 9057 9058 9059 9060 9061 9062 9063 9064 9065 9066 9067 9068 9069 9070 9071 9072 9073 9074 9075 9076 9077 9078 9079 9080 9081 9082

CODIGO BENEFICIO 95988629 METRONIDAZOL - GENERICO 95841130 METRONIDAZOL - GENERICO 95510621 METRONIDAZOL - GENERICO 95057749 METRONIDAZOL - GENERICO 95510630 METRONIDAZOL - GENERICO 95510648 METRONIDAZOL - GENERICO 95021337 METRONIDAZOL - GENERICO 95021345 METRONIDAZOL - GENERICO 95039406 METRONIDAZOL - GENERICO 95112146 METRONIDAZOL - GENERICO (Restrito Hosp,) 95124853 METRONIDAZOL - GENERICO (Restrito Hosp,) 95124861 METRONIDAZOL - GENERICO (Restrito Hosp,) 95124870 METRONIDAZOL - GENERICO (Restrito Hosp,) 95112154 METRONIDAZOL - GENERICO (Restrito Hosp,) 95124888 METRONIDAZOL - GENERICO (Restrito Hosp,) 95124896 METRONIDAZOL - GENERICO (Restrito Hosp,) 95112162 METRONIDAZOL + NISTATINA - GENERICO 95124900 METRONIDAZOL + NISTATINA - GENERICO (Restrito Hosp,) 95001468 METRONIFLEX 95975233 METRONIL 95975241 METRONIL 95975250 METRONIL 95021353 METRONIN 95021361 METRONIN 95057781 METRONIX 95029940 METVIX 95057790 MEVALIP 95057803 MEVALOTIN 95180516 MEVALOTIN 95112170 MEVALOTIN 95180524 MEVALOTIN 95057811 MEVALOTIN 95057820 MEVALOTIN 95180559 MEVALOTIN 95975268 MEVAMOX 95110399 MEXITIL 95110380 MEXITIL 95112189 MIACALCIC

APRESENTAÇÃO Laboratorio Cx, 48 frs, HYPOFARMA Gel bisn, 50 g, EMS Gel bisn, 50 g,+ aplic, TEUTO BRAS, Gel, vag, 100 mg, cx, 50 bisn, x 50 g TEUTO BRAS, Gel, vag, 50 g, PRATI DONADUZZI Gel, vag, 50 g, c/50 PRATI DONADUZZI Gel, vag, bisn, 50 g+ 10 aplic, GERMED Gel, vag, bisn, 50 g+ 10 aplic, GEN - LEGRAND Sol, inj, cx, 100 frs, 100 ml EQUIPLEX 100 mg/g gel, vag, cx, 50 bg, al, x 50 g + aplic, (hosp,) PRATI DONADUZZI 250 mg, com, rev, ct, bl, al, plas, opc, x 600 (hosp,) PRATI DONADUZZI 5 mg/ml bolsa 100 ml HALEX ISTAR 5 mg/ml bolsa polietileno 100 ml ISOFARMA Gel, vag, 100 mg, cx, 50 bisn, x 50 g (hosp,) TEUTO BRAS, Sistema fechado sol, inj, cx, 70 frs, 100 ml IV (hosp,) EQUIPLEX Sol, inj, cx, 100 frs, 100 ml (hosp,) EQUIPLEX 100 mg/g + 20,000 UI/g creme vag, bisn, 50 g + 10 aplic, LUPER 100 mg/g + 20,000 UI/g crem, vag, cx, 50 bg, al, x 50 g + 500 PRATI aplic,DONADUZZI (hosp,) Metronidazol 500 mg em clor, de sodio 0,9% 100 ml - 5 mg/ml BAXTER 100 mg, gel, vag, bisn, 50 g CAZI 250 mg, cx, 20 cprs, CAZI 40 mg, susp, oral fr, 100 ml CAZI 250 mg, 20 cprs, CIFARMA 40 mg/ml susp, oral 100 ml CIFARMA 100 mg/g gel, vag, 50 bisn, 50 g CRISTALIA Pom, tubo 2 g GALDERMA 20 mg, cx, 30 cprs, TEUTO BRAS, 10 mg, cx, 30 cprs, DAIICHI SANKYO 10 mg, cx, 30 cprs, SANKYO PHARMA 20 mg, cx, 30 cprs, DAIICHI SANKYO 20 mg, cx, 30 cprs, SANKYO PHARMA 20mg,cx,30cprs, DAIICHI SANKYO 40 mg cx, 30 cprs, DAIICHI SANKYO 40 mg cx, 30 cprs, SANKYO PHARMA 15 mg, cx, 10 cprs, TEUTO BRAS, 100 mg, 2 bl, x 10 caps, BOEHRINGER INGELHEIM 200 mg, fr, 30 caps, BOEHRINGER INGELHEIM 100 UI 1 ml 5 amps, NOVARTIS

UNIDADE Pco Unt Base A ML 2,29 G 0,18 G 0,19 G 0,14 G 0,26 G 0,05 GRAMA 0,14 GRAMA 0,16 ML 0,02 GRAMA 2,70 COMP 0,10 UNID 7,02 UNID 7,96 GRAMA 7,86 UNID 6,75 UNID 1,94 GRAMA 0,40 GRAMA 0,14 UNID 7,29 G 0,31 CPR 0,40 ML 0,12 COMP 0,35 ML 0,09 UNID 0,20 G 413,70 COMP 1,30 COMP 1,20 CPR 1,16 COMP 2,03 CPR 1,83 COMP 1,73 COMP 4,06 CPR 3,66 CPR 2,72 CPR 0,53 CPR 0,50 AMP 35,91

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9083 9084 9085 9086 9087 9088 9089 9090 9091 9092 9093 9094 9095 9096 9097 9098 9099 9100 9101 9102 9103 9104 9105 9106 9107 9108 9109 9110 9111 9112 9113 9114 9115 9116 9117 9118 9119 9120

CODIGO BENEFICIO APRESENTAÇÃO 95480536 MIACALCIC 100 UI sol, inj, 5 ser, x 1 ml, 95480544 MIACALCIC 200 UI spray nasal fr, vd, 2 ml+ neb 95480528 MIACALCIC 50 UI sol, inj, 5 ser, x 0,5 ml, 95001484 MIANTREX CS (METOTREXATO) 1 g, sol, inj, FA plast, 95541977 MIANTREX (METOTREXATO) 50 mg, sol, inj, FA plast, 95541985 MIANTREX (METOTREXATO) 500 mg, sol, inj, FA plast, 95124918 MIANTREX CS (METOTREXATO) (Restrito Hosp,) 50 mg, sol, inj, FA plast, 95134026 MICARDIS 40 mg, 28 cprs, 95134042 MICARDIS 80 mg ct, 4 bl, x 7 cprs, 95112197 MICARDIS ANLO 40 mg, + 10 mg, bl, al/al x 30 cprs, 95112200 MICARDIS ANLO 40 mg, + 5 mg, bl, al/al x 10 cprs, 95112219 MICARDIS ANLO 40 mg, + 5 mg, bl, al/al x 30 cprs, 95112227 MICARDIS ANLO 80 mg, + 10 mg, bl, al/al x 30 cprs, 95112235 MICARDIS ANLO 80 mg, + 5 mg, bl, al/al x 10 cprs, 95112243 MICARDIS ANLO 80 mg, + 5 mg, bl, al/al x 30 cprs, 95134069 MICARDIS HCT 40 mg+ 12,5 mg ct, 4 bl, x 7 cprs, 95134085 MICARDIS HCT 80 mg+ 12,5 mg ct, 4 bl, x 7 cprs, 95975292 MICLONAZOL 10 mg,cremebisn,20 g 95001492 MICOFENOLATO MOFETIL G - GENERIC 500 mg, cprs, rev, 5 bl, x 10 95057838 MICOFENOLATO DE MOFETILA - GENERICO 500 mg, 5 bl, x 10 cprs, 95112251 MICOFENOLATO DE MOFETILA - GENERICO 500 mg, bl, 50 cprs, rev, 95112260 MICOFENOLATO DE MOFETILA - GENERICO 500 mg, bl, 50 cprs, rev, 95124926 MICOFENOLATO DE MOFETILA - GENERICO (Restrito Hosp,) 500 mg, bl, 500 cprs, rev, (hosp,) 95510680 MICOGYN Creme vag, bisn, 80 g 95112278 MICOGYN Creme vag, bisn, 80 g + 14 aplic, 95072756 MICOLAMINA Creme bisn, 20 g 95112286 MICOLAMINA Spray 30 ml 95975306 MICONAL 100 mg, cx, 10 caps, 95975314 MICONAL 100 mg, cx, 15 caps, 95975322 MICONAL 100 mg, cx, 4 caps, 95975330 MICOPLEX 50 mg,+ 6 mg, pom, bisn, 45 g 95985743 MICORAL (*) Cx, 1 env, 10 cprs, 95985760 MICOSIL Creme 1% bisn, 20 g 95021370 MICOSIN Creme bisn, 28 g 95391304 MICOSTATIN Blister 16 drags, 95510702 MICOSTATIN Creme vag, 60 g, 95391312 MICOSTATIN Susp, oral 50 ml, 95841261 MICOSTEN Creme cx, 20 g

Laboratorio NOVARTIS NOVARTIS NOVARTIS PFIZER PHARMACIA/PFIZER PFIZER PFIZER BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM CAZI CELLOFARM EMS ACCORD EUROFARMA ACCORD ELOFAR ELOFAR THERASKIN THERASKIN DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS CAZI ELOFAR TEUTO BRAS, MEDIC B-MS B-MS B-MS HEXAL

UNIDADE Pco Unt Base A UND 34,70 DOSE 11,42 UND 16,49 F,A, 149,34 FA 12,89 FA 80,15 FA 12,89 CPR 2,51 CPR 2,80 COMP 2,11 COMP 1,91 COMP 1,91 COMP 2,45 COMP 2,45 COMP 2,45 CPR 2,82 CPR 3,15 G 0,55 COMP 6,62 COMP 8,02 COMP 8,21 COMP 8,21 COMP 6,98 G 0,18 GRAMA 0,24 G 1,06 UNID 32,54 CPR 3,45 CPR 3,58 CPR 6,10 G 0,45 COMP 2,33 G 1,22 GRAMA 0,32 CPR 1,77 G 0,24 ML 0,48 G 0,32

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9121 9122 9123 9124 9125 9126 9127 9128 9129 9130 9131 9132 9133 9134 9135 9136 9137 9138 9139 9140 9141 9142 9143 9144 9145 9147 9148 9149 9150 9151 9152 9153 9154 9155 9156 9157 9158 9159

CODIGO BENEFICIO 95975357 MICOSTYL 95975365 MICOSTYL 95975373 MICOTIAZOL 95975403 MICOTRAT 95975411 MICOTRAT (*) 95975420 MICOTRAT (*) 95039414 MICOZEN 95510710 MICOZEN 95124934 MICOZEN (Restrito Hosp,) 95021396 MIDADORM 95066934 MIDADORM 95021400 MIDADORM 95066926 MIDADORM 95075399 MIDADORM 95124942 MIDADORM (Restrito Hosp,) 95895620 MIDAZOLAM - GENERICO 95895639 MIDAZOLAM - GENERICO 95021418 MIDAZOLAM - GENERICO 95021426 MIDAZOLAM - GENERICO 95021434 MIDAZOLAM - GENERICO 95021442 MIDAZOLAM - GENERICO 95895647 MIDAZOLAM - GENERICO 95124950 MIDAZOLAM - GENERICO (Restrito Hosp,) 95124969 MIDAZOLAM - GENERICO (Restrito Hosp,) 95124977 MIDAZOLAM - GENERICO (Restrito Hosp,) 95210385 MIFLASONA 95210393 MIFLASONA 95210407 MIFLONIDE 95210415 MIFLONIDE 95001522 MIGRANETTE 95112294 MIGRANETTE 95975438 MIGRANETTE 95112308 MIGRANETTE 95975446 MILAX 95510729 MINEGYL 95410333 MINEGYL (*) 95510737 MINEGYL (*) 95410341 MINEGYL (*)

APRESENTAÇÃO Creme tb, 45 g Locao cremosa fr, 60 ml Sol, top, fr, 50 ml 20 mg/g bisn, 30 g 200 mg, cart, 2 bl, x 10 cprs, 200 mg, cart, bl, 10 cprs, 20 mg/g creme vag, 80 g c/50 Creme gin, 80 g,+ apl, 20 mg/g creme vag, 80 g c/50 (hosp,) 5 mg/ml cx, 10 amps, 10 ml 5 mg/ml cx, 10 amps, 3 ml 5 mg/ml cx, 5 amps, 10 ml 5 mg/mlcx,5amps,3ml 50 mg/10 ml cx, 50 amps, 15 mg, cx, 50 amps, 3 ml 15 mg, bl, 20 cprs, 15 mg, bl, 30 cprs, 15 mg, sol, inj, 5 amps, x 3 ml 15 mg/3 ml sol, inj, 5 amps, vd, x 3 ml 5 mg/5 ml sol, inj, 5 amps, vd, x 5 ml 50 mg/10 ml sol, inj, 5 amps, vd, x 10 ml 7,5 mg, bl, 20 cprs, 15 mg/3 ml sol, inj, 5 amps, vd, x 3 ml 5 mg/5 ml sol, inj, 5 amps, vd, x 5 ml 50 mg/10 ml sol, inj, 5 amps, vd, x 10 ml 200 mcg, 60 cs, 400 mcg, 60 cs, 200 mcg 60 cs, 400 mcg 60 cs, 2 bl, x 10 cprs, rev, 2 bl, x 10 cprs, rev, Gts, fr, 20 ml Gts, fr, 20 ml, Susp, 240 ml C/Nistatina cr, vag, 50 g 250 mg, 20 cprs, Geleia vag, 50 g Susp, fr, 80 ml

Laboratorio STIEFEL STIEFEL CAZI OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO RANBAXY RANBAXY UNIAO QUIMICA EUROFARMA EUROFARMA EUROFARMA RANBAXY EUROFARMA EUROFARMA EUROFARMA NOVARTIS NOVARTIS NOVARTIS NOVARTIS SIGMA PHARMA LEGRAND SIGMA PHARMA SIGMA PHARMA JOSPER LUPER LUPER LUPER LUPER

UNIDADE Pco Unt Base A G 0,29 ML 0,27 ML 0,19 G 0,41 CPR 1,38 CPR 1,74 G 0,15 G 0,29 GRAMA 15,89 AMP 22,95 AMP 7,53 AMP 22,94 AMP 7,53 AMP 22,95 AMP 7,21 COMP 1,04 COMP 1,04 AMP 6,35 AMP 5,87 AMP 2,73 AMP 15,01 COMP 0,52 AMP 5,87 AMP 2,73 AMP 15,01 CPR 0,29 CPR 0,51 CPR 0,42 CPR 0,73 COMP 0,53 COMP 0,54 GOTAS 0,02 GOTAS 0,02 ML 0,07 G 0,41 CPR 0,43 G 0,29 ML 0,09

239

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9161 9162 9163 9164 9165 9166 9167 9168 9169 9170 9171 9172 9173 9174 9175 9176 9177 9178 9179 9180 9181 9182 9183 9184 9185 9186 9187 9188 9189 9190 9191 9192 9193 9194 9195 9196 9197 9198

CODIGO BENEFICIO 95057846 MINEROLEO 95057854 MINEROLEO 95700188 MINIDEX 95431349 MINIDIAB 5 MG, 95050388 MINILAX 95975454 MINIMA 95460977 MINIPIL 95975462 MINIPIL-2 POST 95134093 MINIPRESS SR 95134107 MINIPRESS SR 95134115 MINIPRESS SR 95379630 MINODERM 95379657 MINOMAX 95895655 MINOTON 95895663 MINUSORB 95480552 MINUSORB 95480560 MINUSORB 95600256 MIOCALVEN 95600264 MIOCALVEN D 95600272 MIOCALVEN D 95001549 MIOCOR 95057862 MIOCORON 95110402 MIODARID 95110410 MIODARON 95895671 MIODON 95895680 MIODON 95001557 MIODON 95500154 MIODRINA 95124993 MIOFIBRAX 95125000 MIOFIBRAX 95125019 MIOFIBRAX 95125027 MIOFIBRAX 95975470 MIOFLEX 95975489 MIOFLEX 95112316 MIOSAN 95001573 MIOSAN 95001581 MIOSAN 95001590 MIOSAN

APRESENTAÇÃO 100% fr, x 100 ml 100% fr, x 200 ml Sol, oft, fr, 5 ml, Cx, c/2 bl, x 15 Cx, 7 bisn, 6,5 g 0,06 mg,+ 0,015 mg, cprs, rev, c/1 bl, al, plast, x 24+ 4 Bl, 35 cprs, 1 bl, x 2 cprs, 1 mg, 15 caps, 2 mg, 15 caps, 4 mg, 15 caps, 100 mg, cart, c/10 cprs, 100 mg, ct, 1 fr, x 30 cprs, 0,24 g cx, 100 amps, 10 ml 70 mg, bl, 4 cprs, Cprs, bl, 15 Cprs, bl, 30 Cx, 60 cprs, 200 mg Cx, 30 sachets Cx, 60 sachets 200 mg, cx, 20 cprs, 200 mg, 20 bl, x 10 cps, 200 mg cx, 2 bl, x 10 cprs, Cx, 20 cprs, 100 mg, 2 bl, x 15 cprs, rev, 200 mg, 2 bl, x 15 cprs, rev, 50 mg/ml sol, inj, 50 amps, x 3 ml 10 mg, cx, 20 cprs, 10 mg, 2 bl, x 15 cprs, rev, 10 mg, bl, 15 cprs, rev, 5 mg, 2 bl, x 15 cprs, rev, 5 mg, bl, 15 cprs, rev, A cx, 12 cprs, 500 mg, Cx,16cprs, 10 mg, cx, 10 cprs, rev, 10 mg, cx, 30, cprs, rev, 5 mg, cx, 10 cprs, rev, 5 mg, cx, 30 cprs, rev,

Laboratorio CRISTALIA CRISTALIA ALCON PFIZER EUROFARMA MEDLEY SIGMA PHARMA SIGMA PHARMA PFIZER PFIZER PFIZER STIEFEL WYETH ARISTON UCI-FARMA UCI-FARMA UCI-FARMA CHIESI CHIESI CHIESI UCI-FARMA CRISTALIA NEO QUIMICA BIOSINTETICA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS APSEN LEGRAND LEGRAND LEGRAND LEGRAND FARMASA FARMASA APSEN APSEN APSEN APSEN

UNIDADE Pco Unt Base A ML 0,03 ML 0,35 GOTAS 0,04 CPR 0,79 G 3,31 CPR 0,77 CPR 0,28 CPR 5,72 CPR 0,91 CPR 1,59 CPR 2,18 CPR 3,76 CPR 1,99 AMP 0,72 COMP 8,04 CPR 2,39 CPR 2,25 CPR 0,48 ENV 1,46 ENV 1,39 COMP 0,79 COMP 0,59 CPR 1,05 CPR 0,98 COMP 0,47 COMP 0,61 AMP 1,94 CPR 1,93 COMP 0,62 COMP 0,62 COMP 0,30 COMP 0,30 CPR 0,90 CPR 0,40 COMP 1,00 COMP 1,01 COMP 0,90 COMP 0,90

240

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9199 9200 9201 9202 9203 9204 9205 9206 9207 9208 9209 9210 9211 9212 9213 9214 9215 9216 9217 9218 9219 9220 9221 9222 9223 9224 9225 9226 9227 9228 9229 9230 9231 9232 9233 9234 9235 9236

CODIGO BENEFICIO 95001603 MIOSAN 95710043 MIOSTAT 95740236 MIRABEL 95072799 MIRADOR 95072780 MIRADOR 95072772 MIRADOR 95072764 MIRADOR 95072802 MIRADOR 95350233 MIRAPEX 95350241 MIRAPEX 95350250 MIRAPEX 95075461 MIRCERA 95075470 MIRCERA 95075488 MIRCERA 95075496 MIRCERA 95075500 MIRCERA 95075445 MIRCERA 95075453 MIRCERA 95001611 MIRTAX 95001620 MIRTAX 95039430 MIRTAX 95001638 MIRTAX 95001646 MIRTAX 95039422 MIRTAX 95001654 MIRTAZAPINA - GENERICO 95001662 MIRTAZAPINA - GENERICO 95021469 MIRTAZAPINA - GENERICO 95072829 MIRTAZAPINA - GENERICO 95072837 MIRTAZAPINA - GENERICO 95072810 MIRTAZAPINA - GENERICO 95001670 MIRTAZAPINA - GENERICO 95072845 MIRTAZAPINA - GENERICO 95075518 MITEXAN 95072853 MITEXAN 95530550 MITEXAN 95072861 MITEXAN 95530568 MITEXAN 95125035 MITEXAN (Restrito Hosp,)

APRESENTAÇÃO 5 mg, cx, 30 cprs, rev, CX C/ 1 AMP x 1,5 ML Col, fr, 10 ml, 500 mg, bl, x 12 cprs, 500 mg, disp, 25 bl, x 6 cprs, 500 mg/ml sol, oral fr, 10 ml 500 mg/ml sol, oral fr, 20 ml Fracao bl, 6 cprs, 0,125 mg, 30 cprs, 0,25 mg, 30 cprs, 1,00 mg, 30 cprs, 100 mcg sol, inj, ser, vd, preench, x 0,3 ml 120 mcg sol, inj, ser, vd, preench, x 0,3 ml 150 mcg sol, inj, ser, vd, preench, x 0,3 ml 200 mcg sol, inj, ser, vd, preench, x 0,3 ml 360 mcg sol, inj, ser, vd, preench, x 0,6 ml 50 mcg sol, inj, ser, vd, preench, x 0,3 ml 75 mcg sol, inj, ser, vd, preench, x 0,3 ml 10 mg, 1 bl, x 15 cprs, rev, 10 mg, 2 bl, x 15 cprs, rev, 10 mg, x 10 cprs, 5 mg, 1 bl, x 15 cprs, rev, 5 mg, 2 bl, x 15 cprs, rev, 5 mg, x 10 cprs, 30 mg, 14 cp, rev, 30 mg, 28 cp, rev, 30 mg, 7 cp, rev, 30 mg, bl, 14 cprs, rev, 30 mg, bl, 28 cprs, rev, 30 mg, bl, 7 cprs, rev, 45 mg, 28 cp, rev, 45 mg, bl, 28 cprs, rev, 100mg,10amps,x4 ml 400 mg, 20 cprs, 400 mg, 20 cprs, 600 mg, 20 cprs, 600 mg, 20 cprs, 100 mg/ml sol, inj, ct, 10 amps, vd, inc, x 4 ml

Laboratorio UNIDADE Pco Unt Base A APOTEX COMP 0,71 ALCON AMP 9,14 ALLERGAN GOTAS 0,03 COSMED COMP 0,35 COSMED COMP 0,35 COSMED GOTA 0,02 COSMED GOTA 0,02 COSMED COMP 0,29 PHARMACIA/PFIZER CPR 0,92 PHARMACIA/PFIZER CPR 1,76 PHARMACIA/PFIZER CPR 5,21 ROCHE UNID 643,22 X ROCHE UNID 743,98 X ROCHE UNID 929,96 X ROCHE UNID 1286,42 X ROCHE UNID 2231,91 X ROCHE UNID 321,62 X ROCHE UNID 482,41 X ACHE COMP 0,58 ACHE COMP 0,58 ACHE CP 0,54 ACHE COMP 0,53 ACHE COMP 0,53 ACHE CP 0,48 NOVARTIS COMP 3,09 NOVARTIS COMP 3,84 NOVARTIS COMP 3,09 SANDOZ COMP 4,32 SANDOZ COMP 4,32 SANDOZ COMP 3,90 NOVARTIS COMP 5,47 SANDOZ COMP 6,14 BAXTER AMP 10,93 BAXTER COMP 5,94 ASTA MEDICA ONCOLOGIA CPR 6,13 BAXTER COMP 8,36 ASTA MEDICA ONCOLOGIA CPR 8,62 BAXTER AMP 10,93

241

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9237 9238 9239 9240 9241 9242 9243 9244 9245 9246 9247 9248 9249 9250 9251 9252 9253 9254 9255 9256 9257 9258 9259 9260 9261 9262 9263 9264 9265 9266 9267 9268 9269 9270 9271 9272 9273 9274

CODIGO BENEFICIO 95542019 MITOCIN 95542027 MITOSTATE 95975497 MM EXPECTORANTE 95975519 MM XAROPE 95290915 MOCLOBEMIDA - GENERICO 95042997 MODULO DE CARBOIDRATOS 95043004 MODULO DE FIBRAS 95043012 MODULO DE GLUTAMINA 95590404 MODULO DE PROTEINAS 95007890 MODULO DE TRIGLICERIDEOS DE CADEIA MEDIA 95982930 MODULO ALIMENTAR MODULO ESPESSANTE INF P/ LACTENTES C/PREDOMINANCIA PROT 95089802 SORO DE INF LEITE-1 SEM DE VIDA MODULO P/ LACTENTES C/PREDOMINANCIA PROT 95089810 SORO DE LEITE-2 SEM DE VIDA MODULO INF P/LACTENTES PREMATUROS 95089829 C/PREDOMINANCIA PROT DO SORO DE LEITE 95100520 MODURETIC 95100512 MODURETIC 95975527 MOMENT 95039473 MONOCEF 95039449 MONOCEF 95039457 MONOCEF 95039465 MONOCEF 95140697 MONOCORDIL 95140719 MONOCORDIL 95140751 MONOCORDIL 95140727 MONOCORDIL 95140735 MONOCORDIL 95140743 MONOCORDIL 95057927 MONOCORDIL RETARD 95021477 MONONITRATO DE ISOSSORBIDA - GENER 95001727 MONONITRATO DE ISOSSORBIDA - GENER 95001735 MONONITRATO DE ISOSSORBIDA - GENER 95021485 MONONITRATO DE ISOSSORBIDA - GENER 95001743 MONONITRATO DE ISOSSORBIDA - GENER 95001751 MONONITRATO DE ISOSSORBIDA - GENER 95134123 MONOPLUS 95134131 MONOPLUS 95134158 MONOPRIL 95134140 MONOPRIL

APRESENTAÇÃO Inj, 5 mg, fr, amp, Inj, 20 mg/10 ml cx, 1 fr, Fr,120 ml Fr, 120 ml 300 mg 30 cprs,

Laboratorio B-MS QUIRAL FARMASA FARMASA APOTEX

LATA C/ 225 G

25 mg, 30 cprs, 50 mg, 3 bl, x 10 cprs, Locao topica fr, 60 ml (roll-on) 750 mg, IV/IM 50 FA+ dil, 750 mg, IV/IM FA 750mg,IV/IM50FA 750mg,IV/IMFA+dil, 20 mg, 20 cprs, 40 mg, 20 cprs, 40 mg, 30 cprs, Inj, 50 amps, 1 ml Retard 50 mg, cx, 24 caps, Sublingualcx, 30 cprs, 50 mg, cx, 30 caps, 20 mg, 3 x 10 cprs, 20 mg, bl, 20 cprs, 20 mg, bl, 30 cprs, 40 mg, 2 x 10 cprs, 40 mg, bl, 20 cprs, 40 mg, bl, 30 cprs, 10 mg/12,5 mg,fr, plast, 16 cprs, 10 mg/12,5 mg,fr, plast, 30 cprs, 10 mg 3 bl, al,/al, x 10 cprs, 10 mg, 2 bl, al,/al, x 8 cprs

MERCK SHARP & DOHME MERCK SHARP & DOHME APSEN BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI ZYDUS BIOSINTETICA BIOSINTETICA ZYDUS BIOSINTETICA BIOSINTETICA B-MS B-MS B-MS B-MS

UNIDADE Pco Unt Base A AP 80,52 FA 932,39 ML 0,09 ML 0,07 CPR 1,79 G 0,05 G 0,07 G 0,99 G 0,35 ML 0,21 G 0,44 GRAMA 0,04 GRAMA 0,04 GRAMA 0,14 CPR 0,27 CPR 0,45 ML 0,48 FA 21,99 FA 21,98 FA 21,99 FA 21,98 CPR 0,37 CPR 0,68 CPR 0,56 AP 1,55 CPR 1,15 CPR 0,32 CAPS 1,30 COMP 0,16 COMP 0,23 COMP 0,19 COMP 0,44 COMP 0,44 COMP 0,37 CPR 2,40 CPR 2,15 CPR 2,52 CPR 2,65

242

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9275 9276 9277 9278 9279 9280 9281 9282 9283 9284 9285 9286 9287 9288 9289 9290 9291 9292 9293 9294 9295 9296 9297 9298 9299 9300 9301 9302 9303 9304 9305 9306 9307 9308 9309 9310

CODIGO BENEFICIO 95134166 MONOPRIL 95057935 MONOTREAN 95057943 MONOTREAN B6 95420967 MONOZOL 95420975 MONOZOL 95112324 MONTELUCASTE SODICO - GENERICO 95112332 MONTELUCASTE SODICO - GENERICO 95137980 MORATUS 95900640 MORFENIL 95900659 MORFENIL 95112340 MOTILIUM 95020900 MOTILIUM 95020918 MOTILIUM 95081518 MOTILIUM 95020888 MOTILIUM 95057951 MOTILIUM 95663002 MOTRIN 95663010 MOVACOX 95663029 MOVACOX 95663053 MOVATEC 95663045 MOVATEC 95663037 MOVATEC 95663061 MOVOXICAM 95663070 MOVOXICAM 95379703 MOXIPLUS 95988653 MTX-BIG 95251200 MUCIBRON 95251219 MUCIBRON 95001760 MUCOCETIL 95001778 MUCOCETIL 95001786 MUCOCETIL 95001794 MUCOCETIL 95001808 MUCOCETIL 95001816 MUCOCETIL 95251227 MUCOCIS 95251235 MUCOCIS

9311 95251243 MUCOCIS 9312 95251251 MUCOCISTEIN

APRESENTAÇÃO 20 mg 3 bl, al,/al, x 10 cprs, 30 drags, Cx, 30 drags, 400 mg 1 cpr, Susp, 15 ml 10 mg, bl, 10 cprs, rev, 10 mg, bl, 30 cprs, rev, 20 mg. bl. 15 cprs. rev. 10 mg/ml cx, 5 amps, vd, x 1 ml 10 mg/ml cx, 50 amps, vd, x 1 ml 1 mg/ml susp, fr, vd, 60 ml 10 mg bl, 30 cprs, 10 mg bl, 60 cprs, 10 mg, bl, 20 cprs, Susp, fr, 100 ml, Susp, fr, 200 ml 600 mg, fr, 30 drags, 15 mg, cx, 10 cprs, 7,5 mg, cx, 10 cprs, 15 mg, 10 cprs, 15 mg, sol, inj, 5 amps, x 1,5 ml 7,5 mg, cx, 10 cprs, 15 mg, fr, 10 cprs, 7,5 mg, fr, 10 cprs, 500 mg, 3 bl, x 7 caps, gel, dura 25 mg/ml sol, inj, cx, fr, amp, vd, inc, x 20 ml Ad, xpe, fr, 100 ml, Ped, xpe, fr, 100 ml, 100 mg, gran, cx, 16 env, x 5 g 200 mg, gran, cx, 16 env, x 5 g 600 mg, gran, cx, 16 env, x 5 g Sol, nasal gts, fr, 12 ml Xpe, fr, 100 ml Xpe, fr, 150 ml Gts, fr, 20 ml Xpe, ad, fr, 100 ml

Laboratorio B-MS DAIICHI SANKYO DAIICHI SANKYO LEGRAND LEGRAND BIOSINTETICA BIOSINTETICA MEDLEY BIOCHIMICO BIOCHIMICO JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG PFIZER HEXAL HEXAL BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BUNKER BUNKER MEDLEY OPEM MEDLEY MEDLEY UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA EMS EMS

Xpe, inf, fr, 100 ml Xpe ad, vd, 100 ml

EMS NEO QUIMICA

UNIDADE Pco Unt Base A CPR 4,94 DRAG 0,71 DRAG 0,91 CPR 6,44 ML 0,51 COMP 1,63 COMP 1,63 COMP 1,15 AMP 2,18 AMP 2,18 ML 0,35 CPR 0,49 CPR 0,46 COMP 0,48 ML 0,35 ML 0,22 CPR 0,92 CPR 2,22 CPR 1,19 CPR 3,94 AP 7,30 CPR 1,89 CPR 2,92 CPR 1,58 CPR 0,96 F,A, 3,30 ML 0,14 ML 0,09 ENV 1,09 ENV 1,22 ENV 2,73 GOTA 0,02 ML 0,16 ML 0,13 GOTAS 0,01 ML 0,12 ML ML

0,08 0,20

243

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9313 9314 9315 9316 9317 9318 9319 9320 9321 9322 9323 9324 9325 9326 9327 9328 9329 9330 9332 9333 9334 9335 9336 9337 9338 9339 9340 9341 9342 9343 9344 9345 9346 9347 9348 9349 9350 9351

CODIGO BENEFICIO 95251260 MUCOCISTEIN 95251278 MUCOCLEAN 95112359 MUCOCLEAN 95251286 MUCOCLEAN 95112367 MUCOCLEAN 95029958 MUCOFAN 95029966 MUCOFAN 95029974 MUCOFAN 95251332 MUCOFLUX 95251324 MUCOFLUX 95029982 MUCOLIN 95251391 MUCOLIN 95251421 MUCOLIN 95251413 MUCOLIN 95251480 MUCOLITIC 95251464 MUCOLITIC 95251456 MUCOLITIC 95251448 MUCOLITIC 95021523 MUCOLIX 95021515 MUCOLIX 95021507 MUCOLIX 95001824 MUCOPLUS 95001832 MUCOPLUS 95251502 MUCOSOLVAN 95251499 MUCOSOLVAN 95251510 MUCOSOLVAN 95112375 MUCOSOLVAN 24 HRS 95251529 MUCOTOSS 95251537 MUCOTOSS 95251553 MUCOXOLAM 95251561 MUCOXOLAM 95112383 MUD 95112391 MUD ORAL 95975543 MULTIELMIN 95975551 MULTIELMIN 95420991 MULTIELMIN 95420983 MULTIELMIN 95379738 MULTIGRAN

APRESENTAÇÃO Xpe inf, vd, 100 ml 15 mg/ml x 120 ml, xpe inf, 3 mg/ml x 120 ml, xpe, inf, 30 mg/ml x 120 ml, xpead, 6 mg/ml x 120 ml, xpe, ad, 20 mg/ml xpe, ct, fr, plas, trans, x 100 ml ped, 50 mg/ml sol, or, ct, fr, vd, amb, gts, x 20 ml 50 mg/ml xpe, ct, fr, plas, inc, x 100 ml ad, 20 mg/ml xpe cart, fr, plast, 100 ml, 50 mg/ml xpe cart, fr, plast, 100 ml, 30 mg, bl, x 20 cprs, Ad, 6 mg/ml xpe fr, 120 ml+ colher medida Ped, 3 mg/ml xpe fr, 120 ml+colher medida Sol, oral 60 ml, 250 mg, cart, 15 envs, x 4 g Ped, gts, 20 ml, Xpe ad, 100 ml, Xpe inf, 100 ml, 100 mg/ml xpe, ped, 100 ml 250 mg/5 ml xpe, ad, 100 ml 50 mg/ml sol, oral gts, 20 ml Xpe, ad, vd, 100 ml Xpe, inf, vd, 100 ml Gts, 1 x 50 ml, Xpe, ad, 1 x 120 ml, Xpe, ped, 1 x 120 ml, 75 mg, 10 caps, gel, dura microg, lib, control, Ad, fr, 100 ml Inf, fr, 100 ml Xpe, ad, 120 ml Xpe, ped, 120 ml Creme derm, bisn, 10 g 1 mg/g pom, bucal bisn, 10 g Cx, 50 envs, c/6 cprs, Cx, 50 frs, c/30 ml Env, 06 cprs, Fr, 30 ml, 500 mg, 300 caps, (bl c/12)

Laboratorio NEO QUIMICA ROYTON ROYTON ROYTON ROYTON UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA MERCK MERCK ABBOTT ABBOTT ABBOTT ABBOTT NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA CIFARMA CIFARMA CIFARMA MEDQUIMICA MEDQUIMICA BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM SIGMA PHARMA SIGMA PHARMA TEUTO BRAS, TEUTO BRAS, EUROFARMA EUROFARMA OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES PRATI DONADUZZI

UNIDADE Pco Unt Base A ML 0,13 ML 0,08 ML 0,08 ML 0,12 ML 0,13 GOTA 0,01 GOTA 0,02 GOTA 0,01 ML 0,14 ML 0,21 CPR 0,63 ML 0,16 ML 0,10 ML 0,19 ENV 2,48 GOTAS 0,04 ML 0,30 ML 0,20 ML 0,09 ML 0,13 GOTA 0,02 ML 0,11 ML 0,08 GOTAS 0,01 ML 0,17 ML 0,12 CAPS 1,98 ML 0,16 ML 0,13 ML 0,12 ML 0,08 GRAMA 0,80 GRAMA 0,99 CPR 23,31 ML 0,13 CPR 0,56 GOTAS 0,01 CPR 0,10

244

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9352 9353 9354 9355 9356 9357 9358 9359 9360 9361 9362 9363 9364 9365 9366 9367 9368 9369 9370 9371 9372 9373 9374 9375 9376 9377 9378 9379 9380 9381 9382 9383 9384 9385 9386 9387 9388 9389

CODIGO BENEFICIO 95975560 MUNOLAN 95542051 MUPHORAN 95841326 MUPIROCINA - GENERICO 95029990 MUPIROCINA - GENERICO 95039481 MUPIROCINA - GENERICO 95975578 MURAZYME 95895710 MURAZYME 95271244 MURICALM 95271252 MURICALM 95975586 MUSCORIL 95001840 MUSCORIL 95975594 MUSCORIL 95042237 MUSCULARE 95975608 MUVINLAX 95975616 MUVINOR 95007946 MVI 12 OPOPLEX A + BH LIOFILIZADO 95125043 MYCAMINE (Restrito Hosp,) 95125051 MYCAMINE (Restrito Hosp,) 95710027 MYDRIACYL 95057960 MYLANTA 95112405 MYLANTA 95057978 MYLANTA 95542060 MYLERAN 95975624 MYLICON 95066942 MYOGRAF 95125060 MYOZYME (Restrito Hosp,) 95057994 MYTEDOM 95066950 MYTEDOM 95057986 MYTEDOM 95048642 MYTEDON 95048650 MYTEDON 95048634 MYTEDON 95740244 NAABAK 95740252 NAAXIA 95112413 NAC 95021590 NAC 95032908 NAC 95021558 NAC

APRESENTAÇÃO Gts, fr, 10 ml FA 20 mg/g creme bisn, 15 g 20 mg/g pom, derm, bisn, x 15 g 20 mg/g pom, derm, ct, bg, al, x 15 g Pom, bisn, 20 g Pom, bisn, 40 g Fr, 10 ml, Vd, 120 ml, 4 mg 2 bl, x 6 cprs, 4mg,inj,3amps,x2ml Creme 2,50 mg, bisn, 30 g 5 mg, bl, 30 cprs, rev, 20 saches 14 g 625 mg, 30 cprs, MVI 12 OPOPLEX A+ BH LIOFILIZADO 100 mg, po liof, sol, inj, FA vd, inc, 50 mg, po liof, sol, inj, FA vd, inc, 1% fr, 5 ml Liq, 240 ml, Menta liq, 240 ml Morango liq, 240 ml, 2 mg, x 25 cprs, Cart, 1 fr, plast, 15 ml 300 mcg sol, inj, ct 5 FA vd, inc, x 1 ml 50 mg, po liof, inj, FA vd, inc, 10 mg, 2 bl, x 10 cprs, 10mg/ml10amps,x1ml 5 mg, 2 bl, x 10 cprs, 10 mg, 2 bl, x 10 cprs, 10mg/ml10amps,x1ml 5 mg, 2 bl, x 10 cprs, 5 ml, 5 ml 20 mg/ml xpe, fr, 100 ml 20 mg/ml xpe, inf, fr, 150 ml 200 mg, gran, 10 envs, x 5 g 200 mg, gran, 16 envs, x 5 g

Laboratorio FARMASA SERVIER CRISTALIA MEDLEY PRATI DONADUZZI EVOLABIS - SIF EVOLABIS - SIF NOVARTIS NOVARTIS SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA EUROFARMA LIBBS LIBBS ASTELLAS ASTELLAS ALCON JOHNSON & JOHNSON JOHNSON & JOHNSON JOHNSON & JOHNSON GLAXOSMITHKLINE JANSSEN - CILAG BERGAMO GENZYME DO BRASIL CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA ALLERGAN ALLERGAN SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA

UNIDADE Pco Unt Base A GOTAS 0,03 FA 2822,07 X G 1,01 G 1,07 G 1,23 G 0,24 G 0,34 ML 0,03 ML 0,06 CPR 1,26 AMP 2,04 G 0,88 COMP 0,59 ENV 1,13 CPR 0,75 FA 5,46 FA 206,02 FA 102,57 GOTAS 0,10 ML 0,06 ML 0,07 ML 0,07 CPR 0,53 ML 0,88 FA 321,96 X FA 1547,86 COMP 0,97 AMP 3,00 COMP 0,51 COMP 0,85 AMP 3,00 COMP 0,45 GOTAS 0,37 GOTAS 0,17 ML 0,09 ML 0,08 ENV 0,49 ENV 0,73

245

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9390 9391 9392 9393 9394 9395 9396 9397 9398 9399 9400 9401 9402 9403 9404 9405 9406 9407 9408 9409 9410 9411 9412 9413 9414 9415 9416 9417 9418 9419 9420 9421 9422 9423 9424 9425 9426 9427

CODIGO BENEFICIO 95021582 NAC 95021566 NAC 95021604 NAC 95032916 NAC 95021574 NAC 95072870 NADIPIM 95612238 NAETENE 95333282 NALDECON 95333290 NALDECON 95895728 NALDECON 95975659 NALDECON DIA 95975667 NALDECON DIA 95975675 NALURIL 95007911 NANQUIM 95046763 NANTRON 95046755 NANTRON 95046780 NANTRON 95046771 NANTRON 95125078 NANTRON (Restrito Hosp,) 95125086 NANTRON (Restrito Hosp,) 95134190 NAOX 95134255 NAPRIX 95134220 NAPRIX 95134212 NAPRIX 95134263 NAPRIX 95134271 NAPRIX 95975683 NAPRIX A 95975691 NAPRIX A 95975705 NAPRIX A 95058001 NAPRIX D 95058010 NAPRIX D 95072896 NAPROFLEN 95112421 NAPROFLEN 95072888 NAPROFLEN 95112430 NAPROFLEN 95663088 NAPRONAX 95058036 NAPROSYN 95663100 NAPROSYN

APRESENTAÇÃO 20mg/mlxpe,fr,100 ml 40 mg/ml xpe, ad, fr, 120 ml 40 mg/ml xpe, ad, fr, 150 ml 600 mg, gran, 10 envs, x 5 g 600 mg, gran, 16 envs, x 5 g 30 mg, cx, 30 cprs, Vd, 30 caps, 3 bl, x 8 cprs, Bebe gts, fr, x 15 ml Sol, oral fr, 60 ml Cart, 25 bl, x 4 cprs, Cart, 3 bl, x 8 cprs, 500 mg, cx, 56 cprs, AMP 1 ML A 1% 4 mg/ml sol, inj, 25 amps, vd, x 2 ml 4 mg/ml sol, inj, 5 amps, vd, x 2 ml 8 mg/ml sol, inj, 25 amps, vd, x 4 ml 8 mg/ml sol, inj, 5 amps, vd, x 4 ml 4 mg/ml sol, inj, 25 amps, vd, x 2 ml 8 mg/ml sol, inj, 25 amps, vd, x 4 ml 5 UI cx, 50 amps, 1 ml 10 mg, x 30 cprs, 2,5 mg, x 20 cprs, 5 mg, x 30 cprs, D-5/12,5 mg, 30 cprs, D-5/25 mg, 30 cprs, 10/5 mg, cap, gel x 30 2,5/5 mg x 30 caps, 5/5 mg x 30 caps, 5/12,5 mg, 30 cprs, 5/25 mg, 30 cprs, 250 mg, 15 cprs, 250 mg, bl, 15 cprs, 500 mg, 20 cprs, 500 mg, bl, 20 cprs, 550 mg cx, 1 bl, x 10 cprs, 250 mg, cx, 15 cprs, 250 mg, cx, 15 cprs,

Laboratorio SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA MILIAN NOVARTIS B-MS B-MS B-MS B-MS B-MS CAZI DR, REDDY'S DR, REDDY'S DR, REDDY'S DR, REDDY'S DR, REDDY'S DR, REDDY'S EUROFARMA LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS LIBBS HEXAL SANDOZ HEXAL SANDOZ NEO QUIMICA BAYER ROCHE

UNIDADE Pco Unt Base A ML 0,08 ML 0,11 ML 0,12 ENV 1,13 ENV 1,66 COMP 0,96 CPR 0,38 CPR 0,94 GOTAS 0,02 ML 0,15 CPR 1,03 CPR 0,94 CPR 1,26 AMP 8,85 AMP 25,71 AMP 23,68 AMP 50,91 AMP 46,89 AMP 24,08 AMP 47,68 AP 0,74 CPR 1,13 CPR 1,02 CPR 1,13 CPR 1,60 CPR 1,60 CPR 1,12 CPR 1,12 CPR 1,12 COMP 1,07 COMP 1,07 COMP 0,44 COMP 0,55 COMP 0,81 COMP 1,01 CPR 1,51 COMP 0,58 CPR 0,54

246

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9428 9429 9430 9431 9432 9433 9434 9435 9436 9437 9438 9439 9440 9441 9442 9443 9444 9445 9446 9447 9448 9449 9450 9451 9452 9453 9454 9455 9456 9457 9458 9459 9460 9461 9462 9463 9464 9465

CODIGO BENEFICIO 95058028 NAPROSYN 95663096 NAPROSYN 95975713 NAPROX 95663118 NAPROX 95001972 NAPROXENO - GENERICO 95058052 NAPROXENO - GENERICO 95975721 NAPROXENO - GENERICO 95975730 NAPROXENO - GENERICO 95001980 NAPROXENO - GENERICO 95058044 NAPROXENO - GENERICO 95975748 NAPROXENO - GENERICO 95895744 NAPROXENO - GENERICO 95001999 NAPROXENO - GENERICO 95039490 NAPROXENO SODICO - GENERICO 95895752 NAPROXENO SODICO - GENERICO 95333304 NARAMIG 95112448 NARATRIN 95300635 NARCAN 95072900 NARCARICINA 95260439 NARIDRIN 95260412 NARIDRIN 95260420 NARIDRIN 95895760 NARISEC 95895779 NARISORO 95982574 NAROPIN 95982566 NAROPIN 95982582 NAROPIN 95983384 NAROPIN 95210423 NASACORT 95039503 NASALFREE 95112456 NASALIV 95975772 NASALIV 95260447 NASIVIN 95260455 NASIVIN 95975780 NASOFELIN 95975799 NASOFELIN 95975802 NASOGRIP 95975810 NASO-JOSP

APRESENTAÇÃO 500 mg, cx, 20 cprs, 500 mg, cx, 20 cprs, 250 mg, cx, 20 cprs, 500 mg, cx, 20 cprs, 250 mg, bl, 15 cprs, 250 mg, bl, 15 cprs, 250 mg, cx, 1 bl, x 15 cprs, 250 mg, cx, 15 cprs, 500 mg, bl, 20 cprs, 500 mg, bl, 20 cprs, 500 mg, cx, 2 bl, x 10 cprs, 500mg,2bl,x10 cprs, 550 mg, bl, al, x 10 cprs, 550 mg, cx, 10 cprs, 550 mg, cx, 20 cprs, 2,5 mg, cx, 4 cprs, 2,5 mg, bl, 4 cprs, rev, Cx, 10 amps, 1 ml, Cx, 30 cprs, 12 H gts, 1 x 30 ml Ad, 1 x 15 ml, Inf, 1 x 15 ml, Gel nasal 150 mg/g - bisn, 30 g Gts, fr, 30 ml 10 MG - CX C/ 5 AMP x 10 ML 10 MG - CX C/ 5 AMP x 20 ML 2 MG - CX C/ 5 AMP x 20 ML 7,5 MG - CX C/ 5 AMP x 20 ML 1 fr, x 16,5 ml Ad, e ped, fr, 30 ml 800 mg, /20 mg, / 4 mg, / 50 bl, x 2 Sol, oral fr, 60 ml Gts, vd, 10 ml, Spray, fr, 10 ml, Sol, nasal 0,5 mg/ml inf, fr, 10 ml Sol, nasal 1 mg/ml ad, fr, 10 ml Cx, 12 drags, 20 ml

Laboratorio BAYER ROCHE TEUTO BRAS, TEUTO BRAS, BIOSINTETICA SANDOZ APOTEX TEUTO BRAS, BIOSINTETICA SANDOZ APOTEX TEUTO BRAS, APOTEX NEO QUIMICA NEO QUIMICA GLAXOSMITHKLINE EMS CRISTALIA EVOLABIS - SIF EMS EMS EMS APSEN LEGRAND ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA SANOFI-AVENTIS MEDQUIMICA UNIAO QUIMICA UNIAO QUIMICA MERCK MERCK NEO QUIMICA NEO QUIMICA CAZI JOSPER

UNIDADE Pco Unt Base A COMP 0,99 CPR 0,78 CPR 0,49 CPR 1,34 COMP 0,43 COMP 0,41 CPR 0,26 CPR 0,44 COMP 0,74 COMP 0,70 CPR 0,45 COMP 0,75 COMP 0,72 CP 0,98 COMP 1,16 CPR 2,90 COMP 2,90 AP 7,36 COMP 0,75 GOTAS 0,03 GOTAS 0,03 GOTAS 0,03 GRAMA 0,44 GOTAS 0,01 AMP 20,28 AMP 40,58 AMP 26,21 AMP 30,00 DOSE 0,38 GOTA 0,01 COMP 1,68 ML 0,13 GOTAS 0,03 DOSE 0,03 GOTAS 0,03 GOTAS 0,04 CPR 0,89 ML 0,25

247

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9466 9467 9468 9469 9470 9471 9472 9473 9474 9475 9476 9477 9478 9479 9480 9481 9482 9483 9484 9485 9486 9487 9488 9489 9490 9491 9492 9493 9494 9495 9496 9497 9498 9499 9500 9501 9502 9503

CODIGO BENEFICIO 95021647 NASOLIN SORO 95072918 NASOMIL 95112464 NASOMIL 95058079 NASONEX 95210440 NASONEX 95058060 NASONEX 95210431 NASONEX 95975837 NATIFA PRO 95002022 NATIGESTA 95134298 NATRILIX 95112472 NATRILIX 95134280 NATRILIX 95134310 NATRILIX 95134301 NATRILIX 95021655 NATURETTI 95058087 NATURETTI 95058095 NATURETTI 95021663 NATURETTI 95021671 NATURETTI 95002030 NATUZILIUM 95066993 NAUMETRON 95125094 NAUSEDRON 95321012 NAUSEDRON 95125108 NAUSEDRON 95321004 NAUSEDRON 95321020 NAUSEDRON 95125116 NAUSEDRON (Restrito Hosp,) 95125124 NAUSEDRON (Restrito Hosp,) 95985840 NAUSICALM 95985859 NAUSICALM 95021698 NAUSILON B6 95021680 NAUSILON B6 95125132 NAVELBINE (Restrito Hosp,) 95125140 NAVELBINE (Restrito Hosp,) 95094504 NAVELBINE ORAL 95094490 NAVELBINE ORAL 95321080 NAVOBAN 95084177 NAVOTRAX

APRESENTAÇÃO Sol nasal gts, de 30 ml Fr, 20 ml Fr, spray 20 ml Spray nasal 60 atom, Spray nasal 60 atom, Spray nasal fr, 120 atom, Spray nasal fr, 120 atom, 1 mg,+ 0,5 mg x 28 cprs, Fr, 30 cprs, 15 drags, 2,5 mg, 30 drags, 30 drags, SR 15 cprs, rev, SR 30 cprs, rev, Ct, 2 bl, x 8 caps, gel, Ct, 30 bl, x 3 caps, gel, dura (emb, mult,) Fracao de venda (3 caps,) Geleia pt, 130 g Geleia pt, 260 g 150 mg cx, 30 caps, gel, mole 5 mg/ml sol, inj, IM/IV cx, 50 amps, vd, x 10 ml (hosp,) 4 mg, 1 amp, x 2 ml 4 mg/ml cx, 1 amp, 2 ml, 8 mg, 1 amp, x 4 ml 8 mg, cx, 1 fr, 10 cprs, 8 mg/ml cx, 1 amp, 4 ml, 2 mg/ml 50 amps, 2 ml 2 mg/ml 50 amps, 4 ml 50 mg, cx, 50 amps, 1 ml, Gts, ped, 20 ml 20 cprs, Gts, 20 ml Sol, inj, 10 mg, cx, FA Sol, inj, 50 mg, cx, FA 20 mg, cx, 1 cap, gelat, 30 mg, cx, 1 cap, gelat, Sol, inj, 1 amp, 5 ml 0,5 mg, cx, 50 bl, x 10 cprs, (hosp,)

Laboratorio CIFARMA MILIAN MULTILAB SCHERING-PLOUGH SCHERING PLOUGH SCHERING-PLOUGH SCHERING PLOUGH LIBBS CHIESI SERVIER SERVIER SERVIER SERVIER SERVIER SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS TEUTO BRAS, NOVAFARMA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA UNIAO QUIMICA UNIAO QUIMICA CIFARMA CIFARMA DARROW DARROW DARROW DARROW NOVARTIS NEO QUIMICA

UNIDADE Pco Unt Base A GOTA 0,01 GOTA 0,01 GOTA 0,01 JATO 0,57 DOSE 0,47 JATO 0,43 DOSE 0,35 CPR 1,49 CPR 0,93 CPR 0,80 COMP 0,79 CPR 0,70 CPR 0,82 CPR 0,82 CAPS 1,61 CAPS 1,77 CAPS 1,77 GRAMA 0,21 GRAMA 0,17 CAPS 1,05 AMP 0,68 AMP 19,52 AP 21,68 AMP 27,62 CPR 11,27 AP 29,69 AMP 19,12 AMP 27,10 AMP 1,23 GOTA 7,07 COMP 0,40 GOTA 0,02 FA 168,50 FA 793,49 CAPS 113,34 CAPS 170,02 AP 87,88 COMP 0,18

248

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9504 9505 9506 9507 9508 9509 9510 9511 9512 9513 9514 9515 9516 9517 9518 9519 9520 9521 9522 9523 9524 9525 9526 9527 9528 9529 9530 9531 9532 9533 9534 9535 9536 9537 9538 9539 9540 9541

CODIGO BENEFICIO 95058109 NAVOTRAX 95975845 NAVOTRAX 95125159 NAVOTRAX (Restrito Hosp,) 95125167 NAVOTRAX (Restrito Hosp,) 95410350 NAXOGIN 95410376 NAXOGIN 95410368 NAXOGIN 95058125 NAXOTEC 95058117 NAXOTEC 95260471 NAZOBIO 95841350 NEBACETIN 95900667 NEBIDO 95076166 NEBILET 95421025 NECAMIN 95421017 NECAMIN 95841393 NEMICINA 95134328 NEMODINE 95112480 NEMODINE 95134336 NEMODINE 95112499 NEMODINE 95112502 NEO AMITRIPTILIN 95058133 NEO AMITRIPTILIN 95058141 NEO AMITRIPTILIN 95290923 NEO AMITRIPTILIN (C1) 95125175 NEO AMITRIPTILIN (Restrito Hosp,) 95379746 NEO AMPICILIN 95379754 NEO AMPICILIN 95421033 NEO BENDAZOL 95421041 NEO BENDAZOL 95421050 NEO BENDAZOL 95612335 NEO CEBETIL 95379770 NEO CEFADRIL 95379789 NEO CEFADRIL 95379827 NEO DOXICILIN 95134352 NEO FEDIPINA 95134360 NEO FEDIPINA 95112510 NEO FENICOL 95379894 NEO FENICOL

APRESENTAÇÃO 2 mg, bl, 500 cprs, (hosp,) 2 mg, cx, 20 cprs 0,5 mg, cx, 50 bl, x 10 cprs, (hosp,) 2 mg, bl, 500 cprs, (hosp,) 500 mg, cx, blist, 1 x 8 cprs, Composto Vag, cx, 10 cprs, Xpe, est, fr, 30 g, gran, 250 mg, 24 cprs, 500 mg, 24 cprs, Gts, fr, 15 ml, Pom, bisn, 15 g, Ampola 1 x 4 ml 5 mg bl 28 cprs Cx, 6 cprs, Susp, fr, 30 ml, Pom, tb, 20 g, 10 mg, cx, 20 cprs, 10 mg, cx, 30 cprs, 5 mg, cx, 20 cprs, 5 mg, cx, 30 cprs, 25 mg cx, 20 cprs, 25 mg cx,20 cprs, 25 mg, 25 bl, x 20 cprs, (hosp,) 25 mg cx,20 cprs, 25 mg, 25 bl, x 20 cprs, (hosp,) 500 mg cx, 1 bl, x 10 caps, Po p/susp, 250 mg vd, 60 ml 200 mg cx, 1 bl, x 2 cprs, 400 mg cx, 1 bl, x 1 cpr, mast, Susp, 400 mg vd, 10 ml Amp, A+B 10 ml 500 mg cx, 2 envs, x 4 caps, Po p/susp, 250 mg/5 ml vd, 100 ml 100 mg cx, 1 bl, x15 cprs, 10 mg cx, 1 bl, x 30 cprs, 20 mg cx, 1 bl, x 30 cprs, 500 mg cx, 2 bl, x 10 cprs, 500 mg cx, 2 bl, x10 cprs,

Laboratorio NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA PHARMACIA/PFIZER PHARMACIA/PFIZER PHARMACIA/PFIZER BIO MACRO BIO MACRO LUPER NYCOMED PHARMA SCHERING BIOLAB SANUS ACHE ACHE BUNKER DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA UNIAO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA

UNIDADE Pco Unt Base A COMP 0,24 CPR 0,32 COMP 0,18 COMP 0,27 CPR 2,88 CPR 2,39 G 0,36 COMP 0,31 COMP 0,69 GOTAS 0,03 G 0,63 AMP 348,65 CPRS 2,19 CPR 0,62 GOTAS 0,01 G 0,54 CPR 1,31 COMP 1,15 CPR 0,74 COMP 0,66 COMP 0,32 COMP 0,35 COMP 0,23 CPR 0,23 COMP 0,26 CPR 2,29 ML 0,32 CPR 1,35 CPR 4,49 ML 0,50 AP 10,67 CPR 3,74 ML 0,32 CPR 1,28 CPR 0,30 CPR 0,46 COMP 1,05 CPR 0,88

249

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9542 9543 9544 9545 9546 9547 9548 9549 9550 9551 9552 9553 9554 9555 9556 9557 9558 9559 9560 9561 9562 9563 9564 9565 9566 9567 9568 9569 9570 9571 9572 9573 9574 9575 9576 9577 9578 9579

CODIGO BENEFICIO 95083111 NEO FENICOL 95379878 NEO FENICOL 95290931 NEO FLUOXETIN (C1) 95058150 NEO FLUOXETIN (C1) 95125183 NEO FLUOXETIN (Restrito Hosp,) 95379932 NEO GENTAMICIN 95379940 NEO GENTAMICIN 95125191 NEO GENTAMICIN (Restrito Hosp,) 95112529 NEO HIDROCLOR 95100539 NEO HIDROCLOR 95510745 NEO ISOCADEN 95391355 NEO ITRAX 95391363 NEO ITRAX 95072926 NEO ITRAX 95125205 NEO ITRAX (Restrito Hosp,) 95379959 NEO LINCO 95379967 NEO LINCO 95231234 NEO LORATADIN 95112537 NEO MEBEND 95039511 NEO MEBEND 95431357 NEO METFORMIN 95410384 NEO METRODAZOL 95072934 NEO METRODAZOL 95510753 NEO METRODAZOL 95410392 NEO METRODAZOL 95125213 NEO METRODAZOL (Restrito Hosp,) 95072942 NEO MISTATIN 95112545 NEO MISTATIN 95510761 NEO MISTATIN 95391371 NEO MISTATIN 95125221 NEO MISTATIN (Restrito Hosp,) 95379975 NEO MOXICILIN 95002049 NEO MOXICILIN 95002057 NEO MOXICILIN 95379983 NEO MOXICILIN 95058168 NEO MOXILIN 95058176 NEO MOXILIN 95058184 NEO MOXILIN

APRESENTAÇÃO Colirio 4 mg/ml fr, plast, 10 ml Colirio 4 mg/ml fr, plast, 8 ml 20 mg cx, 2 bl, x 14 caps, 20 mg, bl, 490 caps, gel, dura (hosp,) 20 mg, bl, 490 caps, gel, dura (hosp,) Inj, 280 mg cx, 1 amp, 2 ml Inj, 80 mg cx, 1 amp, 2 ml 80 mg, sol, inj, cx, 50 amps, vd, x 2 ml (hosp,) 50 mg cx, 1 bl, x 20 cprs, 50 mg cx, 1 bl, x20 cprs, Creme vag, 10 mg/g bisn, 40 g+ aplic, 100 mg cx, 1 bl, x 4 caps, 100 mg cx, 3 bl, x 5 caps, 100 mg, cx, 100 bl, x 5 caps, gel, dura (hosp,) 100 mg, cx, 100 bl, x 5 caps, gel, dura (hosp,) Inj, 300 mg cx, 1 amp, 1 ml Inj, 600 mg cx, 1 amp, 2 ml 10 mgcx, 1 bl, x 12 cprs, Susp, 100 mg/5 ml fr, vd, 30 ml Susp, 100mg/5mlfr,vd,30 ml 850 mg cx, 3 bl, x 10 cprs, 250 mg cx, 2 bl, x 10 cprs, 40 mg/ml susp, oral cx, 50 fr, vd, x 80 ml (hosp,) Creme vag, 500 mg/4 g bisn, 40 g Susp, 40 mg/ml vd, 80 ml 40 mg/ml susp, oral cx, 50 fr, vd, x 80 ml (hosp,) 25,000 UI/g creme vag, cx, 50 bisn, x 60+ aplic, (hosp,) Creme vag, bisn, 60 g Creme vag, bisn, 60 g Susp, 100,000 UI/ml vd, 50 ml 25,000 UI/g creme vag, cx, 50 bisn, x 60 + aplic, (hosp,) 500 mg cx, 2 bl, x 6 caps, 500 mg, cx, 3 bl, x 5 caps, 500 mg, cx, 3 bl, x 7 caps, Po p/susp, 250 mg/5 ml fr, vd, 150 ml 500 mg, bl, 500 caps, gel, dura (hosp,) Po ext, 250 mg/5 ml 50 fr, vd, x 150 ml (hosp,) Po ext, 250 mg/5 ml 50 fr, vd, x 60 ml (hosp,)

Laboratorio NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA

UNIDADE Pco Unt Base A Gota 0,02 GOTAS 0,02 CPR 1,86 CAPS 1,34 CAPS 1,54 AP 7,02 AP 3,55 AMP 3,08 COMP 0,22 CPR 0,16 G 0,81 CPR 7,17 CPR 6,25 CAPS 5,08 CAPS 5,83 AP 6,71 AMP 8,73 CPR 1,68 ML 0,18 ML 0,13 CPR 0,59 CPR 0,50 ML 0,09 G 0,37 ML 0,13 ML 0,10 G 0,22 GRAMA 0,26 G 0,18 ML 0,38 GRAMA 0,24 CPR 1,85 CAPS 1,39 CAPS 1,16 ML 0,21 CAPS 0,83 ML 0,10 ML 0,10

250

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9580 9581 9582 9583 9584 9585 9586 9587 9588 9589 9590 9591 9592 9593 9594 9595 9596 9597 9598 9599 9600 9601 9602 9603 9604 9605 9606 9607 9608 9609 9610 9611 9612 9613 9614 9615 9616 9617

CODIGO BENEFICIO 95125230 NEO MOXILIN (Restrito Hosp,) 95125248 NEO MOXILIN (Restrito Hosp,) 95125256 NEO MOXILIN (Restrito Hosp,) 95134379 NEO VERPAMIL 95841423 NEOBACINA 95841431 NEOBACIPAN 95067027 NEOBUTAMINA 95067035 NEOCAINA 95920145 NEOCAINA 95920153 NEOCAINA 95067043 NEOCAINA 95067051 NEOCAINA 95067060 NEOCAINA 95920129 NEOCAINA 95125264 NEOCAINA (Restrito Hosp,) 95067086 NEOCAINA + EPINEFRINA 95067094 NEOCAINA + EPINEFRINA 95067078 NEOCAINA + EPINEFRINA 95067108 NEOCAINA + EPINEFRINA 95067116 NEOCAINA + EPINEFRINA 95067124 NEOCAINA + EPINEFRINA 95920161 NEOCAINA 0,25% C/V 95920170 NEOCAINA 0,25% S/V 95002065 NEOCAINA 0,5% C/V 95920188 NEOCAINA 0,5% C/V 95920196 NEOCAINA 0,5% S/V 95920200 NEOCAINA 0,5% S/V 95920218 NEOCAINA 0,75% C/V 95920226 NEOCAINA 0,75% S/V 95067132 NEOCAINA ISOBARICA 95067140 NEOCAINA PESADA 95067159 NEOCAINA PESADA 95380027 NEOCEFLEX 95058192 NEOCEFLEX 95058206 NEOCEFLEX 95125272 NEOCEFLEX (Restrito Hosp,) 95067167 NEOCEFTRIONA 95895787 NEOCETRIN

APRESENTAÇÃO 500 mg, bl, 500 caps, gel, dura (hosp,) Po ext, 250 mg/5 ml 50 fr, vd, x 150 ml (hosp,) Po ext, 250 mg/5 ml 50 fr, vd, x 60 ml (hosp,) 80 mg cx, 2 bl, x 10 cprs, Bisn, 10 g, 15 g, pom, 1 bisn, Sol, inj, 250 mg, 10 amps, 20 ml (hosp,) 0,25% S/V 10 etj, 20 ml (SP) 0,5% C/V 10 etj, 30 ml (OF) 0,5% C/V 6 fr, 20 ml, 0,5% S/V 10 etj, 20 ml (SP) 0,5% S/V 6 fr, 20 ml 0,75% S/V 10 etj, 20 ml (SP) Pesada 0,5% cx, 40 est, 4 ml 0,5% S/V 10 fr, 20 ml 0,25% C/V 10 etj, 20 ml (SP) 0,5% C/V 10 etj, 20 ml (OF) 0,5% C/V 10 etj, 30 ml (OF) 0,5% C/V 25 carps, 1,8 ml 0,5% C/V6frs,20ml 0,75% C/V 10 etj, 20 ml (OF) 10 etj, 20 ml, (OF) 10 etj, 20 ml, (SP) 0,5% C/V 6 fr, 20 ml, 10 etj, 20 ml, (OF) 10 etj, 20 ml, (SP) 6 fr, - 20 ml, 10 etj, 20 ml, (OF) 10 etj, 20 ml, (SP) 0,5% isob, 40 etj, 4 ml (SP) 0,5% pesada 40 etj, 4 ml (SP) 5 mg/ml+ 80 mg/ml sol, inj, cx, 20 amps, vd, inc, x 4 ml 500 mg cx, 2 envs, x 4 cprs, Po p/susp, 125 mg vd, 60 ml Po p/susp, 250 mg vd, 60 ml 50 mg/ml po susp, or, cx, 50 frs, vd, x 60 ml (hosp,) 1 g po inj, cx, 50 FA vd,+ amp, dil, x 10 ml (hosp,) Pom, derm, bisn, 30 g

Laboratorio NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA HEXAL ROYTON NEO QUIMICA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA BUNKER

UNIDADE Pco Unt Base A CAPS 0,95 ML 0,11 ML 0,11 CPR 0,56 G 0,57 G 0,66 AMP 17,18 ML 0,75 ML 0,84 ML 0,90 ML 0,79 ML 0,87 ML 1,09 AP 7,34 ML 0,46 ML 0,82 ML 0,97 ML 0,84 AMP 1,50 ML 0,90 ML 1,13 ML 0,82 ML 0,75 ML 0,90 ML 0,97 ML 0,79 ML 0,87 ML 1,13 ML 1,09 AMP 5,97 AMP 7,34 AMP 7,34 CPR 2,57 ML 0,27 ML 0,59 ML 0,50 FA 19,00 G 0,51

251

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9618 9619 9620 9621 9622 9623 9624 9625 9626 9627 9628 9629 9630 9631 9632 9633 9634 9635 9636 9637 9638 9639 9640 9641 9642 9643

CODIGO BENEFICIO 95975853 NEOCINA 95841466 NEOCINA 95790730 NEOCINOLON 95067175 NEOCITEC 95067183 NEOCITEC 95112553 NEOCOFLAN 95112561 NEOCOFLAN 95020934 NEOCOPAN 95895795 NEOCOPAN 95020942 NEOCOPAN 95125280 NEOCOPAN 95072950 NEODAZOL 95380051 NEODAZOL 95380035 NEODAZOL 95380060 NEODAZOL 95380078 NEODAZOL 95072969 NEODAZOL 95380043 NEODAZOL 95125299 NEODAZOL (Restrito Hosp,) 95125302 NEODAZOL (Restrito Hosp,) 95039520 NEO-DECAPEPTYL 95542132 NEO-DECAPEPTYL 95072977 NEODEX 95112570 NEODEX 95125310 NEODEX (Restrito Hosp,) 95020950 NEODIMETICON

APRESENTAÇÃO Bisn, 20 g Pom, bisn, 20 g, Pom, tb, 20 g, 10 mg/ml sol, inj, FA vd, amb, x 1 ml 10 mg/ml sol, inj, FA vd, amb, x 5 ml Gel bisn, 30 g Gel bisn, 60 g Composto inj, 50 amps, 5 ml, Cx, 2 bl, x10 cprs, rev, Gts fr, 20 ml, Inj, cx, 50 amps, 5 ml 1 g cx, 50 bl, x 10 cprs, (hosp,) 1000 mg cx, 1 bl, x 2 cprs, 450 mg po p/susp, vd, 15 ml 500 mg cx, 1 bl, x 4 cprs, 500 mg cx, 2 bl, x 4 cprs, 500 mg, 50 bl, x 10 cprs, (hosp,) 900 mg po p/susp, vd, 30 ml 1 g cx, 50 bl, x 10 cprs, (hosp,) 500 mg, 50 bl, x 10 cprs, (hosp,) 11,25 mg, liof, inj, FA+ dil, amp, x 2 ml Liof, inj, FA+ dil 0,1 mg/ml elixir ct, 50 fr, vd, x 120 ml (hosp,) Creme bisn, 15 g 0,1 mg/ml elixir ct, 50 fr, vd, x 120 ml (hosp,) 40 mg cx, 2 bl, 10 cprs,

Laboratorio ELOFAR HEXAL TEUTO BRAS, SANDOZ SANDOZ NEO QUIMICA NEO QUIMICA DUCTO DUCTO DUCTO DUCTO NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA ACHE ACHE NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA

9644 95020969 NEODIMETICON

Gts, 75 mg fr, pl, 10 ml,

NEO QUIMICA

GOTAS

0,03

9645 9646 9647 9648 9649 9650 9651 9652 9653 9654 9655

100 mg, cx, 25 bl, x 4 cprs, 100 mg, cx, 40 bl, x 10 cprs, 400 mg cx, 2 bl, x 7 cprs, 5 mg cx, 1 bl, x20 cprs, Inj, 10 mg cx, 100 amps, 2 ml 25 mg cx, 3 bl, x 14 cprs, 50 mg cx, 2 bl, x 14 cprs, Creme bisn, 30 g Creme bisn,30 g Pom, 30 g Pom,30 g

NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA

CP CPR CPR CPR AP CPR CPR GRAMA G GRAMA G

0,23 0,19 1,34 0,24 1,48 0,21 0,32 0,89 0,64 0,86 0,61

95039538 NEODRIN 95975861 NEODRIN 95663169 NEOFLOXIN 95612343 NEO-FOLICO 95321101 NEOLASIL 95450920 NEOLIDONA 95450939 NEOLIDONA 95112596 NEOLON-D 95380086 NEOLON-D 95112600 NEOLON-D 95380094 NEOLON-D

UNIDADE Pco Unt Base A G 0,21 G 0,37 G 0,50 FA 135,36 FA 629,50 GRAMA 0,21 GRAMA 0,21 AP 4,19 COMP 0,37 GOTAS 0,02 AMP 4,49 COMP 4,72 CPR 7,47 ML 0,78 CPR 2,83 CPR 2,58 COMP 2,23 ML 0,58 COMP 5,39 COMP 2,24 FA 1479,37 X FA 495,63 ML 0,05 GRAMA 0,77 ML 0,05 CPR 0,31

252

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9656 9657 9658 9659 9660 9661 9662 9663 9664 9665 9666 9667 9668 9669 9670 9671 9672 9673 9674 9675 9676 9677 9678 9679 9680 9681 9682 9683 9684 9685 9686 9687 9688 9689 9690 9691 9692 9693

CODIGO BENEFICIO 95380108 NEOMEBEND 95380116 NEOMEBEND 95112618 NEOMICIN 95021701 NEOMICON 95380167 NEOMINA 95542140 NEOPLATINE 95042245 NEOPLATINE 95031162 NEOPRAZOL 95031170 NEOPRAZOL 95031189 NEOPRAZOL 95058214 NEOPRAZOL 95134417 NEOPRESS 95112634 NEOPRESS H 95031197 NEOSAC 95031200 NEOSAC 95333312 NEOSALDINA 95067191 NEOSEMID 95100547 NEOSEMID 95321128 NEOSETRON 95321110 NEOSETRON 95260480 NEOSORO 95058222 NEOSORO H 95058230 NEOSORO INFANTIL 95251570 NEOSSOLVAN 95251588 NEOSSOLVAN 95112642 NEOSTATIN 95663177 NEOSULIDA 95072985 NEOSULIDA 95663185 NEOSULIDA 95125329 NEOSULIDA (Restrito Hosp,) 95663193 NEOTAFLAN 95663207 NEOTAFLAN 95663215 NEOTAFLAN 95663223 NEOTAREN 95663231 NEOTAREN 95002146 NEOTAXEL 95002154 NEOTAXEL 95112650 NEOTIAPIM

APRESENTAÇÃO Laboratorio Cx, 1 bl, x 6 cprs, NEO QUIMICA Susp, 20 mg/ml vd, 30 ml NEO QUIMICA Bisn, 20 g DELTA 5 mg/g pom, 10 g CIFARMA Pom, bisn, 15 g BRASTERAPICA Inj, 450 mg/45 ml cx, 1 fr, QUIRAL Inj,150 mg/15ml,cx,1FA QUIRAL 10 mg fr, 14 caps, NEO QUIMICA 20 mg fr, 14 caps, NEO QUIMICA 20 mg fr, 7 caps, NEO QUIMICA 20 mg, fr, 28 caps, NEO QUIMICA 50 mg+ 12,5 mg cx, 3 bl, x 10 cprs, NEO QUIMICA Cx, 3 bl, x 10 cprs, NEO QUIMICA 150 mg cx, 5 envs, al, x 4 cprs, NEO QUIMICA 300 mg cx, 5 envs, al, x 4 cprs, NEO QUIMICA Cx, 2 bl, x 10 drags, NYCOMED PHARMA 10 mg/ml 50 amps, sol, inj, cx, vd, amb, x 2 ml (hosp,) NEO QUIMICA 40 mg cx, 1 bl, x 20 cprs, NEO QUIMICA Inj, 1 mg/1 ml cx, 1 amp, QUIRAL Inj, 3 mg/3 ml cx, 1 amp, QUIRAL Sol,nasal ad, fr, 30 ml NEO QUIMICA 30 mg/ml sol, nasal fr, pet, x 60 ml NEO QUIMICA Fr, vd, 30 ml+ CGT NEO QUIMICA Xpe ad, vd, 120 ml NEO QUIMICA Xpe inf, vd, 120 ml NEO QUIMICA Susp, fr, 50 ml DELTA 100 mg cx, 1 bl, x 12 cprs, NEO QUIMICA 50 mg/ml susp, oral cx, 100fr,plast,opc,got,x15 ml(hosp,) NEO QUIMICA Gts, 50 mg/ml fr, 15 ml NEO QUIMICA 50 mg/ml susp, oral cx, 100 fr, plast, opc, got, x 15 ml (hosp,) NEO QUIMICA 50 mg cx, 1 bl, x 20 cprs, NEO QUIMICA Gts, 15 mg/ml fr, plast, 20 ml NEO QUIMICA Inj, 75 mg cx, 3 amps, 3 ml NEO QUIMICA 50 mg cx, 1 bl, x 20 drags, NEO QUIMICA Inj, 75 mg cx, 5 amps,3 ml NEO QUIMICA 20 mg, sol, inj, FA 0,5 ml+ dil, QUIRAL 80 mg, sol, inj, FA 2,0 ml+ dil, QUIRAL 100 mg, bl, 14 cprs, rev, SANDOZ

UNIDADE Pco Unt Base A CPR 0,48 ML 0,12 GRAMA 0,51 GRAMA 0,97 G 0,39 AP 1207,72 X FA 466,11 CPR 1,06 CPR 1,98 CPR 2,12 CAPS 0,74 CPR 0,93 COMP 1,10 CPR 0,94 CPR 1,71 CPR 0,62 AMP 0,69 CPR 0,25 AP 59,98 AP 120,51 GOTAS 0,01 GOTA 0,01 GOTA 0,01 ML 0,19 ML 0,12 ML 0,31 CPR 1,34 GOTA 0,04 GOTAS 0,05 GOTAS 0,04 CPR 0,53 GOTAS 0,03 AP 1,91 CPR 0,38 AP 2,15 F,A, 729,65 F,A, 2555,11 COMP 5,64

253

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9694 9695 9696 9697 9698 9699 9700 9701 9702 9703 9704 9705 9706 9707 9708 9709 9710 9711 9712 9713 9714 9715 9716 9717 9718 9719 9720 9721 9722 9723 9724 9725 9726 9727 9728 9729 9730 9731

CODIGO BENEFICIO 95112669 NEOTIAPIM 95112677 NEOTIAPIM 95112685 NEOTIAPIM 95112693 NEOTIAPIM 95800042 NEOTIGASON 95800050 NEOTIGASON 95870164 NEOTOP 95251600 NEOTOSS 95251618 NEOTOSS 95895809 NEOTRICIN 95380175 NEOTRIN 95380183 NEOTRIN 95910700 Neotutocaina 95421068 NEOVERMIN 95421076 NEOVERMIN 95421084 NEOVERMIN 95280472 NEOZINE 95280464 NEOZINE 95280499 NEOZINE 95280480 NEOZINE 95895817 NEOZOLAM 95895825 NEOZOLAM 95895833 NEOZOLAM 95075542 NEPHROTECT 95075550 NEPHROTECT 95975900 NEPODEX 95975918 NEPODEX 95134441 NEPRESOL 95032983 NERVEN 95032991 NEULASTIM 95280502 NEULEPTIL 95280510 NEULEPTIL 95280529 NEULEPTIL 95340467 NEURAL 95058249 NEURAL 95340440 NEURAL 95340459 NEURAL 95975926 NEURI B6

APRESENTAÇÃO 100 mg, bl, 30 cprs, rev, 200 mg, bl, 30 cprs, rev, 25 mg, bl, 14 cprs, rev, 25 mg, bl, 30 cprs, rev, 10 mg, 20 bl, x 5 caps, 25 mg, 20 bl, x 5 caps, Pom, bisn, 10 g, Xpe, ad, 3 mg/ml vd, 100 ml Xpe, inf, 1,5 mg/ml vd, 60 ml Pom, bisn, 15 g Cx, 2 bl, x 10cprs, Susp, vd,60 ml 3% 100ml Cx, 1 bl, x 12 cprs, Cx, 1 bl, x 6 cprs, Susp, vd, 30 ml 100 mg, est, 20 cprs, 25 mg, est, 20 cprs, 25 mg, inj, cx, 5 amps, Gts, 4% oral fr, 20 ml, 0,25 mg, cx, 20 cprs, 0,5 mg, cx, 20 cprs, 1 mg, cx, 20 cprs, 10% 250 ml - 1 x 250 ml 10% 500 ml - 1 x 500 ml Bisn, 3,5 g Fr, 5 ml 20 mg, cx, 50 amps, 1 ml 300 mg, 3 bl, x 10 cprs, 10 mg/ml sol, inj, ser, vd, preench, x 0,6 10 mg, est, 20 cprs, Gts, 1% ped, fr, 20 ml, Gts, 4% fr, 20 ml, 100 mg 3 bl, x 10 cps, 100 mg, 20bl,10cps, 25 mg 3 bl, x 10 cps, 50 mg 3 bl, x 10 cps, 40 mg, cx, 20 cprs,

Laboratorio SANDOZ SANDOZ SANDOZ SANDOZ ROCHE ROCHE MEDLEY NEO QUIMICA NEO QUIMICA LEGRAND NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS NEO QUIMICA NEO QUIMICA NEO QUIMICA FRESENIUS KABI FRESENIUS KABI LATINOFARMA LATINOFARMA CRISTALIA UNIAO QUIMICA ROCHE SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS CRISTALIA CRISTALIA CRISTALIA CRISTALIA CAZI

UNIDADE Pco Unt Base A COMP 5,64 COMP 10,14 COMP 1,69 COMP 1,69 CPR 3,68 CPR 8,91 G 0,37 ML 0,10 ML 0,12 G 0,58 CPR 0,47 ML 0,10 ML 0,08 CPR 1,05 CPR 1,45 ML 0,45 CPR 0,69 CPR 0,32 AP 1,28 GOTAS 0,02 CPR 0,21 COMP 0,41 COMP 0,73 ML 0,27 ML 0,24 G 4,64 GOTAS 0,10 AP 3,15 CPR 0,50 AMP 3571,96 X CPR 0,30 GOTAS 0,02 GOTAS 0,03 CPR 1,81 COMP 4,93 CPR 0,66 CPR 1,09 CPR 0,57

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9732 9733 9734 9735 9736 9737 9738 9739 9740 9741 9742 9743 9744 9745 9746 9747 9748 9749 9750 9751 9752 9753 9754 9755 9756 9757 9758 9759 9760 9761 9762 9763 9764 9765 9766 9767 9768 9769

CODIGO BENEFICIO 95271317 NEURILAN 95271287 NEURILAN 95271309 NEURILAN 95271295 NEURILAN 95340483 NEURIUM 95975934 NEURIVIT 95975942 NEURONTIN 95340491 NEURONTIN 95340505 NEURONTIN 95340513 NEURONTIN 95021744 NEUROTRYPT 95021736 NEUROTRYPT 95571361 NEUTROFER 95571345 NEUTROFER 95571353 NEUTROFER 95571388 NEUTROFER 95571370 NEUTROFER 95571337 NEUTROFER 95571329 NEUTROFER 95571310 NEUTROFER 95112707 NEUTROFER FOLICO 95975950 NEUTROFER FOLICO 95975969 NEUTROFER NEONATAL 95011390 NEXIUM 95011382 NEXIUM 95011412 NEXIUM 95011404 NEXIUM 95900675 NEXIUM 95542191 NEXVEP 95975977 NIAR 95975985 NIAR 95134468 NICORD 95134484 NICORD 95134450 NICORD 95021779 NICOSTAN 95021787 NICOSTAN 95134514 NIFEDAX 95002243 NIFEDIPRESS

APRESENTAÇÃO 3 mg, cx, 1 bl, x 20 cprs, 3 mg, cx, 2 bl, x 15 cprs, 6 mg, cx, 1 bl, x 20 cprs, 6 mg, cx, 2 bl, x 15 cprs, 100 mg 30 cprs, 100 mg, cx, 20 cprs, 300 mg, 10 caps, 300 mg, cx, 30 caps, 400 mg, cx, 30 caps, 600 mg 27 caps, 25 mg, 2 bl, x 15 cprs, rev, 75 mg, 2 bl, x 15 cprs, rev, 150 mg, fr, 30 cprs, 300 mg, fr, 30 cprs, Cx, 20 flac, x 5 ml Folico 20 flac, 5 ml, Folico 30 cprs, Fr, 15 cprs, 500 mg, Fr, 30 cprs, 500 mg, Gts, fr,30 ml 30 cprs, Gts,fr, 30 ml 250 mg, gts, fr, 15 ml 20 mg, cx, 14 cprs, 20 mg, cx, 7 cprs, 40 mg, cx, 14 cprs, 40 mg, cx, 7 cprs, Inj,40mg,cx,10amps, 100 mg, po liof, FA vd, inc, 5 mg, 2 bl, x 15 5 mg, 4 bl, x 15 10 mg, 20 cprs, 2,5 mg, 20 cprs, 5 mg, 20 cprs, Creme vag, bisn, 60 g Susp, oral fr, 60 ml 10 mg cx, 30 caps, Retard, 10 mg, cx, 30 cprs,

Laboratorio GROSS GROSS GROSS GROSS SOLVAY FARMA CAZI PFIZER PFIZER PFIZER PFIZER SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA B-MS ABBOTT ABBOTT MARJAN MARJAN MARJAN MEDIC MEDIC ROYTON MEDQUIMICA

UNIDADE Pco Unt Base A CPR 0,42 CPR 0,43 CPR 0,74 CPR 0,70 CPR 4,18 CPR 0,56 CPR 3,09 CPR 3,09 CPR 3,34 CPR 4,94 COMP 0,29 COMP 0,83 CPR 0,51 CPR 0,89 UND 1,72 UND 1,04 CPR 0,67 CPR 1,43 CPR 1,33 GOTAS 0,05 COMP 0,69 GOTAS 0,05 GOTAS 0,05 CPR 3,30 CPR 3,61 CPR 6,90 CPR 7,85 FA 31,95 FA 59,73 CPR 1,53 CPR 1,29 CPR 2,35 CPR 0,70 CPR 1,30 GRAMA 0,15 ML 0,21 CPR 0,51 CPR 0,22

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9770 9771 9772 9773 9774 9775 9776 9777 9778 9779 9780 9781 9782 9783 9784 9785 9786 9787 9788 9789 9790 9791 9792 9793 9794 9795 9796 9797 9798 9799 9800 9801 9802 9803 9804 9805 9806 9807

CODIGO BENEFICIO 95002251 NIFEDIPRESS 95134557 NIFEHEXAL 95134549 NIFEHEXAL 95134565 NIFELAT 95134573 NIFELAT 95333339 NILPERIDOL 95067205 NILPERIDOL 95663240 NIMALGEX 95271333 NIMBIUM 95271350 NIMBIUM 95271341 NIMBIUM 95530606 NIMESILAM 95530614 NIMESILAM 95002260 NIMESUBAL 95002278 NIMESULIDA - GENERICO 95002286 NIMESULIDA - GENERICO 95058257 NIMESULIDA - GENERICO 95530657 NIMESULIDA - GENERICO 95002294 NIMESULIDA - GENERICO 95073000 NIMESULIDA - GENERICO 95058303 NIMESULIDA - GENERICO 95895841 NIMESULIDA - GENERICO 95895850 NIMESULIDA - GENERICO 95072993 NIMESULIDA - GENERICO 95058290 NIMESULIDA - GENERICO 95058281 NIMESULIDA - GENERICO 95039627 NIMESULIDA - GENERICO 95039635 NIMESULIDA - GENERICO 95058265 NIMESULIDA - GENERICO 95530665 NIMESULIDA - GENERICO 95044000 NIMESULIDA - GENERICO 95043993 NIMESULIDA - GENERICO 95058273 NIMESULIDA - GENERICO 95039643 NIMESULIDA - GENERICO 95021795 NIMESULIDA - GENERICO 95530649 NIMESULIDA - GENERICO 95975993 NIMESULIDA - GENERICO 95039651 NIMESULIDA - GENERICO (*)

APRESENTAÇÃO Retard, 20 mg, cx, 30 cprs, Retard 20 mg, cx, 20 cprs, Retard 20 mg, cx, 30 cprs, 10/25 mg, 28 caps, gel dura 20/50 mg, cx,28 caps, 50 amp, 2 ml, 50 amps, 2 ml 100 mg, cx, 12 cprs, 10 mg inj, cx, 5 amps, 150 mg, inj, cx, 1 FA 20 mg inj, cx, 5 amps, 100 mg, cx, 12 cprs, Gts, fr, 15 ml (50 mg/ml) 100 mg, cx, 12 cprs, 100 mg, 10 cp, 100 mg, 12 cprs, 100 mg, 12 cprs, 100 mg, 12 cprs, 100 mg, 20 cp, 100 mg, bl, 10 cprs, 100 mg, bl, 12 cprs, 100 mg, bl, 12 cprs, 100 mg, bl, 12 cprs, 100 mg, bl, 20 cprs, 100 mg, cx, 12 cprs, 100 mg, est,2 bl, x 6 cprs, 20 mg/g gel derm, bisn, 30 g 20mg/ggelbisn, 30 g 50 mg, gts, 15 ml 50 mg/ml gts, fr, 15 ml, 50 mg/ml sus, or, ct, cx, 100 fr, plas, opc, got, x 15 ml (e 50 mg/ml sus, or, ct, fr, plas, opc, got, x 15 ml 50 mg/ml susp, gts, 15 ml 50 mg/ml susp, oral fr, plast, 15 ml 50 mg/ml susp, oral fr, plast, trans, got, x 15 ml Gts, 15 ml, Gts, 50 mg/ml fr, 15 ml 100 mg cx, 12 cprs,

Laboratorio MEDQUIMICA HEXAL HEXAL BIOSINTETICA BIOSINTETICA CRISTALIA CRISTALIA HEXAL GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE SIGMA PHARMA SIGMA PHARMA BALDACCI NOVARTIS EUROFARMA BIOSINTETICA MEDLEY NOVARTIS SANDOZ GEN - LEGRAND FARMASA BRAINFARMA SANDOZ ARROW RANBAXY EMS GERMED BIOSINTETICA MEDLEY PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, DUCTO BRAINFARMA EUROFARMA NEO QUIMICA EMS

UNIDADE Pco Unt Base A CPR 0,37 CPR 0,39 CPR 0,38 CPR 0,91 CPR 1,24 AP 6,92 AMP 7,63 CPR 1,12 AP 23,08 FA 175,20 AP 44,89 CPR 0,84 GOTAS 0,03 COMP 1,16 COMP 0,91 COMP 1,07 COMP 1,07 CPR 1,13 COMP 0,84 COMP 1,27 COMP 1,07 COMP 1,12 COMP 1,12 COMP 1,17 COMP 1,06 COMP 1,01 G 0,29 G 0,29 GOTA 0,04 GOTAS 0,04 GOTA 1,57 GOTA 0,04 GOTA 0,04 GOTA 0,03 GOTA 0,04 GOTAS 0,04 GOTAS 0,03 CP 1,21

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9808 9809 9810 9811 9812 9813 9814 9815 9816 9817 9818 9819 9820 9821 9822 9823 9824 9825 9826 9827 9828 9829 9830 9831 9832 9833 9834 9835 9836 9837 9838 9839 9840 9841 9842 9843 9844 9845

CODIGO BENEFICIO 95039660 NIMESULIDA - GENERICO (*) 95021809 NIMESULIN 95021817 NIMESULIN 95530681 NIMESULIX 95530673 NIMESULIX 95530690 NIMESULIX 95002308 NIMOBAL 95042253 NIMODIPINO - GENERICO 95042261 NIMODIPINO - GENERICO 95042270 NIMODIPINO - GENERICO 95042288 NIMODIPINO - GENERICO 95120939 NIMODIPINO - GENERICO 95021825 NIMOPAX 95120947 NIMOTOP 95134581 NIMOVAS 95090339 NIPRIDE 95976019 NIQUITIN ADESIVO 95976027 NIQUITIN ADESIVO 95976035 NIQUITIN ADESIVO 95663282 NISALGEN (*) 95663266 NISALGEN (*) 95663274 NISALGEN (*) 95073019 NISTATEC 95021841 NISTATINA - GENERICO 95895868 NISTATINA - GENERICO 95510788 NISTATINA - GENERICO 95895876 NISTATINA - GENERICO 95039686 NISTATINA - GENERICO 95510770 NISTATINA - GENERICO 95021833 NISTATINA - GENERICO 95500200 NISTATINA - GENERICO 95002324 NISTATINA - GENERICO 95510850 NISTATINA - GENERICO 95002332 NISTATINA - GENERICO 95002340 NISTATINA - GENERICO 95039678 NISTATINA - GENERICO 95976043 NISTATINA - GENERICO 95510842 NISTATINA - GENERICO

APRESENTAÇÃO 50 mg/ml, fr, 15 ml 100 mg, 12 cprs, 50 mg/ml susp, oral 15 ml 100 mg, cx, 12 cprs, Susp, oral fr, 60 ml, Susp, oral gts, fr, 15 ml, 30 mg, cx, 30 cprs, 30 mg, 2 bl, x 15 cprs, rev, 30 mg, 2 bl, x 15 cprs, rev, 30 mg, 2 bl, x 15 cprs, rev, 30 mg, 30 cprs, rev, 30 mg, 30 cprs, rev, 30 mg, 30 cprs, 30 mg, cx, 30 cprs, 30 mg, cx, 30 cprs, 50 mg, cx, 5 FA+ dil, 14 mg, 6 x 7 21 mg, 6 x 7 7 mg, 6 x 7 100 mg, cx, 12 cprs, Gts, fr, 15 ml Susp, fr, 60 ml 100,000 UI/4 mg, 1 bisn, 60 g+ 1 aplic, 100 UI susp, oral 50 ml c/50 100,000 UI susp, oral 50 ml 100,000 UI/ml susp, oral fr, 50 ml 100,000 UI/ml susp, oral, cx, 50 frs, plast, 50 ml (hosp,) 25,000 UI/g crem, vag, ct, bg, al, x 60 g+ aplic, 25,000 UI/g creme bisn, 60 g Creme vag, 50 bisn, 60 g Creme vag, 50 g, c/50 Creme vag, 60 g c/50 bisn, Creme vag, 60 g, Creme vag, bisn, 60 g, Creme vag, bisn, 60 g, Creme vag, bisn, 60 g+ 14 aplic, Creme vag, bisn, 60 g+ aplic, Sol, oral 100,000 UI vd, 50 ml,

Laboratorio EMS CIFARMA CIFARMA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BALDACCI EMS GERMED GEN - LEGRAND SANDOZ HEXAL CIFARMA BAYER DIFFUCAP - CHEMOBRAS BIOLAB SANUS GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE UCI-FARMA UCI-FARMA UCI-FARMA ROYTON TEUTO BRAS, TEUTO BRAS, EMS PRATI DONADUZZI PRATI DONADUZZI EMS TEUTO BRAS, PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, MEDLEY GERMED NEO QUIMICA DUCTO

UNIDADE Pco Unt Base A GOTA 0,04 COMP 1,14 GOTA 0,04 CPR 1,18 ML 0,21 GOTAS 0,04 COMP 1,14 COMP 1,55 COMP 1,55 COMP 1,45 COMP 1,13 CPR 1,10 COMP 0,96 CPR 2,48 CPR 0,85 FA 19,73 CPR 1,01 CPR 1,06 CPR 0,97 CPR 0,78 GOTAS 0,03 ML 0,15 G 0,24 ML 1,96 ML 0,26 ML 0,31 ML 0,07 G 0,13 G 0,15 GRAMA 5,02 G 2,41 G 0,05 G 0,09 G 0,13 G 0,14 G 0,13 G 0,13 ML 0,19

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9846 9847 9848 9849 9850 9851 9852 9853 9854 9855 9856 9857 9858 9859 9860 9861 9862 9863 9864 9865 9866 9867 9868 9869 9870 9871 9872 9873 9874 9875 9876 9877 9878 9879 9880 9881 9882 9883

CODIGO BENEFICIO 95510834 NISTATINA - GENERICO 95500197 NISTATINA - GENERICO 95895884 NISTATINA - GENERICO 95510869 NISTATINA - GENERICO 95895892 NISTATINA - GENERICO 95895906 NISTATINA - GENERICO 95510826 NISTATINA - GENERICO 95895914 NISTATINA - GENERICO 95895922 NISTATINA - GENERICO 95058311 NISTATINA - GENERICO 95112715 NISTATINA + OXIDO DE ZINCO - GENERICO 95002359 NISTATINA + OXIDO DE ZINCO - GENERICO 95021850 NISTATINA + OXIDO DE ZINCO - GENERICO 95058320 NISTATINA + OXIDO DE ZINCO - GENERICO 95976078 NISTATINA + OXIDO DE ZINCO - GENERICO 95039694 NISTATINA + OXIDO DE ZINCO - GENERICO 95058338 NISTATINA + OXIDO DE ZINCO - GENERICO 95391436 NISTAX 95391444 NISTAX 95021868 NISTOMIC 95976086 NISUFLEX 95663363 NISULID (*) 95663312 NISULID (*) 95663355 NISULID (*) 95663320 NISULID (*) 95663304 NISULID (*) 95110429 NITRADISC 95110437 NITRADISC 95044019 NITRAPAN 95044027 NITRAPAN 95021892 NITRATO DE MICONAZOL - GENERICO 95021884 NITRATO DE MICONAZOL - GENERICO 95046437 NITRATO DE MICONAZOL - GENERICO 95046445 NITRATO DE MICONAZOL - GENERICO 95046470 NITRATO DE MICONAZOL - GENERICO 95021876 NITRATO DE MICONAZOL - GENERICO 95046453 NITRATO DE MICONAZOL - GENERICO 95046461 NITRATO DE MICONAZOL - GENERICO

APRESENTAÇÃO Susp, 100,000 UI/ml vd, 50 ml Susp, 30 ml 200 frs, Susp, 50 frs, 50 ml Susp, 50 ml Susp, cx, 200 frs, plast, 30 ml Susp, fr, plast, 50 ml Susp, oral cx, 1 fr, vd,ambar 50 ml,+ CGT Susp, oral fr, 50 ml Susp, oral fr, 50 ml Susp, oral fr, vd, 50 ml 100,000 UI/g + 200 mg/g pom, derm, bisn, x 60 g 100,000 UI/g+ 200 mg/g pom, bisn, 60 g 100,000 UI/g+ 200 mg/g pom, derm, bisn, 60 g 100,000 UI/g+ 200 mg/g pom, derm, bisn, 60 g 100,000 UI/g+ 200 mg/g pom, derm, bisn, 60 g 100,000 UI/g+ 200 mg/g pom, derm, ct, bg, al, x 60 g Pom, derm, bisn, 60 g Creme bisn, 60 g Susp, fr, 50 ml 25000 UI/g creme vag, 60 g 100 mg, cx, 12 cprs, 100 mg, 12 sup, 12 cprs, 50 mg, 12 sup, Sol, oral 15 ml, Susp, 60 ml, 10 MG/24 HORAS - CX C/ 7 ADESIVOS 5 MG/24 HORAS - CX C/ 7 ADESIVOS 10 mg, 20 bl, 10 cps, 5 mg, 20 bl, 10 cps, 20 mg, cr, vag, bisn, x 80 g+ 14 aplic, 20 mg/g cr, vag, bisn, x 80 g+ 14 aplic, 20 mg/g crem, vag, ct, bg, al, x 80 g c/ aplic, vag, 20 mg/g crem, vag, cx, 50 bg, al, x 60 g c/ aplic, vag, (emb 20 mg/g crem, vag, cx, 50 bg, al, x 80 g c/ 50 aplic, vag, ( 20 mg/g creme vag, 80 g+ 14 aplic, 20 mg/g loc, ct, fr, plast, x 30 g 20 mg/g loc, cx, 200 fr, plast, x 30 g (emb, hosp,)

Laboratorio NEO QUIMICA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI CRISTALIA GERMED GEN - LEGRAND MEPHA-RATIOPHARM TEUTO BRAS, EMS PRATI DONADUZZI NEO QUIMICA MEDLEY PRATI DONADUZZI MEPHA-RATIOPHARM LUPER LUPER CIFARMA CAZI ACHE ACHE ACHE ACHE ACHE PHARMACIA/PFIZER PHARMACIA/PFIZER CRISTALIA CRISTALIA EUROGENUS - LEGRAND GERMED PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI EMS PRATI DONADUZZI PRATI DONADUZZI

UNIDADE Pco Unt Base A ML 0,23 ML 0,07 ML 3,45 ML 0,19 ML 2,02 ML 0,25 ML 0,28 ML 0,28 ML 0,29 ML 0,28 GRAMA 0,34 G 0,34 GRAMA 0,24 G 0,34 G 0,35 G 0,35 G 0,33 G 0,24 ML 0,39 GRAMA 0,22 CPR 1,70 G 0,57 CPR 1,66 UND 0,90 ML 1,22 ML 0,24 UNID 8,92 UNID 5,83 CP 1,65 CP 1,35 GRAMA 0,10 GRAMA 0,12 G 0,15 G 0,06 G 0,05 GRAMA 0,16 G 0,25 G 0,06

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9884 9885 9886 9887 9888 9889 9890 9891 9892 9893 9894 9895 9896 9897 9898 9899 9900 9901 9902 9903 9904 9905 9906 9907 9908 9909 9910 9911 9912 9913 9914 9915 9916 9917 9918 9919 9920 9921

CODIGO BENEFICIO 95042296 NITRATO DE MICONAZOL - GENERICO 95058346 NITRATO DE MICONAZOL - GENERICO 95058354 NITRATO DE MICONAZOL - GENERICO 95058389 NITRATO DE MICONAZOL - GENERICO 95058362 NITRATO DE MICONAZOL - GENERICO 95058370 NITRATO DE MICONAZOL - GENERICO 95510885 NITRATO DE ISOCONAZOL - GENERICO 95002383 NITRATO DE ISOCONAZOL - GENERICO 95002391 NITRATO DE ISOCONAZOL - GENERICO 95510893 NITRATO DE ISOCONAZOL - GENERICO 95039708 NITRATO DE ISOCONAZOL - GENERICO 95073027 NITRATO DE ISOCONAZOL - GENERICO 95510877 NITRATO DE ISOCONAZOL - GENERICO 95002405 NITRATO DE ISOCONAZOL - GENERICO 95002413 NITRATO DE ISOCONAZOL - GENERICO 95002421 NITRATO DE ISOCONAZOL - GENERICO 95002430 NITRATO DE ISOCONAZOL - GENERICO 95021914 NITRATO DE ISOCONAZOL - GENERICO 95021906 NITRATO DE ISOCONAZOL - GENERICO 95895930 NITRATO DE ISOCONAZOL - GENERICO 95895949 NITRATO DE ISOCONAZOL - GENERICO 95510931 NITRATO DE MICONAZOL - GENERICO 95510923 NITRATO DE MICONAZOL - GENERICO 95976124 NITRATO DE MICONAZOL - GENERICO 95002448 NITRATO DE MICONAZOL - GENERICO 95895957 NITRATO DE MICONAZOL - GENERICO 95002456 NITRATO DE MICONAZOL - GENERICO 95058397 NITRATO DE MICONAZOL - GENERICO 95058400 NITRATO DE MICONAZOL - GENERICO 95073035 NITRATO DE MICONAZOL - GENERICO 95895965 NITRATO DE MICONAZOL - GENERICO 95976132 NITRATO DE MICONAZOL - GENERICO 95033009 NITRATO DE MICONAZOL - GENERICO 95039716 NITRATO DE MICONAZOL - GENERICO 95021922 NITRATO DE MICONAZOL - GENERICO 95033017 NITRATO DE MICONAZOL - GENERICO 95510907 NITRATO DE MICONAZOL - GENERICO 95002472 NITRATO DE MICONAZOL - GENERICO

(*) (*) (*) (*) (*)

APRESENTAÇÃO Laboratorio Creme vag, bisn, 80 g+ 14 aplic, MEDLEY 20 mg/g crem, vag, ct, bg, al, x 80 g c/ aplic, vag, PRATI DONADUZZI 20 mg/g crem, vag, cx, 50 bg, al, x 60 g c/ aplic, vag, (emb, PRATI hosp,) DONADUZZI 20 mg/g crem, vag, cx, 50 bg, al, x 80 g c/ 50 aplic, vag, (emb, PRATI hosp,) DONADUZZI 20 mg/g loc, ct, fr, plast, x 30 g PRATI DONADUZZI 20 mg/g loc, cx, 200 fr, plast, x 30 g (emb, hosp,) PRATI DONADUZZI 10 mg/g 40 g creme vag, cx, c/1 CRISTALIA 10 mg/g bisn, 20 g EMS 10 mg/g bisn, 40 g+ 7 aplic, EMS 10 mg/g cr, vag, bisn, al, 40 g+ 7 aplic, desc, de 5 g ATIVUS 10 mg/g crem, derm, ct, bg, al, x 20 g PRATI DONADUZZI 10 mg/g crem, vag, cx, 50 bg al, x 40 g+ 350 aplic, (hosp,) HIPOLABOR 10 mg/g creme 20 g, CRISTALIA 10 mg/g creme derm, bisn, 20 g MEDLEY 10 mg/g creme vag, bisn, 40 g+ 7 aplic, MEDLEY 10 mg/g creme vag, bisn, 40 g+ 7 aplic, vag, PRATI DONADUZZI 10 mg/g creme vag, c/50 bisn, 40 g+ 7 aplic, vag, PRATI DONADUZZI Creme bisn, 20 g GEN - LEGRAND Creme derm, bisn, 20 g GERMED Creme vag, bisn, 40 g+ 7 aplic, GERMED Creme vag, bisn, 40 g+ 7 aplic, GEN - LEGRAND 2% creme vag, 60 g c/50 PRATI DONADUZZI 2% creme vag, 80 g PRATI DONADUZZI 2% creme vag, 80 g c/50 PRATI DONADUZZI 20 mg, cr, vag, bisn, x 80 g+ 14 aplic, EUROGENUS - LEGRAND 20 mg/g cr, vag, bisn, 80 g+ 14 aplic, BLAUSIEGEL 20 mg/g cr, vag, bisn, x 80 g+ 14 aplic, GERMED 20 mg/g crem, derm, ct, bg, al, x 28 g PRATI DONADUZZI 20 mg/g crem, derm, cx, 100 bg, al, x 28 g (emb, hosp,) PRATI DONADUZZI 20 mg/g creme derm, bisn, x 28 g NEO QUIMICA 20 mg/g creme vag, 80 g+ 14 aplic, EMS 20 mg/g locao 30 ml CRISTALIA 20 mg/g locao cremosa x 30 g MEDLEY 20mg/gcremebisn,28 g GERMED Creme 2% bisn, 80 g TEUTO BRAS, Creme bisn, 28 g MEDLEY Creme vag, bisn, 80 g+ 14 aplic, MEDLEY Locao fr, 30 g GERMED

UNIDADE Pco Unt Base A GRAMA 0,16 G 0,15 G 0,06 G 0,05 G 0,25 G 0,06 G 0,55 G 0,56 G 0,57 G 0,46 G 0,59 G 0,42 G 0,54 G 0,56 G 0,57 G 0,59 G 0,26 GRAMA 0,50 GRAMA 0,56 G 0,55 G 0,46 G 0,05 G 0,11 G 0,43 G 0,10 GRAMA 0,15 G 0,12 G 0,28 G 0,10 G 0,28 GRAMA 12,91 ML 0,28 G 0,29 G 0,27 GRAMA 0,12 G 0,28 G 0,14 G 0,20

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9922 9923 9924 9925 9926 9927 9928 9929 9930 9931 9932 9934 9935 9936 9937 9938 9939 9940 9941 9942 9943 9944 9945 9946 9947 9948 9949 9950 9951 9952 9953 9954 9955 9956 9957 9958 9959 9960

CODIGO BENEFICIO 95002480 NITRATO DE MICONAZOL - GENERICO 95976140 NITRATO DE MICONAZOL - GENERICO 95002464 NITRATO DE MICONAZOL - GENERICO 95021930 NITRATO DE MICONAZOL - GENERICO 95002499 NITRATO DE MICONAZOL - GENERICO 95002502 NITRATO DE MICONAZOL - GENERICO 95976159 NITRATO DE MICONAZOL - GENERICO 95138013 NITRATO DE MICONAZOL - GENERICO (Restrito Hosp.) 95039724 NITRATO DE OXICONAZOL - GENERICO 95002510 NITRATO DE OXICONAZOL - GENERICO 95002529 NITRATO DE OXICONAZOL - GENERICO 95002537 NITRAZEPAM - GENERICO 95002545 NITRAZEPAM - GENERICO 95134590 NITRENCORD 95976175 NITRENDIPINO - GENERICO 95976183 NITRENDIPINO - GENERICO 95976191 NITROFEN 95138021 NITROFURANTOINA - GENERICO (Restrito Hosp.) 95988718 NITROP 95134638 NITROPLUS 95982639 NITROPRESABBOTT 95067213 NITROPRUS 95380205 NIXIN 95380230 NIXIN 95380248 NIXIN 95391460 NIZORAL 95391479 NIZORAL (*) 95391487 NIZORAL (*) 95976205 NOAN 95271376 NOAN 95002561 NOCICLIN 95271392 NOCTAL 95976221 NOCTAVAL 95058427 NOCTIDEN 95058419 NOCTIDEN 95058435 NOEX 95002570 NOEX 95002588 NOEX

APRESENTAÇÃO Locao fr, 30 g Locao fr, 30 g Locao20 mg/mlfr,30 ml Locaoderm,2%fr,30 ml Po fr, 30 g Po fr, 30 g Po fr, 30 g 20 mg/ml locao cx. 100 fr. plast. x 30 ml (hosp.) 10 mg/g crem, derm, ct, bg, al, x 20 g 10 mg/g creme derm, bisn, 20 g 10 mg/ml sol, top, gts, 20 ml 5 mg, 2 bl, x 10 cprs, 5 mg, 2 bl, x 10 cprs, 10 mg, cx, 30 cprs, 10 mg, 2 bl, x 15 cprs, rev, 20 mg, 2 bl, x 15 cprs, rev, 100 mg cx, 24 caps, 100 mg. bl. 280 caps. gel dura (hosp.) Cx, 1 x 2 ml 50 mg kit 5 fr, amp,+ 5 dil, CX C/ 1 FA x 2 ML 50 mg, kit 5 fr, amp,+ 5 dil, 250 mg, 6 cprs, 500 mg, 14 cprs, 750 mg, 6 cprs, Shampoo fr, 100 ml,(incluso 5%IPI) Cx, blist, 10 cprs, Cx, blist, 30 cprs, 10 mg, cx, 20 cprs, 5 mg, fr, 20 cprs, 1 bl, x 21 cprs, 2 mg, cx, 20 cprs, 50 mg, 20 drags, 10 mg, bl, 10 cprs, rev, 10 mg, bl, 20 cprs, rev, 100 mcg 100 doses 32 mcg 120 doses 50 mcg 200 doses

Laboratorio GEN - LEGRAND EMS NEO QUIMICA TEUTO BRAS, GERMED GEN - LEGRAND EMS TEUTO BRAS. PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GERMED GEN - LEGRAND BIOSINTETICA BIOSINTETICA BIOSINTETICA TEUTO BRAS, TEUTO BRAS. HYPOFARMA CRISTALIA ABBOTT CRISTALIA MEPHA MEPHA MEPHA JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG FARMASA FARMASA EMS ABBOTT SIGMA PHARMA BIOLAB SANUS BIOLAB SANUS EUROFARMA EUROFARMA EUROFARMA

UNIDADE Pco Unt Base A G 0,25 G 0,27 ML 0,25 ML 0,19 G 0,38 G 0,45 G 0,44 FR 5,70 G 0,45 G 0,34 GOTA 0,03 COMP 0,32 COMP 0,30 CPR 0,82 CPR 0,47 CPR 0,84 CPR 0,26 CAPS 0,14 AMP 16,60 AP 17,85 FA 9,47 AMP 22,68 CPR 3,70 CPR 5,60 CPR 7,80 ML 0,40 CPR 3,25 CPR 2,88 CPR 0,17 CPR 0,10 COMP 0,31 CPR 0,62 CPR 0,97 COMP 1,55 COMP 1,60 Dose 0,33 UNID 0,16 UNID 0,16

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9961 9962 9963 9964 9965 9966 9967 9968 9969 9970 9971 9972 9973 9974 9975 9976 9977 9978 9979 9980 9981 9982 9983 9984 9985 9986 9987 9988 9989 9990 9991 9992 9993 9994 9995 9996 9997 9998

CODIGO BENEFICIO 95002596 NOEX 95333363 NOFEBRIN 95333355 NOFEBRIN 95333347 NOFEBRIN 95002600 NOGRIPE 95073043 NOLIPO 95560238 NOLVADEX 95560220 NOLVADEX 95560211 NOLVADEX 95300660 NOODIPINA 95300651 NOODIPINA 95300686 NOOTRON 95300708 NOOTRON 95300724 NOOTROPIL 95300716 NOOTROPIL 95021957 NOPROSIL 95136495 NOPROSIL (Restrito Hosp,) 95380256 NORACIN 95002669 NORDITROPIN 95002677 NORDITROPIN 95125736 NORDITROPIN NORDIFLEXX 95125744 NORDITROPIN NORDIFLEXX 95125728 NORDITROPIN NORDIFLEXX 95039732 NORDITROPIN NORDILET 10 95002634 NORDITROPIN SIMPLEXX 95002642 NORDITROPIN SIMPLEXX 95002650 NORDITROPIN SIMPLEXX 95042300 NOREGYNA 95983244 NORELBIN 95900683 NOREPHED (BITARTARATO DE NOREPINEFINA) 95090622 NOREPINE 95520651 NORESTIN 95895973 NORF 95380264 NORFLAMIN 95985913 NORFLOXACINO - GENERICO 95985921 NORFLOXACINO - GENERICO 95976248 NORFLOXACINO - GENERICO 95033025 NORFLOXACINO - GENERICO

APRESENTAÇÃO 64 mcg 120 doses Cx, 30 envs, x 4 cprs, Gts, fr, 10 ml Gts, fr, 20 ml Cx, 100 cprs, 15 mg, bl, 30 caps, gel, dura D 20 mg, cx, 30 cprs, Fr, 250 cprs, Fr, 30 cprs, 0,2 mg/ml, inj, fr, 50 ml, perfusor 30 mg, cps, rev, cx, c/30 Cx, 60 cprs, Ped, vd, 110 ml, 800 mg, est, 30 cprs, Inj, cx, 12 amps, 10 mg/2 ml cx, 100 amps, plast, 5 mg/ml cx, 200 amps, plast, x 2 ml 400 mg, 14 cprs,rev, 12 UI 4 UI 10mg 1,5ml,1FA vd,inc, 15mg 1,5/ml,1FA vd,inc, 5mg 1,5/ml,1FA vd,inc, 1 x 1,5 ml 1 sist, apl, plast, 10 mg, 15mg, 5 mg, Amp,1 ml+ser,esteril 50 mg FA cx, c/1 x 5 ml 4 mg/4 ml cx, 10 un, 8 mg, sol, inj, cx, 10 amps, vd, inc, x 4 ml 0,35 mg, 35 cprs, 400 mg, 2 bl, x 7 cprs, 400 mg, cx, 14 cprs, 400 mg 2 str, al, x 7 cprs, rev, 400 mg str, al, x 7 cprs, rev, 400 mg, 1 bl, x 6 cprs, rev, 400 mg, 10 bl, x 6 cprs, rev,

Laboratorio EUROFARMA LEGRAND LEGRAND LEGRAND TEUTO BRAS, TEUTO BRAS, ASTRAZENECA ASTRAZENECA ASTRAZENECA APSEN APSEN BIOSINTETICA BIOSINTETICA SANOFI-AVENTIS SANOFI-AVENTIS ISOFARMA ISOFARMA CIBRAN NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK NOVO NORDISK CIFARMA EUROFARMA SANVAL OPEM BIOLAB SANUS SIGMA PHARMA ROYTON BIOSINTETICA BIOSINTETICA MEDLEY EMS

UNIDADE Pco Unt Base A UNID 0,28 ENV 0,30 GOTAS 0,02 GOTAS 0,02 COMP 0,26 CAPS 0,57 CPR 5,03 CPR 1,17 CPR 2,45 FA 69,07 CPR 1,02 CPR 0,38 ML 0,08 CPR 0,68 AP 1,68 AMP 0,48 AMP 0,52 CPR 1,17 F,A, 374,81 F,A, 127,73 FA 1163,68 FA 1736,89 FA 578,93 UND 1163,68 X F,A, 1133,09 F,A, 1487,75 F,A, 566,51 UND 16,62 CPR 20,35 AMP 14,85 AMP 3,30 CPR 0,19 COMP 1,18 CPR 1,13 CPR 1,55 CPR 1,63 CPR 2,06 CPR 1,72

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 9999 10000 10001 10002 10003 10004 10005 10006 10007 10008 10009 10010 10011 10012 10013 10014 10015 10016 10017 10018 10019 10020 10021 10022 10023 10024 10025 10026 10027 10028 10029 10030 10031 10032 10033 10034 10035 10036

CODIGO BENEFICIO 95380329 NORFLOXACINO - GENERICO 95021973 NORFLOXACINO - GENERICO 95033033 NORFLOXACINO - GENERICO 95083138 NORFLOXACINO - GENERICO 95976264 NORFLOXACINO - GENERICO 95021981 NORFLOXACINO - GENERICO 95033041 NORFLOXACINO - GENERICO 95976299 NORFLOXACINO - GENERICO 95021965 NORFLOXACINO - GENERICO 95033050 NORFLOXACINO - GENERICO 95976310 NORFLOXACINO - GENERICO 95380345 NORFLOXACINO - GENERICO 95033068 NORFLOXACINO - GENERICO 95083120 NORFLOXACINO - GENERICO 95033076 NORFLOXACINO - GENERICO 95033084 NORFLOXACINO - GENERICO 95380337 NORFLOXACINO - GENERICO 95976329 NORFLOXACINO - GENERICO 95033092 NORFLOXACINO - GENERICO 95039740 NORFLOXACINO - GENERICO 95058443 NORFLOXACINO - GENERICO 95380310 NORFLOXACINO - GENERICO 95985930 NORFLOXACINO - GENERICO 95895981 NORFLOXACINO - GENERICO 95976337 NORFLOXACINO - GENERICO 95002685 NORFLOXACINO - GENERICO 95039759 NORFLURIN 95021990 NORFLURIN 95039767 NORFLURIN 95058460 NORIPURUM 95571400 NORIPURUM 95571418 NORIPURUM 95571426 NORIPURUM 95571442 NORIPURUM 95033106 NORIPURUM 95571434 NORIPURUM 95571396 NORIPURUM 95058451 NORIPURUM

APRESENTAÇÃO 400 mg, 14 cp, 400 mg, 14 cprs, 400 mg, 14 cprs, 400 mg, 14 cprs, 400 mg, 14 cprs, 400 mg, 14 cprs, rev, 400 mg, 2 bl, x 7 cprs, rev, 400 mg, 2 bl, x 7 cprs, rev, 400 mg, 6 cprs, 400 mg, 6 cprs, 400 mg, 6 cprs, 400 mg, bl, 14 cprs, 400 mg, bl, 14 cprs, rev, 400 mg, bl, 14 cprs, rev, 400 mg, bl, 140 cprs, rev, 400 mg, bl, 420 cprs, rev, 400 mg, bl, 6 cprs, 400 mg, bl, 6 cprs, rev, 400 mg, bl, 7 cprs, rev, 400 mg, com, rev, ct, bl, al, plas, leit x 14 400 mg, com, rev, ct, bl, al, plas, leit, x 140 400 mg, fr, 14 cprs, 400 mg, fr, 14 cprs, 400 mg, fr, 14 cprs, rev, 400 mg, fr, plast, opc x 14 400 mg, fr, plast, opc x 6 400 mg, cx, 14 cprs, rev, 400 mg, cx, 50 bl, x 14 cprs, rev, 400 mg, cx, 50 bl, x 14 cprs, rev, 100 mg, 30 cprs, mast, Cx, 20 cprs, mast, Folico 20 cprs, mast, Gts, 15 ml, Inj, cx, 5 amps, x 2 ml+ 5 agulhas Sol, oral fr, 30 ml Vit, cx, 30 cprs, rev, Xpe, fr, 100 ml, Xpe, fr, 120 ml

Laboratorio NOVARTIS UNIAO QUIMICA MEPHA-RATIOPHARM MULTILAB BRAINFARMA TEUTO BRAS, MERCK MEDLEY UNIAO QUIMICA RATIOPHARM BRAINFARMA RANBAXY PRATI DONADUZZI SANDOZ PRATI DONADUZZI PRATI DONADUZZI RANBAXY MERCK PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI EMS GERMED GEN - LEGRAND APOTEX APOTEX CELLOFARM CELLOFARM CELLOFARM NYCOMED PHARMA NYCOMED PHARMA ALTANA PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA ALTANA PHARMA NYCOMED PHARMA NYCOMED PHARMA

UNIDADE Pco Unt Base A CPR 1,21 COMP 1,80 CPR 1,72 COMP 1,39 CPR 1,71 COMP 1,71 CPR 1,32 CPR 1,71 COMP 2,06 CPR 1,47 CPR 1,57 CPR 1,64 CPR 1,20 COMP 1,70 CPR 1,18 CPR 0,61 CPR 1,89 CPR 1,68 CPR 1,45 CP 1,28 COMP 1,02 CPR 1,72 CPR 1,63 COMP 1,63 CPR 1,14 COMP 1,30 CP 1,55 COMP 1,28 CP 1,32 COMP 1,08 CPR 1,04 CPR 0,99 GOTAS 0,03 AP 8,54 GOTA 0,03 CPR 1,36 ML 0,12 ML 0,13

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10037 10038 10039 10040 10041 10042 10043 10044 10045 10046 10047 10048 10049 10050 10051 10052 10053 10054 10055 10056 10057 10058 10059 10060 10061 10062 10063 10064 10065 10066 10067 10068 10069 10070 10071 10072 10073 10074

CODIGO BENEFICIO 95571450 NORIPURUM (*) 95976353 NORMAPRIL 95976361 NORMAPRIL 95976370 NORMAPRIL 95002693 NORMASTIG 95300732 NOROGIL 95046020 NORTRIGIN 95046011 NORTRIGIN 95895990 NORTRIP 95896007 NORTRIP

APRESENTAÇÃO Inj, cx, 5 amps, x 5 ml 12,5 mg, cx, 30 cprs, 25 mg, cx, 28 cprs, 50 mg, cx, 30 cprs, 0,5 mg/ml sol, inj, ct, 50 amp, vd, inc, x 1 ml (emb, HOSP,) 20 drags, 100 mg, bl, 28 cprs, simp, 50 mg, bl, 28 cprs, simp, 25 mg, 20 caps, 50 mg, 20 caps,

Laboratorio NYCOMED PHARMA CAZI CAZI CAZI UNIAO QUIMICA SANOFI-AVENTIS MEIZLER MEIZLER TEUTO BRAS, TEUTO BRAS,

95896015 NORTRIP 95136509 NORTRIP (Restrito Hosp,) 95136517 NORTRIP (Restrito Hosp,) 95136525 NORTRIP (Restrito Hosp,) 95134646 NORVASC 95134662 NORVASC 95134654 NORVASC 95073051 NORVIR (ICMS 0%) 95976388 NORXIN 95976396 NOSTIL 95251626 NOTUSS 95251634 NOTUSS 95002707 NOVABUPI 95002715 NOVABUPI 95920234 NOVABUPI 95920250 NOVABUPI 95002723 NOVABUPI 95002731 NOVABUPI 95920242 NOVABUPI 95067221 NOVABUPI + EPINEFRINA 95067230 NOVABUPI ISOBARICA 95391541 NOVACORT 95391533 NOVACORT 95067248 NOVACTAM 95800069 NOVADERM 95800077 NOVADERM 95022015 NOVALEX (DIPIRONA 50%) 95022023 NOVALEX (DIPIRONA 50%)

75 mg, 20 caps, 25 mg, bl, 300 caps, dura (hosp,) 50 mg, bl, 300 caps, dura (hosp,) 75 mg, bl, 300 caps, dura (hosp,) 10 mg, 30 cprs, 20 cprs, x 5 mg, 5 mg, 30 cprs, Sol, oral 240 ml 400 mg, cx, 14 cprs, Fr, 5 ml Xpe, ad, fr, 120 ml Xpe, ped, fr, 120 ml 0,25% c/v 10 est, 20 ml 0,25% s/v 10 est, 20 ml 0,5% c/v cx,10 est, x 20 ml, 0,5% s/v cx,10 est, 20 ml, 0,75% c/v 10 est, 20 ml 0,75% s/v 10 est, 20 ml Isobarica 0,5% cx,30 est, 4 ml, 0,5% C/V10etj,20ml 0,5% isobarica 30 etj, 4 ml Creme 30 g, Pom, 30 g, 1,0 g+ 0,5 g po sol, inj, IM/IV 20 FA vd, (hosp,) Cicatrizante bisn, 30 g, Creme vag,c/aplic, 40 g, c/ 8 aplic, Amp, 2 ml Amp, 5 ml

TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, PFIZER PFIZER PFIZER ABBOTT CAZI LATINOFARMA ACHE ACHE CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA ACHE ACHE NOVAFARMA FARMASA FARMASA HALEX ISTAR HALEX ISTAR

UNIDADE Pco Unt Base A AP 8,24 CPR 0,57 CPR 0,89 CPR 1,64 AMP 0,62 CPR 1,07 COMP 3,95 COMP 1,96 CAPS 0,49 CAPS 0,73 CAPS CAPS CAPS CAPS CPR CPR CPR ML CPR GOTAS ML ML ML ML ML ML ML ML AP AMP AMP G G FA G G AMP AMP

0,98 0,43 0,63 0,85 2,24 2,07 1,14 2,47 1,66 0,22 0,12 0,11 0,90 0,83 0,97 0,88 1,13 1,09 5,97 19,36 5,97 0,56 0,56 15,26 0,55 0,57 0,53 1,29

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10075 10076 10077 10078 10079 10080 10081 10082 10083 10084 10085 10086 10087 10088 10089 10090 10091 10092 10093 10094 10095 10096 10097 10098 10099 10100 10101 10102 10103 10104 10105 10106 10107 10108 10109 10110 10111 10112

CODIGO BENEFICIO 95333380 NOVALEX (DIPIRONA) 95333398 NOVALEX (DIPIRONA) 95058486 NOVALGINA 95033114 NOVALGINA 95333487 NOVALGINA 95976418 NOVALGINA 95976434 NOVALGINA 95333452 NOVALGINA 95333460 NOVALGINA 95058494 NOVALGINA 95058508 NOVALGINA 95333436 NOVALGINA 95333444 NOVALGINA 95084193 NOVAMICIN 95067256 NOVAMICIN 95075577 NOVAMICIN 95380370 NOVAMIN 95380388 NOVAMIN 95380396 NOVAMIN 95380400 NOVAMOX 95380418 NOVAMOX 95380450 NOVAMOX 2 X 95380442 NOVAMOX 2 X 95380426 NOVAMOX 2 X 95380434 NOVAMOX 2 X 95075585 NOVANOR 95380469 NOVASUTIN 95075593 NOVATAZ 95067264 NOVATAZ 95380477 NOVATREX 95380485 NOVATREX 95380493 NOVATREX 95380507 NOVATREX 95421106 NOVELMIN 95421092 NOVELMIN 95896023 NOVIAL 95002766 NOVIDAT 95002774 NOVIDAT

APRESENTAÇÃO Amp, 2 ml, Amp, 5 ml, 1 g bl, 200 cprs, 1 g ct, 1 bl, al, plast, inc, x 10 cprs, 500 mg, 25 bl, x 4 cprs, 500 mg/ml sol, or ct fr, vd, amb, got x 10 ml 500 mg/ml sol, or, ct, fr, vd, amb, got x 20 ml Cx, 50 x 2 ml, Cx, 50 x 5 ml, Fr, de venda 4 cprs, Fracao de venda 10 cprs, Sol, oral vd, 100 ml, Sup, inf, cx, 5 sups, 1 g po liof, inj, FA vd, (hosp,) 500 mg, po inj, cx, 20 FA vd, 500 mg, po liof, inj, cx, 50 FA vd, x 10 ml (hosp,) 100 mg, inj, cx c/1 amp x 2 ml 250 mg, inj, cx c/1 amp x 2 ml, 500 mg, inj, cx c/1 amp x 2 ml Fr, 21 cprs, Susp, fr, 105 ml, 400 mg+ 57 mg susp, or,fr, 100 ml,+ dil, 400 mg+ 57 mg susp, or,fr, 70 ml,+ dil 875 mg+ 125 mg fr, 14 cprs, rev, 875 mg+ 125 mg fr, 20 cprs, rev, 2 mg/ml sol, inj, cx, 50 amps, vd, x 4 ml Cr, vag, 25 mg/g+12,5 mg/g 1 bisn, 60 g+ 1 aplic, 4 g+ 0,5 g po liof, sol, inj, cx, 10 FA vd, x 20 ml (hosp,) 4 g+ 0,5 g po liof, sol, inj, FA vd, x 20 ml (emb, hosp,) 500 mg, bl, 2 cprs, rev, 500 mg, bl, 3 cprs, rev, Susp, oral fr, 600 mg,+ dil, Susp, oral fr, 900 mg,+ dil, Cx, 6 cprs, Fr, 30 ml, 1 bl, x 21 cprs, 150 mg, cx, c/14 cprs, 75 mg, cx, c/14 cprs,

Laboratorio HALEX ISTAR HALEX ISTAR SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS NOVAFARMA NOVAFARMA NOVAFARMA B-MS B-MS B-MS ACHE ACHE ACHE ACHE ACHE ACHE NOVAFARMA BLAUSIEGEL NOVAFARMA NOVAFARMA ACHE ACHE ACHE ACHE BUNKER BUNKER SIGMA PHARMA DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS

UNIDADE Pco Unt Base A AP 0,53 AP 1,29 COMP 1,04 CPR 1,07 CPR 0,69 GOTAS 0,03 GOTAS 0,03 AP 1,69 AP 2,69 COMP 1,04 COMP 0,66 ML 0,12 UND 1,12 FA 42,02 FA 21,04 FA 19,86 AP 8,00 AP 13,16 AP 18,53 CPR 2,78 ML 0,34 ML 0,48 ML 0,46 CPR 3,37 CPR 3,25 AMP 9,05 G 0,36 FA 61,34 FA 61,34 CPR 17,25 CPR 15,41 ML 3,50 ML 4,36 CPR 0,64 GOTAS 0,01 COMP 1,20 COMP 2,71 COMP 1,78

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10113 10114 10115 10116 10117 10118 10119 10120 10121 10122 10123 10125 10126 10127 10128 10129 10130 10131 10132 10133 10134 10135 10137 10138 10139 10140 10141 10142 10143 10144 10145 10146 10147 10148 10149 10150 10151 10152

CODIGO BENEFICIO 95380531 NOVOCILIN 95380540 NOVOCILIN 95380558 NOVOCILIN 95976442 NOVOFER 95571477 NOVOFER 95571469 NOVOFER 95431365 NOVONORM 95431373 NOVONORM 95431381 NOVONORM 95750460 NOVOPULMON 95750479 NOVOPULMON 95542221 NOVOSEVEN 95571507 NOVOSEVEN 95571493 NOVOSEVEN 95380582 NOVOXIL 95137971 NPS - NITROPRUSSIATO DE SODIO 50 MG 95333517 NUBAIN 95050396 NUJOL 95900705 NUOVODOX 95790772 NUTRACORT 95112723 NUTRAPLUS 95896031 NUTRICAL D 95900713 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900721 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900730 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900748 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900756 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900764 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900772 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95900780 NUTRICAO PARENTERAL - EMULSOES LIPIDICAS 95049088 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95049096 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900799 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900802 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900810 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900829 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900837 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900845 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC

APRESENTAÇÃO 250 mg, fr, 11,25 g+ dil, 400 mg, susp,fr, 100 ml, 875 mg, bl, 14 cprs, Cx, 45 drags, Gts, 30 ml, c/conta-gotas Liq, 120 ml, 0,5 mg, 30 cprs, 1,0 mg, 30 cprs, 2,0 mg, 30 cprs, 200 mcg inal,+ refil 200 doses 200 mcg refil 200 doses 120 KUI 2,4 mg, 240 KUI 4,8 mg, 60 KUI 1,2 mg, 250 mg, susp, fr, 150 ml 50 mg. po inj. cx. 25 FA Cx, 10 amps, x 10 mg/ml, 1 x 120 ml, 50mg,poliof,inj,1FA 1% creme bisn, plast, 15 g, 200 mg/g creme derm, bisn, 60 g 500 mg,+ 2 mg, fr, 60 cprs, rev, Celepid 10% - 1 x 250 ml Celepid 10% - 1 x 500 ml Celepid 20% - 1 x 250 ml Celepid 20% - 1 x 500 ml Celepid MCT-LCT 10% - 1 x 250 ml Celepid MCT-LCT 10% - 1 x 500 ml Celepid MCT-LCT 20% - 1 x 250 ml Celepid MCT-LCT 20% - 1 x 500 ml Celemin 10 (BOLS PLAS) - 1 x 1000 ml Celemin 10 (BOLS PLAS) - 1 x 2000 ml Celemin 10 plus - 1 x 1000 ml Celemin 10 plus - 1 x 500 ml Celemin Hepa 8% - 1 x 1000 ml Celemin Hepa 8% - 1 x 250 ml Celemin Hepa 8% - 1 x 500 ml Celemin Nephro 7% - 1 x 1000 ml

Laboratorio ACHE ACHE ACHE ACHE ACHE ACHE NOVO NORDISK NOVO NORDISK NOVO NORDISK LIBBS LIBBS NOVO NORDISK NOVO NORDISK NOVO NORDISK LUPER LEBON CRISTALIA MANTECORP BERGAMO GALDERMA GALDERMA FARMOQUIMICA CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS

UNIDADE Pco Unt Base A ML 0,06 ML 0,16 CPR 1,61 CPR 0,41 GOTAS 0,01 ML 0,07 CPR 1,44 CPR 1,80 CPR 2,08 DOSE 0,38 DOSE 0,29 AP 6026,72 X FA 12055,24 X FA 3013,33 X ML 0,16 COMP 13,50 AP 11,09 ML 0,20 FA 255,98 G 0,70 GRAMA 0,51 COMP 0,72 ML 0,52 ML 0,33 ML 0,74 ML 0,47 ML 0,56 ML 0,35 ML 0,85 ML 0,53 ML 0,11 ML 0,11 ML 0,10 ML 0,18 ML 0,10 ML 0,34 ML 0,18 ML 0,08

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10153 10154 10155 10156 10157 10158 10159 10160 10161 10162 10163 10164 10165 10166 10167 10168 10169 10170 10171 10172 10173 10174 10175 10176 10177 10178 10179 10180 10181 10182 10183 10184 10185 10186 10187 10188 10189 10190

CODIGO BENEFICIO 95900853 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95900861 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95049118 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95049100 NUTRICAO PARENTERAL - SOLUCAO DE AMINOAC 95067280 NUTRICAO PARENTERAL - SOLUCAO DE AMINOACIDOS 95067299 NUTRICAO PARENTERAL - SOLUCAO DE AMINOACIDOS 95976493 NUVARING 95033122 OCERAL 95033130 OCERAL 95075607 OCITOC 95075631 OCITOC 95075615 OCITOC 95075623 OCITOC 95125337 OCITOCINA - GENERICO (Restrito Hosp,) 95125345 OCITOCINA - GENERICO (Restrito Hosp,) 95081526 OCTIFEN 95067302 OCTRIDE 95690158 OCUFEN 95976515 OCUPRESS 95134689 ODRIK 95896040 OESTROGEL 95680055 OFLOX 95380671 OFLOXACINO - GENERICO 95896058 OFLOXACINO - GENERICO 95896066 OFLOXACINO - GENERICO 95896074 OFLOXACINO - GENERICO 95112731 OFLOXACINO - GENERICO 95380710 OFOXIN 95976523 OFTPRED 95896082 OLCADIL 95291008 OLCADIL 95896090 OLCADIL 95290990 OLCADIL 95896104 OLCADIL 95291016 OLCADIL 95982655 OLEO DE SILICONE 95982663 OLEO DE SILICONE 95022058 OLEO MINERAL

APRESENTAÇÃO Celemin Nephro 7% - 1 x 250 ml Celemin Nephro 7% - 1 x 500 ml Diamin - 1 x 100 ml Diamin - 1 x 50 ml Celemin 10 (BOLS PLAS) - 1 x 500 ml Celemin 10 plus - 1 x 250 ml 1 anel vag, Bisn, creme 20 g, Sol, top, fr, 20 ml, 5 UI cx, 1 amp, 5 UI cx, 100 amps, 5 UI cx, 5 amps, 5 UI cx, 50 amps, 5 UI/ml ct, 100 amps, vd, inc, x 1 ml 5 UI/ml ct, 50 amps, vd, inc, x 1 ml 0,25 mg/ml sol, oft, x 5 ml 0,10 mg/ml sol, inj, ct, 5 amps, vd, inc, x 1 ml 0,03% Sol, oft, 5 ml, 2% sol, oft, fr, plast, got, x 5 ml 2 mg, cx, 20 caps, 60 mg, tb, 80 g Fr, 5 ml, 0,3% fr, 5 ml, 0,3% sol, oft, fr, 5 ml 0,3% sol, oft, fr, 5 ml 0,3% sol, oft, fr, 5 ml Sol, oft, 3 mg/ml fr, 5 ml Sol, otol, fr, vd, cgt x 10 ml Fr, 5 ml 1 mg, 30 cprs, 1 mg, cx, 20 cprs, 2 mg, 30 cprs, 2 mg, cx, 20 cprs, 4 mg, 30 cprs, 4 mg,cx, 20 cprs, 1,300 cst SERINGA C/ 10 ML 5,500 cst SERINGA C/ 10 ML Fr, 100 ml

Laboratorio CLARIS CLARIS CLARIS CLARIS CLARIS CLARIS ORGANON BAYER BAYER BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BLAUSIEGEL BLAUSIEGEL UNIAO QUIMICA SUN ALLERGAN UNIAO QUIMICA ASTA MEDICA FARMOQUIMICA ALLERGAN ALCON EMS GERMED GEN - LEGRAND NEO QUIMICA ZAMBON LATINOFARMA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS AMO AMO MEDIC

UNIDADE Pco Unt Base A ML 0,31 ML 0,15 ML 3,76 ML 4,28 ML 0,35 ML 0,35 UND 45,50 G 0,80 GOTA 0,04 AMP 1,07 AMP 1,07 AMP 1,07 AMP 1,07 AMP 0,92 AMP 0,92 Gota 0,16 AMP 40,92 GOTAS 0,15 GOTAS 0,44 CPR 1,83 GRAMA 32,93 GOTAS 0,23 GOTAS 0,11 GOTA 0,13 GOTA 0,13 GOTA 0,13 GOTAS 0,13 GOTAS 0,11 GOTAS 0,24 COMP 0,74 CPR 0,74 COMP 1,16 CPR 1,16 COMP 1,75 CPR 1,75 UNID 196,20 UNID 227,25 ML 0,09

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10191 10192 10193 10194 10195 10196 10197 10198 10199 10200 10201 10203 10204 10205 10206 10207 10208 10209 10210 10211 10212 10213 10214 10215 10216 10217 10218 10219 10220 10221 10222 10223 10224 10225 10226 10227 10228 10229

CODIGO BENEFICIO 95073060 OLEO MINERAL 95089691 OLEO MINERAL 95988750 OLEO MINERAL 95058575 OLEPTAL 95058583 OLEPTAL 95663436 OLFEN 95663380 OLFEN 95663428 OLFEN 95663398 OLFEN 95663444 OLFEN 95663401 OLFEN 95976540 OLMETEC 95976558 OLMETEC 95896112 OLMETEC HCT 95896120 OLMETEC HCT 95896139 OLMETEC HCT 95790780 OMCILON - A 95790802 OMCILON - A M 95790799 OMCILON - A M 95380647 OMEGASTROL 95896147 OMEGASTROL 95002847 OMEGAVEN 95002855 OMEGAVEN 95031286 OMEP 95031278 OMEP 95002863 OMEPRAMIX 95896155 OMEPRAMIX 95002871 OMEPRAMIX 95031308 OMEPRASEC 95031316 OMEPRAZIN 95031332 OMEPRAZIN 95058591 OMEPRAZIN 95002880 OMEPRAZIN 95002901 OMEPRAZOL - GENERICO 95976590 OMEPRAZOL - GENERICO 95976604 OMEPRAZOL - GENERICO 95031367 OMEPRAZOL - GENERICO 95031480 OMEPRAZOL - GENERICO

APRESENTAÇÃO Fr, 100 ml Fr, 100 ml Fr, 100 ml 300 mg, cx, 30 cprs, 600 mg, cx, 30 cprs, 100 mg, 5 suposit, 25 mg, cx, 2 bl, x 10 cprs, 50 mg, 5 suposit, 50 mg, cx, 2 bl, x 10 cprs, 75 mg, cx, 5 amps, x 2 ml SR 100 mg, cx, 1 bl, x 10 caps, 20 mg, 30 cprs, 40 mg, 30 cprs, 20 mg,+ 12,5 mg, x 30 cprs, 40 mg,+ 12,5 mg, x 30 cprs, 40 mg,+ 25 mg, x 30 cprs, Orabase tb, 10 g, 30 g creme 30 g pomada 20 mg cx, 1 fr, plast, x 14 caps, 20 mg, cx, 1 fr, plast, x 28 caps, 1 x 100 ml 1 x 50 ml 10 mg, cx, 14 caps, 20 mg, cx, 7 caps, 7 cartelas 7 cartelas+ 28 7 cartelas+14 Inj, 4 mg/ml po liof, 1 FA+ amp, dil, x 10 ml 10 mg, 14 caps, 20 mg, 14 caps, 20 mg, 4 bl, x 7 cprs, 40 mg, bl, 7 caps, 10 mg cx, 14 caps, 10 mg, 2 bl, x 7 10 mg, 2 bl, x 7 caps, 10 mg, 2 bl, x 7 caps, gel, mcgran 10 mg, cx, 14 caps,

Laboratorio MILIAN MULTILAB UNIAO QUIMICA TORRENT TORRENT MEPHA MEPHA MEPHA MEPHA MEPHA MEPHA PFIZER PFIZER PFIZER PFIZER PFIZER B-MS B-MS B-MS DUCTO DUCTO FRESENIUS KABI FRESENIUS KABI UCI-FARMA UCI-FARMA ACHE ACHE ACHE SANOFI-AVENTIS EMS EMS EMS EMS LIBBS EMS GERMED BIOSINTETICA MEDLEY

UNIDADE Pco Unt Base A ML 0,08 ML 0,08 ML 0,09 COMP 1,03 COMP 1,98 UND 1,49 CPR 0,33 UND 0,87 CPR 0,51 AP 1,24 CPR 0,99 CPR 2,52 CPR 2,90 COMP 2,44 COMP 2,78 COMP 2,78 G 1,15 G 0,99 G 0,91 CPR 1,08 CAPS 0,93 F,A, 149,28 F,A, 74,65 CPR 0,97 CPR 2,19 COMP 12,11 COMP 12,54 COMP 4,15 FA 75,28 CPR 0,81 CPR 2,10 COMP 1,49 CAPS 4,03 CAPS 0,90 CPR 1,18 CPR 0,87 CPR 1,15 CPR 1,18

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10230 10231 10232 10233 10234 10235 10236 10237 10238 10239 10240 10241 10242 10243 10244 10245 10246 10247 10248 10249 10250 10251 10252 10253 10254 10255 10256 10257 10258 10259 10260 10261 10262 10263 10264 10265 10266 10267

CODIGO BENEFICIO 95022066 OMEPRAZOL - GENERICO 95002910 OMEPRAZOL - GENERICO 95976620 OMEPRAZOL - GENERICO 95002928 OMEPRAZOL - GENERICO 95031383 OMEPRAZOL - GENERICO 95976639 OMEPRAZOL - GENERICO 95976647 OMEPRAZOL - GENERICO 95031375 OMEPRAZOL - GENERICO 95976655 OMEPRAZOL - GENERICO 95002936 OMEPRAZOL - GENERICO 95033149 OMEPRAZOL - GENERICO 95022104 OMEPRAZOL - GENERICO 95022090 OMEPRAZOL - GENERICO 95033157 OMEPRAZOL - GENERICO 95058605 OMEPRAZOL - GENERICO 95031499 OMEPRAZOL - GENERICO 95976663 OMEPRAZOL - GENERICO 95002944 OMEPRAZOL - GENERICO 95976671 OMEPRAZOL - GENERICO 95976680 OMEPRAZOL - GENERICO 95976698 OMEPRAZOL - GENERICO 95022074 OMEPRAZOL - GENERICO 95031391 OMEPRAZOL - GENERICO 95031430 OMEPRAZOL - GENERICO 95976701 OMEPRAZOL - GENERICO 95002952 OMEPRAZOL - GENERICO 95058613 OMEPRAZOL - GENERICO 95031502 OMEPRAZOL - GENERICO 95083146 OMEPRAZOL - GENERICO 95022082 OMEPRAZOL - GENERICO 95033165 OMEPRAZOL - GENERICO 95002979 OMEPRAZOL - GENERICO 95002987 OMEPRAZOL SODICO - GENERICO 95031537 OMEPROTEC 95031545 OMEPROTEC 95002995 OMEPROTEC 95976710 OMEPROTEC 95530720 OMNIC

APRESENTAÇÃO Laboratorio 10mg, 10bl, x 6 caps, EMS 20 mg cx, 7 caps, LIBBS 20 mg, 1 bl, x 7 EMS 20 mg, 1 bl, x 7 caps, GERMED 20 mg, 1 bl, x 7 caps, gel, mcgran BIOSINTETICA 20 mg, 2 bl, x 7 EMS 20 mg, 2 bl, x 7 caps, GERMED 20 mg, 2 bl, x 7 caps, gel, mcgran BIOSINTETICA 20 mg, 4 bl, x 7 EMS 20 mg, 4 bl, x 7 caps, GERMED 20 mg, bl, 14 caps, gel, dura MERCK 20 mg, bl, 28 caps, CRISTALIA 20 mg, bl, 7 caps, CRISTALIA 20 mg, bl, 7 caps, gel, dura MERCK 20 mg, caps, gel, dura c/mcgran, ct, bl, al, plas, inc, x 30 PRATI DONADUZZI 20 mg, cx, 14 caps, MEDLEY 20 mg, cx, 28 caps, TEUTO BRAS, 20 mg, cx, 4 bl, x 7 caps, MEDLEY 20 mg, fr, 14 caps, MEPHA-RATIOPHARM 20 mg, fr, 28 caps, MEPHA-RATIOPHARM 20 mg, fr, 7 caps, RATIOPHARM 20mg, 10bl, x 6 caps, EMS 40 mg 1 bl,x 7 caps, gel, mcgran BIOSINTETICA 40 mg cx, 7 caps, LIBBS 40 mg, 1 bl, x 7 EMS 40 mg, 1 bl, x 7 caps, GERMED 40 mg, caps, gel, dura c/mcgran, ct, bl, al, plas, inc, x 10 PRATI DONADUZZI 40 mg, cx, 7 caps, MEDLEY 40 mg, po liof, p/sol, inj, cx, 25 FA vd, inc,+ 25 amps, dil, x 10 CRISTALIA ml 40mg, 10bl, x 6 caps, EMS Inj, 40 mg, fr, 25 amps,+ dil, 10 ml EMS IV 40 mg, 25 FA+ 25 dil, CRISTALIA 40 mg, cx, 50 FA+ 50 dil, EUROFARMA 10 mg cx, 14 caps, HEXAL 20 mg cx, 7 caps, HEXAL 20 mg, cx, 28 caps, HEXAL 40 mg, cx, 7 caps, HEXAL 0,4 mg cx, 20 caps, EUROFARMA

UNIDADE Pco Unt Base A CAPS 1,06 CAPS 1,81 CPR 2,27 CAPS 1,74 CPR 2,23 CPR 1,90 CPR 1,74 CPR 2,07 CPR 1,86 CAPS 1,77 CAPS 1,60 CAPS 1,67 CAPS 1,62 CAPS 1,67 CAPS 1,35 CPR 1,91 CPR 0,65 CAPS 1,86 CPR 1,80 CPR 1,67 CPR 2,01 CAPS 1,20 CPR 4,14 CPR 3,22 CPR 3,79 CAPS 3,49 CAPS 3,38 CPR 3,81 FA 18,89 CAPS 3,42 AMP 16,58 F,A, 21,67 F,A, 22,10 CPR 1,17 CPR 2,42 CAPS 1,44 CPR 3,91 CPR 5,17

268

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10268 10269 10270 10271 10272 10273 10274 10275 10276 10277 10278 10279 10280 10281 10282 10283 10284 10285 10286 10287 10288 10289 10290 10291 10292 10293 10294 10295 10296 10297 10298 10299 10300 10301 10302 10303 10304 10305

CODIGO BENEFICIO 95058621 ONCILEG 95058630 ONCILEG 95048707 ONCOBINE 95048715 ONCOBINE 95039775 ONCODOCEL 95039783 ONCODOCEL 95075640 ONCOLOGICOS (FILAXIS/Itaca) 95075780 ONCOLOGICOS (FILAXIS/Itaca) 95075798 ONCOLOGICOS (FILAXIS/Itaca) 95542264 ONCOSIDEO 95542280 ONCOTAXEL 95542272 ONCOTAXEL 95067329 ONCOTECAN 95900977 ONCOVIN 95003029 ONDANLES 95321187 ONDANSETRONA - GENERICO 95321195 ONDANSETRONA - GENERICO 95976728 ONDANTRIL 95976736 ONDANTRIL 95042318 ONDANTRIL 95042326 ONDANTRIL 95067345 ONDRALIX 95067353 ONICIT 95003053 ONTAX 95988769 ONTAX 95022147 ONTRAX 95022163 ONTRAX 95542310 ONXEL 95542302 ONXEL 95039791 OPHTCOL 95542337 O-PLAT 95542329 O-PLAT 95612459 OPOPLEX 95612467 OPOPLEX 95901000 OPRAZON 95380736 OPTACILIN 95380744 OPTACILIN 95022180 OPTAFLAN

APRESENTAÇÃO Creme bisn, 30 g Pom, bisn , 30 g 10 mg/ml sol, inj, FA vd, x 1 ml 10 mg/ml sol, inj, FA vd, x 5 ml 20 mg, sol, inj, FA vd, x 0,5 ml+ FA dil, x 1,5 ml (rest, h 80 mg, sol, inj, FA vd, x 2,0 ml+ FA dil, x 6 ml (rest, hos Carboplatina 150 mg, liof, 1 fr amp, x 150 mg, Cisplatina 10 mg, liof, 1 fr, amp, x 10 mg, Cisplatina 50 mg, liof, 1 fr, amp, x 50 mg, Inj, 100 mg/5 ml cx, 1 fr, Inj, 102 mg/17 ml cx, 1 fr, Inj, 30 mg/5 ml cx, 1 fr, 4 mg, po liof, FA vd, x 10 ml 1 mg, inj, FA+ dil, Inj, 8 mg/4 ml cx, 50 amps, 4 mg/2 ml, 5 amps, 8 mg/4 ml, 5 amps, 4 mg, 10 cprs, rev, 8 mg, 10 cprs, rev, Inj, 4 mg, 50 amps, x 2 ml Inj, 8 mg, 50 amps, x 4 ml 2 mg/ml sol, inj, IM/IV cx, 50 amps, vd, x 2 ml 0,05 mg/ml sol, inj, FA vd, x 5 ml 100 mg, 1 FA 30 mg, 1 FA 2 mg/ml sol, inj, cx, 20 amps, vd, 2 ml 2 mg/ml sol, inj, cx, 20 amps, vd, 4 ml Sol, inj, 102 mg cx, 1 FA Sol, inj, 30 mg cx, 1 FA 0,1 mg/ml sol, oft, FA vd, x 2 ml 100 mg, po liof, 50 mg, po liof, IV inj, ad, cx, 25 amps, 10 ml IV inj, ped, cx, 25 amps, 10 ml Cx, 20 FA+ 20 dil, 10 ml Amp, 250 mg, Amp, 500 mg, 100 mg, cx, 12 cprs,

Laboratorio LEGRAND LEGRAND MEIZLER MEIZLER ZODIAC ZODIAC FRESENIUS KABI FRESENIUS KABI FRESENIUS KABI QUIRAL QUIRAL QUIRAL ZODIAC ABL QUIRAL EUROFARMA EUROFARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA NOVAFARMA SCHERING-PLOUGH LIBBS LIBBS BLAUSIEGEL BLAUSIEGEL DARROW DARROW OPHTHALMOS ZODIAC ZODIAC ICN ICN ARISTON NYCOMED PHARMA NYCOMED PHARMA GALLIA

UNIDADE Pco Unt Base A G 0,56 G 0,53 F,A, 146,78 F,A, 713,08 FA 703,34 X FA 2536,82 X FA 316,40 X FA 39,93 FA 147,65 FA 46,34 FA 1520,54 X FA 447,21 X FA 613,90 FA 28,57 AMP 46,16 AP 23,43 AP 49,62 CPR 2,26 CPR 2,14 AMP 4,37 AMP 8,74 AMP 23,88 FA 203,18 F,A, 1398,10 F,A, 444,16 AMP 33,64 AMP 60,68 FA 1441,88 X FA 498,28 X FA 10,41 FA 2432,01 X FA 1215,98 X AP 4,72 AP 4,34 FA 20,32 AP 6,57 AP 7,37 COMP 1,43

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10306 10307 10308 10309 10310 10311 10312 10313 10314 10315 10316 10317 10318 10319 10320 10321 10322 10323 10324 10325 10326 10327 10328 10329 10330 10331 10332 10333 10334 10335 10336 10337 10338 10339 10340 10341 10342 10343

CODIGO BENEFICIO 95022198 OPTAFLAN 95085700 OPTHAAC 40 95896163 ORALPRED 95280545 ORAP 95280553 ORAP 95500227 ORASTINA 95380752 ORELOX 95380779 ORELOX 95380760 ORELOX 95039805 ORENCIA 95976752 ORGANONEURO OPTICO 95081534 ORMIGREIN 95896171 OROSPREVENT 95896180 OROSPREVENT 95896198 OROSPREVENT 95022210 OROXADIN 95022201 OROXADIN 95550194 ORTHOCLONE OKT-3 95663487 ORTOFLAN 95663460 ORTOFLAN 95663479 ORTOFLAN 95630139 OS-CAL 95630147 OS-CAL 95630155 OS-CAL 95022228 OSSOMAX 95630210 OSTENAN 95630244 OSTENAN 95976760 OSTEOFORM 95630295 OSTEOFORM 95976779 OSTEOFORM 95976787 OSTEOFORM 95022236 OSTEOFORM 95042334 OSTEOFORM 95630317 OSTEORAL 95750088 OTO-BETNOVATE 95750096 OTO-BIOTIC 95976795 OTOCIRIAX 95750100 OTODOL

APRESENTAÇÃO Gts, fr, cgt 15 ml Ampola 1 ml 3 mg/ml sol, oral x 60 ml 1 mg, 20 cprs, 4 mg, blist, 20 cprs, Cx, 5 bl, x 10 amps, 1 ml, emb, mult, 100 mg, 10 cprs, rev, 200 mg, 10 cprs, 8 mg/ml gran, prep, ext, fr, vd,100 ml+ colher dos, Sol, inj, 250 mg, Fr, 20 drags, Cx, 20 cprs, 20 mg,+ 100 mg, 4 bl, x 7+ 7 cprs, 30 mg,+ 100 mg, 4 bl, x 7+ 7 cprs, 60 mg,+ 100 mg, 4 bl, x 7+ 7 cprs, 10 cprs, 30 cprs, Cx, 5 amps, 5 ml 50 mg, 2 bl, x 10 cprs, rev 75 mg, 5 amps, 3 ml, Retard 10 cprs, 100 mg, 500 mg, fr, 60 cprs, D 500 mg, 60 cprs, D 500 mg,+ 200 UI fr, plast, 75 cprs, rev, 70 mg, cx, 4 cprs, 10 mg, 30 cprs, 70 mg, cx, 2 cprs, rev, 10 mg, 2 bl, x 14 cprs, 10 mg, bl, 14 cprs, 70 mg 1 bl, x 2 cprs, 70 mg 1 bl, x 4 cprs, 70 mg, bl, x 8 cprs, 70mg,7bl, x 10 cprs, 10 mg, 2 bl, x 15 cprs, Fr, 5 ml, Fr, 10 ml, 5 ml Fr, 8 ml,

Laboratorio GALLIA OPHTHALMOS BIOLAB SANUS JANSSEN - CILAG JANSSEN - CILAG AVENTIS PHARMA AVENTIS PHARMA AVENTIS PHARMA AVENTIS PHARMA B-MS GROSS ORGANON BAYER BAYER BAYER SANOFI-AVENTIS SANOFI-AVENTIS JANSSEN - CILAG MEDLEY MEDLEY MEDLEY SANOFI-AVENTIS AVENTIS PHARMA AVENTIS PHARMA GALLIA MARJAN MARJAN SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ACHE FARMOQUIMICA FARMASA FARMOQUIMICA FARMION

UNIDADE Pco Unt Base A GOTA 0,05 AMP 39,51 ML 0,22 CPR 0,40 CPR 0,69 AP 3,63 CPR 4,88 CPR 10,47 ML 0,50 FA 1348,32 X CPR 1,97 COMP 0,48 COMP 1,06 COMP 1,27 COMP 1,82 COMP 2,74 COMP 2,66 AP 1857,05 X CPR 0,49 AP 0,74 CPR 0,90 CPR 0,75 CPR 0,68 CPR 0,72 COMP 7,32 CPR 2,34 CPR 17,82 CPR 0,99 CPR 1,31 CPR 7,72 CPR 7,73 COMP 7,60 COMP 7,60 CPR 3,24 GOTAS 0,06 GOTAS 0,02 FA 21,38 GOTAS 0,04

270

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10344 10345 10346 10347 10348 10349 10350 10351 10352 10356 10357 10358 10359 10360 10361 10362 10363 10364 10365 10366 10367 10368 10369 10370 10371 10372 10373 10374 10375 10376 10377 10378 10379 10380 10381 10382 10383 10384

CODIGO BENEFICIO 95976809 OTOFENICOL D 95750126 OTOMICINA 95750134 OTOMIXYN 95750150 OTOSPORIN 95750169 OTOSYNALAR 95750177 OTO-XILODASE 95750185 OTRIVINA 95896201 OTRIVINA 95750207 OTURGA 95750215 OUVIDONAL 95126007 OVIDREL 95067370 OXACILIL 95048464 OXACILINA - GENERICO 95380795 OXACILINA SODICA - GENERICO 95125353 OXACILINA SODICA - GENERICO 95049045 OXACILINA SODICA - GENERICO 95049037 OXACILINA SODICA - GENERICO 95125361 OXACILINA SODICA - GENERICO (Restrito Hosp,) 95075810 OXALIBBS 95075801 OXALIBBS 95022260 OXALIPLATINA - GENERICO 95003088 OXALIPLATINA - GENERICO 95022252 OXALIPLATINA - GENERICO 95075836 OXANON 95075828 OXANON 95901035 OXANON 95896210 OXCARB 95058656 OXCARB 95896228 OXCARB 95896236 OXCARBAMAZEPINA - GENERICO 95896244 OXCARBAMAZEPINA - GENERICO 95896252 OXCARBAMAZEPINA - GENERICO 95896260 OXCARBAMAZEPINA - GENERICO 95112740 OXCARBAZEPINA - GENERICO 95112758 OXCARBAZEPINA - GENERICO 95112766 OXCARBAZEPINA - GENERICO 95112774 OXCARBAZEPINA - GENERICO 95112782 OXCARBAZEPINA - GENERICO

APRESENTAÇÃO Gts,fr,10 ml Gts, fr, 10 ml, Gts, 5 ml, Fr, 10 ml, 1 fr, 5 ml, Cx, 1 fr, 8 ml, 1% 15 ml, Umectante 0,1% 15 ml Gotas 10 ml Gts, fr, 10ml 250 mcg, sol, inj, 1 ser, preenchida x 0,5 ml 500 mg, po inj, cx, 50 FA vd, Po sol, inj, 500 mg, cx, 50 FA 500 mg cx, 50 fr,+ dil, 5 ml, 500 mg, FA po liof, sol, inj, 3 ml + dil, 500 mg, po sol, inj, 50 FA vd,+ 50 dil, amp, vd, x 5 ml 500 mg, po sol, inj, FA vd,+ dil, amp, vd, x 5 ml 500 mg, 50 FA po liof, sol, inj, + 50 dil, 3 ml 100 mg, OR 1 FA 50 mg, OR 1 FA 100 mg, po liof, p/sol, inj, FA vd, x 50 ml 50 mg, 1 FA 50 mg, po liof, p/sol, inj, FA vd, x 50 ml 500 mg, po inj, cx, 100 FA vd, inc, 500 mg, po inj, cx, 50 FA vd, inc, 500 mg, po inj, cx, 50 FA vd,+ 50 amps, dil, plast, x 5 ml 300 mg, 2 bl, x 10 cprs, rev, 6% susp,oralfr,100ml 600 mg, 2 bl, x 10 cprs, rev, 300 mg, 20 cprs, rev, 300 mg, 30 cprs, rev, 600 mg, 20 cprs, rev, 600 mg, 30 cprs, rev, 300 mg, 20 cprs, 300 mg, 30 cprs, 300 mg, 60 cprs, 300 mg, bl, pvc/pvdc x 30 cprs, rev, 600 mg, 20 cprs,

Laboratorio FARMASA MEDLEY EMS FARMOQUIMICA ROCHE APSEN NOVARTIS NOVARTIS LEGRAND NEO QUIMICA MERCK NOVAFARMA TEUTO BRAS, EUROFARMA ASPEN PHARMA AUROBINDO PHARMA AUROBINDO PHARMA ASPEN PHARMA LIBBS LIBBS GLENMARK EUROFARMA GLENMARK ARISTON ARISTON ARISTON UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA MEDLEY MEDLEY MEDLEY MEDLEY RANBAXY RANBAXY RANBAXY ZYDUS RANBAXY

UNIDADE Pco Unt Base A GOTAS 0,03 GOTAS 0,04 GOTAS 0,10 GOTAS 0,04 GOTAS 0,05 GOTAS 0,07 GOTAS 0,01 GOTA 4,91 GOTAS 0,03 GOTAS 0,03 FA 338,28 FA 2,40 F,A, 1,46 FA 1,97 FA 1,85 F,A, 3,96 F,A, 3,96 FA 1,88 FA 2346,53 X FA 1181,58 X FA 1452,10 F,A, 784,99 FA 726,02 FA 2,09 FA 2,02 FA 2,04 COMP 0,95 ML 0,30 COMP 1,92 COMP 0,94 COMP 0,94 COMP 1,81 COMP 1,81 COMP 0,83 COMP 0,83 COMP 0,82 COMP 0,71 COMP 1,60

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10385 10386 10387 10388 10389 10390 10391 10392 10393 10394 10395 10396 10397 10398 10399 10400 10401 10402 10403 10404 10405 10406 10407 10408 10409 10410 10411 10412 10413 10414 10415 10416 10417 10418 10419 10420 10421 10422

CODIGO BENEFICIO 95112790 OXCARBAZEPINA - GENERICO 95112804 OXCARBAZEPINA - GENERICO 95112812 OXCARBAZEPINA - GENERICO 95134700 OXCORD 95134697 OXCORD 95134719 OXCORD 95058664 OXERON 95542345 OXERON 95896279 OXIFRIN 95003100 OXIGEN 95976817 OXINEST 95201050 OXIS 95201041 OXIS 95500235 OXITON 95976841 OXSORALEN 95333533 OXYCONTIN 95333541 OXYCONTIN 95333568 OXYCONTIN 95003126 OXYCONTIN 95988793 PACLIRED 95988807 PACLIRED 95988815 PACLIRED 95067426 PAcl*tAX 95075852 PAcl*tAXEL - GENERICO 95075844 PAcl*tAXEL - GENERICO 95049460 PAcl*tAXEL - GENERICO 95067434 PAcl*tAXEL - GENERICO 95067442 PAcl*tAXEL - GENERICO 95049444 PAcl*tAXEL - GENERICO 95022295 PAcl*tAXEL - GENERICO 95049452 PAcl*tAXEL - GENERICO 95410406 PALUTHER 95896287 PAMELOR 95976850 PAMELOR 95291067 PAMELOR 95291040 PAMELOR 95976868 PAMELOR 95896295 PAMELOR

APRESENTAÇÃO 600 mg, 30 cprs, 600 mg, 60 cprs, 600 mg, bl, pvc/pvdc x 30 cprs, rev, 10 mg, fr, 30 cprs, 20 mg, cx, 20 cprs, Retard 20 mg, cx, 60 cprs, 500 mg, 100 cprs, 500 mg, cx, 100 caps, Sol, nasal ad, 0,5 mg/ml fr, 30 ml Inj, fr, 50 ml, Fr, 10 ml Turb, 12 mcg x 60 D Turb, 6 mcg x 60 D 5 UI cx, 50 amps, 1 ml 1 fr, 30 caps, 10 mg, 30 cprs, 20 mg, 30 cprs, 40 mg, 30 cprs, 40 mg, fr, 12 cprs, 100 mg, 250 mg, 30 mg, 150 mg, FA 100 mg, 6 mg/ml sol, inj, 10 FA vd, x 16,7 ml 30 mg, 6 mg/ml sol, inj, 10 FA vd, x 5 ml 6 mg/ml sol, inj, IV FA vd, x 16,7 ml 6 mg/ml sol, inj, IV FA vd, x 16,7 ml 6 mg/ml sol, inj, IV FA vd, x 25 ml 6 mg/ml sol, inj, IV FA vd, x 5 ml 6 mg/ml sol, inj, IV FA vd, x 50 ml 6 mg/ml sol, inj, IV FA vd, x 50 ml 80 mg, cx, 6 amps, 10 mg, 20 cs, 10 mg, 30 cp 2 mg/ml sol, oral fr, vd, amb, x 100 ml, 25 mg, 20 caps, 25 mg, 30 cp 50 mg, 20 cs,

Laboratorio RANBAXY RANBAXY ZYDUS BIOSINTETICA BIOSINTETICA BIOSINTETICA GLENMARK ITACA TEUTO BRAS, BIOSINTETICA LATINOFARMA ASTRAZENECA ASTRAZENECA UNIAO QUIMICA VALEANT ZODIAC ZODIAC ZODIAC ZODIAC DR, REDDY'S DR, REDDY'S DR, REDDY'S EUROFARMA EUROFARMA EUROFARMA ACCORD GLENMARK GLENMARK ACCORD GLENMARK ACCORD AVENTIS PHARMA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS

UNIDADE Pco Unt Base A COMP 1,61 COMP 1,61 COMP 1,37 CPR 0,39 CPR 0,64 CPR 0,64 COMP 1,52 CPR 1,54 GOTA 11,18 F,A, 72,19 GOTAS 0,07 DOSE 1,74 DOSE 1,04 AP 1,20 CPR 2,18 CPR 5,82 CPR 10,43 CPR 17,74 COMP 15,40 F,A, 1249,46 F,A, 3115,00 F,A, 388,95 FA 1541,30 FA 1013,88 X FA 304,15 X F,A, 1013,88 FA 734,46 FA 1101,74 F,A, 304,13 FA 2446,48 F,A, 3041,67 AP 14,75 COMP 0,53 CPR 0,53 ML 0,21 CPR 0,82 CPR 0,83 COMP 1,20

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10423 10424 10425 10426 10427 10428 10429 10430 10431 10432 10433 10434 10435 10436 10437 10438 10439 10440 10441 10442 10443 10444 10445 10446 10447 10448 10449 10450 10451 10452 10453 10454 10455 10456 10457 10458 10459 10460

CODIGO BENEFICIO 95976876 PAMELOR 95291059 PAMELOR 95976884 PAMELOR 95044035 PAMERGAN 95044736 PAMERGAN 95067485 PAMIDROM 95067493 PAMIDROM 95022309 PAMIDRON 95022317 PAMIDRON 95003150 PAMIDRONATO - GENERICO 95003177 PAMIDRONATO - GENERICO 95988823 PAMIRED 95988831 PAMIRED 95080414 PANCREASE 95067507 PANCURON 95421130 PANFUGAN 95380809 PANGEST 95020993 PANGEST 95058680 PANKREOFLAT 95080430 PANKREOFLAT 95058672 PANKREOFLAT 95750223 PANOTIL NF 95976906 PANOXIL 95976914 PANOXIL 95022325 PANTEC 95058699 PANTEC 95421173 PANTELMIN 95421157 PANTELMIN 95067523 PANTIUM 95067515 PANTIUM 95067531 PANTIUM 95031600 PANTOCAL 95031570 PANTOCAL 95022333 PANTOCAL 95058702 PANTOGAR 95058710 PANTOGAR 95058729 PANTOGAR 95988858 PANTONAX

APRESENTAÇÃO 50 mg, 30 cp 75 mg, 20 caps, 75 mg, 30 cp 25 mg, 20 bl, 10 cps, 50 mg, 50 amps, 2 ml 60 mg, po liof, inj, cx, cprs, 5 frs,+5amps,dil,x10ml 90 mg, po liof, cx, cprs, 5 frs,+ 5 amps, dil, x 10 ml 60 mg, po liof, cx, 5 fr,+ 5 amps, dil, x 10 ml 90 mg, po liof, cx, 5 fr,+ 5 amps, dil, x 10 ml 30 mg, 2 FA vd, x 2 amps, plast, dil, x 10 ml 90 mg, 1 FA vd, x 1 amps, plast, dil, x 10 ml 30 mg, c/2 frs, 60 mg, Fr, 100 caps, 2 mg/ml - 50 amps, 2 ml Cx, 8 caps, 10 mg, 20 caps, Sol, oral vd, 120 ml Cx, 20 drags, Cx, 20 drags, Cx, 30 drags, Sol, otol, fr, vd, cgt x 8 ml Gel 05 tb, 45 g Gel 10 tb, 45 g 150 mg, 1 cap, 150 mg, 2 caps, 500 mg bl, 1 cpr, Vd, 30 ml, 6 mg/ml sol, inj, FA vd, x 16,7 ml 6 mg/ml sol, inj, FA vd, x 5 ml 6 mg/ml sol, inj, FA vd, x 50 ml 20 mg, fr, 7 cprs, 40 mg, fr, 7 cprs, EV 40 mg, po liof, FA+ dil, x 10 ml Bl, 30 caps, Bl, 60 caps, Bl, 90 caps, 40 mg, cx, 7 cprs, rev,

Laboratorio NOVARTIS NOVARTIS NOVARTIS CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA EUROFARMA EUROFARMA DR, REDDY'S DR, REDDY'S JANSSEN - CILAG CRISTALIA NYCOMED PHARMA FARMASA FARMASA APSEN SOLVAY FARMA APSEN ZAMBON STIEFEL STIEFEL CIFARMA CIFARMA JANSSEN - CILAG JANSSEN - CILAG ACCORD ACCORD ACCORD EUROFARMA EUROFARMA EUROFARMA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS MEDQUIMICA

UNIDADE Pco Unt Base A CPR 1,20 CPR 1,62 CPR 1,62 CP 0,28 AMP 1,86 FA 565,71 FA 865,71 FA 565,71 FA 865,71 F,A, 175,36 F,A, 505,99 F,A, 608,27 F,A, 571,10 CPR 1,49 AMP 6,51 CPR 0,48 CPR 0,93 ML 0,16 DRAG 0,47 CPR 0,47 DRAG 0,53 GOTAS 0,06 G 0,35 G 0,36 CAPS 15,62 CAPS 10,15 CPR 7,25 ML 0,29 FA 1247,77 FA 374,35 FA 3743,32 CPR 1,90 CPR 3,17 FA 84,31 CAPS 1,58 CAPS 1,41 CAPS 1,58 COMP 2,51

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10461 10462 10463 10464 10465 10466 10467 10468 10469 10470 10471 10472 10473 10474 10475 10476 10477 10478 10479 10480 10481 10482 10483 10484 10485 10486 10487 10488 10489 10490 10491 10492 10493 10494 10495 10496 10497 10498

CODIGO BENEFICIO 95988840 PANTONAX 95976922 PANTOPAZ 95976930 PANTOPAZ 95976949 PANTOPAZ 95976957 PANTOPAZ 95976965 PANTOPAZ 95976973 PANTOPAZ 95003223 PANTOPRAZOL - GENERICO 95976981 PANTOPRAZOL - GENERICO 95003231 PANTOPRAZOL - GENERICO 95044043 PANTOPRAZOL - GENERICO 95976990 PANTOPRAZOL - GENERICO 95044051 PANTOPRAZOL - GENERICO 95977007 PANTOPRAZOL - GENERICO 95022341 PANTOPRAZOL - GENERICO 95977015 PANTOPRAZOL - GENERICO 95083162 PANTOPRAZOL - GENERICO 95039830 PANTOPRAZOL - GENERICO 95081569 PANTOPRAZOL - GENERICO 95081550 PANTOPRAZOL - GENERICO 95977023 PANTOPRAZOL - GENERICO 95977031 PANTOPRAZOL - GENERICO 95022368 PANTOPRAZOL - GENERICO 95022376 PANTOPRAZOL - GENERICO 95003240 PANTOPRAZOL - GENERICO 95977040 PANTOPRAZOL - GENERICO 95003258 PANTOPRAZOL - GENERICO 95044060 PANTOPRAZOL - GENERICO 95977058 PANTOPRAZOL - GENERICO 95044078 PANTOPRAZOL - GENERICO 95977066 PANTOPRAZOL - GENERICO 95003266 PANTOPRAZOL - GENERICO 95022350 PANTOPRAZOL - GENERICO 95977074 PANTOPRAZOL - GENERICO 95083154 PANTOPRAZOL - GENERICO 95039821 PANTOPRAZOL - GENERICO 95977082 PANTOPRAZOL - GENERICO 95081577 PANTOPRAZOL - GENERICO

APRESENTAÇÃO 40mg,cx,14cprs,rev, 20 mg, cx, 14 cprs, 20 mg, cx, 28 cprs, 20 mg, cx, 7 cprs, 40 mg, cx, 14 cprs, 40 mg, cx, 28 cprs, 40 mg, cx, 7 cprs, 20 mg, 1 bl, x 14 cprs, 20 mg, 2 bl, x 14 20 mg, 2 bl, x 14 cprs, 20 mg, 2 bl, x 7 cprs, rev, 20 mg, 2 bl, x 7 cprs, rev, 20 mg, 4 bl, x 7 cprs, rev, 20 mg, 4 bl, x 7 cprs, rev, 20 mg, 6 bl, x 10 cprs, rev, 20 mg, bl, 14 20 mg, bl, 42 cprs, rev, 20 mg, bl, 7 cprs, rev, 20 mg, bl, al,/al, x 14 cprs, rev, 20 mg, bl, al,/al, x 28 cprs, rev, 20 mg, bl, x 7 cprs, 20 mg, bl, x 7 cprs, rev, 20 mg, bl,14cprs,rev, 20 mg, bl,28cprs,rev, 40 mg, 1 bl, x 14 cprs, 40 mg, 2 bl, x 14 40 mg, 2 bl, x 14 cprs, 40 mg, 2 bl, x 7 cprs, rev, 40 mg, 2 bl, x 7 cprs, rev, 40 mg, 4 bl, x 7 cprs, rev, 40 mg, 4 bl, x 7 cprs, rev, 40 mg, 50 fr, 10 ml 40 mg, 6 bl, x 10 cprs, rev, 40 mg, bl, 14 40 mg, bl, 42 cprs, rev, 40 mg, bl, 7 cprs, rev, 40 mg, bl, 7 cprs, rev, 40 mg, bl, al,/al, x 14 cprs, rev,

Laboratorio MEDQUIMICA HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL GERMED EMS GERMED GERMED MEDLEY GERMED MEDLEY EMS EMS MEDLEY MERCK SANDOZ SANDOZ EMS MEDLEY MERCK MERCK GERMED EMS GERMED GERMED MEDLEY GERMED MEDLEY EUROFARMA EMS EMS MEDLEY MERCK MEDLEY SANDOZ

UNIDADE Pco Unt Base A COMP 1,46 CPR 1,61 CPR 1,51 CPR 1,89 CPR 2,85 CPR 2,58 CPR 3,20 COMP 0,95 CPR 1,14 COMP 0,79 CP 1,39 CPR 1,50 CP 1,16 CPR 1,43 COMP 0,88 CPR 1,19 COMP 1,21 CP 1,40 COMP 1,48 COMP 1,42 CPR 1,79 CPR 1,79 COMP 1,03 COMP 0,97 COMP 1,59 CPR 2,55 COMP 1,59 CP 2,32 CPR 2,70 CP 2,32 CPR 2,55 F,A, 37,08 COMP 2,30 CPR 2,05 COMP 2,16 CP 2,48 CPR 2,96 COMP 2,67

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Orde Geral 10499 10500 10501 10502 10503 10504 10505 10506 10507 10508 10509 10510 10511 10512 10513 10514 10515 10516 10517 10518 10519 10520 10521 10522 10523 10524 10525 10526 10527 10528 10529 10530 10531 10532 10533 10534 10535 10536

CODIGO BENEFICIO 95081542 PANTOPRAZOL - GENERICO 95977090 PANTOPRAZOL - GENERICO 95022384 PANTOPRAZOL - GENERICO 95022392 PANTOPRAZOL - GENERICO 95058745 PANTOPRAZOL - GENERICO 95058753 PANTOPRAZOL - GENERICO 95058737 PANTOPRAZOL - GENERICO 95003274 PANTOPRAZOL - GENERICO 95003282 PANTOPRAZOL - GENERICO 95003290 PANTOPRAZOL - GENERICO 95058770 PANTOPRAZOL SODICO - GENERICO 95058788 PANTOPRAZOL SODICO - GENERICO 95058796 PANTOPRAZOL SODICO - GENERICO 95058761 PANTOPRAZOL SODICO - GENERICO 95896309 PANTOZOL 95031693 PANTOZOL 95031707 PANTOZOL 95896317 PANTOZOL 95031642 PANTOZOL 95125698 PANTOZOL 95125701 PANTOZOL 95421181 PANVERM 95986022 PANVERM 95033190 PARACETAMOL - GENERICO 95033203 PARACETAMOL - GENERICO 95033211 PARACETAMOL - GENERICO 95083189 PARACETAMOL - GENERICO 95333703 PARACETAMOL - GENERICO 95003304 PARACETAMOL - GENERICO 95073124 PARACETAMOL - GENERICO 95058842 PARACETAMOL - GENERICO 95896333 PARACETAMOL - GENERICO 95058885 PARACETAMOL - GENERICO 95896341 PARACETAMOL - GENERICO 95003312 PARACETAMOL - GENERICO 95003320 PARACETAMOL - GENERICO 95033220 PARACETAMOL - GENERICO 95033238 PARACETAMOL - GENERICO

APRESENTAÇÃO Laboratorio 40 mg, bl, al,/al, x 28 cprs, rev, SANDOZ 40 mg, bl, x 7 cprs, EMS 40 mg, bl,14cprs,rev, MERCK 40 mg, bl,28cprs,rev, MERCK 40 mg, est, 2 bl, 7 cprs, RANBAXY 40 mg, est, 4 bl, 7 cprs, RANBAXY 40 mg, est, bl, 7 cprs, RANBAXY 40 mg, fr, 14 cprs, EUROFARMA 40 mg, fr, 28 cprs, EUROFARMA 40 mg, fr, 7 cprs, EUROFARMA 20 mg, bl, al,/al, x 14 cprs, rev, SANDOZ 20 mg, bl, al,/al, x 28 cprs, rev, SANDOZ 40 mg, bl, al,/al, x 14 cprs, rev, SANDOZ 40 mg, bl, al,/al, x 28 cprs, rev, SANDOZ 20 mg, bl, 42 cprs, rev, (6 semanas) NYCOMED PHARMA 20 mg, cart, 28 cprs, NYCOMED PHARMA 40 mg inj, EV 1 FA NYCOMED PHARMA 40 mg, bl, 42 cprs, rev, (6 semanas) NYCOMED PHARMA 40 mg, cart, 7 cprs, NYCOMED PHARMA 40 mg, gran, rev, ct, 28 envs, NYCOMED PHARMA 40 mg, gran, rev, cx, 2 envs, NYCOMED PHARMA Bl, 6 cprs, TEUTO BRAS, Susp, 30 ml TEUTO BRAS, 100 mg/ml sol, oral fr, 15 ml GERMED 100 mg/ml sol, oral, fr, 15 ml EMS 100 mg/ml sol, oral, fr, 15 ml GEN - LEGRAND 200 mg, gts, fr, 15 ml MEDQUIMICA 200 mg, gts, fr, 15 ml MEDLEY 200 mg/ml sol, or ct fr, plas, opc, gts, x 15 ml UNIAO QUIMICA 200 mg/ml sol, or, ct, 200 frs, plas, opc, got, x 15 ml (hosp,)HIPOLABOR 200 mg/ml sol, or, cx, 200 frs, plas, opc, got, x 10 ml (emb, hosp,) PRATI DONADUZZI 200 mg/ml sol, oral fr, 15 ml GEN - LEGRAND 200 mg/ml sol, oral fr, plast, 15 ml MEPHA-RATIOPHARM 200 mg/ml sol, oral fr, plast, 15 ml FARMASA 200 mg/ml sol, oral fr, plast, opc, got, x 15 ml BIOSINTETICA 200 mg/ml sol, oral, fr, plast, opc, got, x 15 ml MERCK 32 mg/ml sol, oral fr, 60 ml EMS 32 mg/ml sol, oral fr, 60 ml GERMED

UNIDADE Pco Unt Base A COMP 2,44 CPR 2,96 COMP 1,83 COMP 1,71 COMP 2,04 COMP 2,00 COMP 2,07 COMP 1,91 COMP 2,17 COMP 2,06 COMP 1,06 COMP 1,01 COMP 1,91 COMP 1,74 COMP 3,84 CPR 3,50 FA 80,53 COMP 6,66 CPR 7,22 Env 6,16 Env 5,49 CPR 0,33 ML 0,13 GOTA 0,03 GOTA 0,03 GOTA 0,03 Gota 0,02 GOTAS 0,03 GOTA 0,02 GOTA 0,00 GOTA 0,01 GOTA 4,62 GOTA 0,02 GOTA 4,36 GOTA 0,02 GOTA 0,02 GOTA 0,01 GOTA 0,01

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10537 10538 10539 10540 10541 10542 10543 10544 10545 10546 10547 10548 10549

CODIGO BENEFICIO 95033246 PARACETAMOL - GENERICO 95986030 PARACETAMOL - GENERICO 95986049 PARACETAMOL - GENERICO 95896350 PARACETAMOL - GENERICO 95003339 PARACETAMOL - GENERICO 95022449 PARACETAMOL - GENERICO 95022490 PARACETAMOL - GENERICO 95039856 PARACETAMOL - GENERICO 95022457 PARACETAMOL - GENERICO 95022503 PARACETAMOL - GENERICO 95039864 PARACETAMOL - GENERICO 95073108 PARACETAMOL - GENERICO 95039872 PARACETAMOL - GENERICO

APRESENTAÇÃO 32 mg/ml sol, oral fr, 60 ml 500 mg 20 cprs, 500 mg 500 cprs, 500 mg, 100 cprs, 500 mg, 25 bl, x 4 cprs, (HOSP,) 500 mg, 25 bl, x 4 cprs, rev, 500 mg, 25 bl, x 4 cprs, rev, 500 mg, 25 bl, x 4 cprs, rev, 500 mg, 50 bl, x 4 cprs, rev, 500 mg, 50 bl, x 4 cprs, rev, 500 mg, 50 bl, x 4 cprs, rev, 500 mg, bl, al, plas, amb, x 500 cprs, (hosp,) 500 mg, com, ct, 50 bl, al, plas, inc, x 10 (emb, hosp,)

Laboratorio GEN - LEGRAND PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI APOTEX EMS GERMED GEN - LEGRAND EMS GERMED GEN - LEGRAND HIPOLABOR PRATI DONADUZZI

10550 10551 10552 10553 10554 10555 10556 10557 10558 10559 10560 10561 10562 10563 10564 10565 10566 10567 10568 10569 10570 10571 10572 10573 10574

95039880 PARACETAMOL - GENERICO 95058826 PARACETAMOL - GENERICO 95058800 PARACETAMOL - GENERICO 95333762 PARACETAMOL - GENERICO 95977112 PARACETAMOL - GENERICO 95977120 PARACETAMOL - GENERICO 95896376 PARACETAMOL - GENERICO 95896384 PARACETAMOL - GENERICO 95003347 PARACETAMOL - GENERICO 95083197 PARACETAMOL - GENERICO 95022511 PARACETAMOL - GENERICO 95022538 PARACETAMOL - GENERICO 95083200 PARACETAMOL - GENERICO 95003355 PARACETAMOL - GENERICO 95003363 PARACETAMOL - GENERICO 95003371 PARACETAMOL - GENERICO 95977139 PARACETAMOL - GENERICO 95058966 PARACETAMOL - GENERICO 95058974 PARACETAMOL - GENERICO 95022473 PARACETAMOL - GENERICO 95022481 PARACETAMOL - GENERICO 95003380 PARACETAMOL - GENERICO 95022465 PARACETAMOL - GENERICO 95022520 PARACETAMOL - GENERICO 95022546 PARACETAMOL - GENERICO

500 mg, com, ct, bl, al, plas, inc, x 100 (emb, mult,) 500 mg, com, ct, bl, al, plas, inc, x 360 (emb, mult,) 500 mg, cx, 200 cprs, 750 mg 24 cprs, 750 mg cx, c/20 750 mg cx, c/200 750 mg, 100 cprs, 750 mg, 100 cprs, rev, 750 mg, 2 bl, x 10 cprs, 750 mg, 2 bl, x 10 cprs, 750 mg, 2 bl, x 10 cprs, rev, 750 mg, 2 bl, x 10 cprs, rev, 750 mg, 20 bl, x 10 cprs, 750 mg, 20 cprs, 750 mg, 20 cprs, 750 mg, 20 cprs, rev, 750 mg, 200 cprs, 750 mg, 25 bl, lar, x 4 cprs, (mult,) 750 mg, 25 bl, lar, x 8 cprs, (mult,) 750 mg, 5 bl, x 4 cprs, 750 mg, 50 bl, x 4 cprs, 750 mg, 50 bl, x 4 cprs, (HOSP,) 750 mg, 50 bl, x 4 cprs, rev, 750 mg, 50 bl, x 4 cprs, rev, 750 mg, 50 bl, x 4 cprs, rev,

PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, PRATI DONADUZZI TEUTO BRAS, TEUTO BRAS, MEDLEY PRATI DONADUZZI APOTEX MULTILAB GERMED GEN - LEGRAND MULTILAB EUROFARMA BRAINFARMA MERCK EUROFARMA MARIOL MARIOL ARROW ARROW APOTEX NEO QUIMICA GERMED GEN - LEGRAND

UNIDADE Pco Unt Base A GOTA 0,01 COMP 0,32 COMP 0,07 COMP 0,19 COMP 0,79 COMP 0,28 COMP 1,07 CP 0,27 COMP 1,28 COMP 1,07 CP 0,27 COMP 0,16 CP 0,07 CP COMP COMP CPR CPR CPR COMP COMP COMP COMP COMP COMP COMP COMP COMP COMP CPR COMP COMP COMP COMP COMP COMP COMP COMP

0,25 0,26 0,14 0,44 0,34 0,31 0,70 0,31 0,36 0,38 0,38 0,40 0,39 0,29 0,53 0,52 0,40 0,35 0,35 0,53 1,73 1,31 1,90 1,55 1,60

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10575 10576 10577 10578 10579 10580 10581 10582 10583 10584 10585 10586 10587 10588 10589 10590 10591 10592 10593 10594 10595 10596 10597 10598 10599 10600 10601 10602 10603 10604 10605 10606 10607 10608 10609 10610 10611 10612

CODIGO BENEFICIO 95033262 PARACETAMOL - GENERICO 95003398 PARACETAMOL - GENERICO 95058915 PARACETAMOL - GENERICO 95073078 PARACETAMOL - GENERICO 95333711 PARACETAMOL - GENERICO 95058893 PARACETAMOL - GENERICO 95003401 PARACETAMOL - GENERICO 95083170 PARACETAMOL - GENERICO 95896392 PARACETAMOL - GENERICO 95073086 PARACETAMOL - GENERICO 95073132 PARACETAMOL - GENERICO 95058931 PARACETAMOL - GENERICO 95058907 PARACETAMOL - GENERICO 95003410 PARACETAMOL - GENERICO 95073116 PARACETAMOL - GENERICO 95058940 PARACETAMOL - GENERICO 95058958 PARACETAMOL - GENERICO 95058869 PARACETAMOL - GENERICO 95058850 PARACETAMOL - GENERICO 95058834 PARACETAMOL - GENERICO 95058877 PARACETAMOL - GENERICO 95046348 PARACETAMOL - GENERICO 95896406 PARACETAMOL - GENERICO 95896414 PARACETAMOL - GENERICO 95333649 PARACETAMOL - GENERICO 95022430 PARACETAMOL - GENERICO 95022422 PARACETAMOL - GENERICO 95044086 PARACETAMOL - GENERICO 95022414 PARACETAMOL - GENERICO 95073094 PARACETAMOL - GENERICO 95039848 PARACETAMOL - GENERICO 95058923 PARACETAMOL - GENERICO 95333720 PARACETAMOL - GENERICO 95333738 PARACETAMOL - GENERICO 95333673 PARACETAMOL - GENERICO 95333665 PARACETAMOL - GENERICO 95896430 PARACETAMOL - GENERICO 95977147 PARACETAMOL - GENERICO

APRESENTAÇÃO 750 mg, 50 x 4 cprs, 750 mg, bl, 20 cprs, 750 mg, bl, 20 cprs, 750 mg, bl, 20 cprs, 750 mg, bl, 20 cprs, 750 mg, bl, 20 cprs, rev, 750 mg, bl, 200 cprs, 750 mg, bl, 200 cprs, 750 mg, bl, 200 cprs, 750 mg, bl, 200 cprs, (emb, mult,) 750 mg, bl, 200 cprs, (emb, mult,) 750 mg, bl, 200 cprs, (hosp,) 750 mg, bl, 200 cprs, rev, (hosp,) 750 mg, bl, 4 cprs, 750 mg, bl, al, plas, amb, x 500 cprs, (hosp,) 750 mg, bl, lar, x 4 cprs, 750 mg, bl, lar, x 8 cprs, 750 mg, com, rev, ct, bl, al, plas, amb, x 100 (mult,) 750 mg, com, rev, ct, bl, al, plas, amb, x 24 750 mg, com, rev, ct, bl, al, plas, amb, x 300 (emb, hosp,) 750 mg, com, rev, ct, bl, al, plas, amb, x 480 (hosp,) 750 mg, com, rev, ct, bl, al, plas, inc, x 300 (emb, mult,) 750 mg, cx, 20 cprs, 750 mg, cx, 200 cprs, 750 mg, cx, 50 bl, 4 cprs, 750 mg, x 20 cprs, 750 mg, x 200 cprs, (50 bl, x 4) Cprs, ct, bl, al, plas, amb, x 20 Fracao de venda Fracao de venda (4 cprs,) Fracao deVenda Fracao deVenda Gotas 15 ml Gotas 15 ml 200 frs, Gts, 200 mg/ml fr, 15 ml, Gts, 200 mg/ml, fr, 15 ml Gts, fr, 15 ml Gts, fr, 15 ml

Laboratorio ZYDUS UNIAO QUIMICA SANDOZ SANOFI-AVENTIS MEDLEY MEPHA-RATIOPHARM UNIAO QUIMICA ARROW FARMASA SANOFI-AVENTIS SANDOZ SANDOZ MEPHA-RATIOPHARM BRAINFARMA HIPOLABOR MARIOL MARIOL PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI BUNKER BUNKER EMS BIOSINTETICA BIOSINTETICA FARMASA BIOSINTETICA SANOFI-AVENTIS MEDLEY SANDOZ PRATI DONADUZZI PRATI DONADUZZI EMS TEUTO BRAS, GERMED EUROFARMA

UNIDADE Pco Unt Base A CPR 1,24 COMP 0,45 COMP 0,52 COMP 0,45 CPR 0,74 COMP 0,51 COMP 0,42 COMP 0,47 COMP 0,43 COMP 0,41 COMP 0,48 COMP 0,35 COMP 0,49 COMP 0,51 COMP 0,31 COMP 0,35 COMP 0,36 COMP 0,31 COMP 0,44 COMP 0,27 COMP 0,10 COMP 0,25 COMP 0,40 COMP 0,35 CPR 1,79 COMP 0,45 COMP 1,73 CP 0,58 COMP 0,36 COMP 0,41 CP 1,54 COMP 0,35 GOTAS 0,02 UND 2,47 GOTAS 0,02 GOTAS 0,01 GOTA 0,02 GOTAS 0,02

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10613 10614 10615 10616 10617 10618 10619 10620 10621 10622 10623 10624 10625 10626 10627 10628 10629 10630 10631 10632 10633 10634 10635 10636 10637 10638 10639 10640 10641 10642 10643 10644 10645 10646 10647 10648 10649 10650

CODIGO BENEFICIO 95988866 PARACETAMOL - GENERICO 95058818 PARACETAMOL - GENERICO 95136568 PARACETAMOL - GENERICO (Restrito Hosp,) (Liberado) 95136533 PARACETAMOL - GENERICO (Restrito Hosp,) (Liberado) 95136550 PARACETAMOL - GENERICO (Restrito Hosp,) (Liberado) 95136541 PARACETAMOL - GENERICO (Restrito Hosp,) (Liberado) 95083219 PARACETAMOL + FOSFATO DE CODEINA - GENERICO 95333797 PARALGEN 95977155 PARALGEN 95333789 PARALGEN 95333800 PARALON 95542388 PARAPLATIN 95542396 PARAPLATIN 95136576 PARAPSYL 95977171 PARARTRIN 95977180 PARARTRIN 95421211 PARASIN 95421203 PARASIN 95977198 PARAZOL 95977201 PARAZOL 95073140 PARECETREX 95073159 PARECETREX 95333827 PARENZYME 95333835 PARENZYME 95333843 PARENZYME (*) 95333860 PARENZYME (*) 95333851 PARENZYME (*) 95542400 PAREXEL 95003460 PAREXEL 95542418 PAREXEL 95003479 PAREXEL 95031715 PARIET 95031723 PARIET 95560262 PARINORTH 95058982 PARKEXIN 95058990 PARKIDOPA 95977228 PARKIDOPA 95059008 PARKINSOL

APRESENTAÇÃO Gts,200mg/mlfr,15ml Sol, oral 200 mg/ml cx, 50 fr, x 15 ml 500 mg, cx, 200 cprs, (hosp,) 750 mg cx, c/200 (hosp,) Sol, oral 200 mg/ml cx, 100 fr, x 15 ml (hosp,) Sol, oral 200 mg/ml cx, 50 fr, x 15 ml (hosp,) 30 mg, 12 cprs, 20 cprs, 750 mg, 50 bl, x 4 cprs, Gts, 15 ml 2 bl, 6 cps, FA, 150 mg, FA, 450 mg, Cx, 10 saches 300 mg, cx, 30 cprs, 600 mg, cx, 30 cprs, 400 mg, bl, 1 cprs, mast, Susp, oral fr, 10 ml 200 mg, cx, 2 cprs, 40 mg/ml susp, oral fr, 10 ml 500 mg, cx, 200 cprs, 750 mg, cx, 200 cprs, Analg, 2 bl, x 9 drags, Enzimas Cx, 1 bl, 16 drags, Ampic, 16 caps, Ampic, 8 caps, Tetra 500 mg, 8 caps, 100 mg, sol, inj, 150 mg, sol,inj, cx,1FA 30 mg, sol, inj, 300 mg, sol, inj, cx, 1 FA 10 mg, cart, 14 cprs, rev, 20 mg, cart, 7 cprs, rev, 5000 UI 5 ml, cx, 100 FA 5 mg, cx, 30 cprs, 250 mg,+ 25 mg, - 50 bl, 10 cps, 250 mg+ 25 mg cx, 3 bl, x 10 cprs, 2 mg, cx, 75 cprs,

Laboratorio NEO QUIMICA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, ARROW LEGRAND LEGRAND LEGRAND JANSSEN - CILAG B-MS B-MS FARMASA CAZI CAZI ACHE ACHE CAZI CAZI ROYTON ROYTON MEDLEY MEDLEY MEDLEY MEDLEY MEDLEY ZODIAC ZODIAC ZODIAC ZODIAC JANSSEN - CILAG JANSSEN - CILAG ITACA TEUTO BRAS, CRISTALIA CRISTALIA TEUTO BRAS,

UNIDADE Pco Unt Base A GOTA 0,01 GOTA 0,01 COMP 0,29 COMP 0,34 GOTAS 4,08 GOTAS 3,82 COMP 0,84 CPR 0,71 CPR 0,43 GOTAS 0,03 CPR 1,44 FA 486,46 X FA 1260,40 X Sache 2,36 CPR 0,50 CPR 0,86 CPR 6,58 ML 0,67 CPR 2,21 ML 0,03 COMP 0,34 COMP 0,61 CPR 0,84 CPR 0,87 CPR 2,57 CPR 2,81 CPR 1,56 AP 1028,74 F,A, 1509,60 AP 296,86 F,A, 3018,95 CPR 2,74 CPR 7,26 FA 2,87 COMP 0,78 COMP 0,72 CPR 0,99 COMP 0,18

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10651 10652 10653 10654 10655 10656 10657 10658 10659 10660 10661 10662 10663 10664 10665 10666 10667 10668 10669 10670 10671 10672 10673 10674 10675 10676 10677 10678 10679 10680 10681 10682 10683 10684 10685 10686 10687 10688

CODIGO BENEFICIO 95059016 PARKLEN 95977236 PARKLEN 95059032 PARLODEL 95059024 PARLODEL 95350306 PARLODEL 95896449 PAROX 95067540 PARTOGAMA SDF 95067558 PARTOGAMA SDF 95003525 PASALIX 95977279 PASIC 95022562 PASMODEX 95022570 PASMODEX 95380906 PASSIFURIL 95380914 PASSIFURIL 95047336 PASTA D'AGUA 95841849 PASTA DE ALUMINIO 95670130 PASTA STOMAHESIVE 95039902 PATANOL 95039910 PATANOL S 95690174 PATANOL SOL, OFT, 0,1% 95022589 PAXAN 95022597 PAXAN 95003541 PAXIL CR 95003550 PAXIL CR 95003568 PAXIL CR 95003584 PAXTRAT 95007849 PED-ELEMENT 95620591 PEDIALYTE 95620621 PEDIALYTE 95380949 PEFLACIN 95380922 PEFLACIN 95901060 PEGASYS (ICMS 0%) 95067574 PEGINTRON (ICMS 0%) 95067582 PEGINTRON (ICMS 0%) 95067566 PEGINTRON (ICMS 0%) 95067620 PEGINTRON REDIPEN (ICMS 0%) 95067612 PEGINTRON REDIPEN (ICMS 0%) 95067604 PEGINTRON REDIPEN (ICMS 0%)

APRESENTAÇÃO Laboratorio 25 mg,+ 250 mg, ct, 20 bl, x 10 cprs, (hosp,) NEO QUIMICA 25 mg,+ 250 mg, cx, 3 bl, x 10 cprs, NEO QUIMICA 2,5 mg, 14 cp, NOVARTIS 2,5 mg, 28 cp, NOVARTIS Fr, 28 cprs, NOVARTIS 20mg,cx,30cprs, rev, TEUTO BRAS, 250 mcg sol, inj, cart, ser, preenchida de 1,0 ml BAXTER 330 mcg sol, inj, cart, ser, preenchida de 1,32 ml BAXTER Cx, 20cprs, MARJAN 2 bl, x 10 cprs,rev, CRISTALIA 0,25 mg/ml cx, 100 amps, - plast, ISOFARMA 0,25 mg/ml cx, 120 amps, - plast, ISOFARMA Fr, 12 caps, MILLET-ROUX Susp, fr, 40 ml, MILLET-ROUX Tb, 80 g MILIAN TUBO C/ 50 G Tb com 56,7 g 0,1% sol, oft, fr, 5 ml ALCON 2,0 mg/ml sol, oft, fr, plast, x 2,5 ml ALCON Fr, 5 ml ALCON 20mg,bl, 20 cprs, rev, BIOSINTETICA 20mg,bl, 30 cprs, rev, BIOSINTETICA 12,5 mg, 30 cprs, GLAXOSMITHKLINE 25 mg, 10 cprs, GLAXOSMITHKLINE 25 mg, 30 cprs, GLAXOSMITHKLINE 20 mg, com rev, ct, bl, al, plas, inc, x 20 UNIAO QUIMICA AMP C/ 4 ML DARROW 90 po cx, 1 env, NEO QUIMICA 90 sol, fr, 500 ml NEO QUIMICA 400 mg, cx, 10 amps, SANOFI-AVENTIS 400 mg, est, 1 blist, x 10 cprs, SANOFI-AVENTIS 180 mcg/ml sol, inj, 1 ser, preenchida 0,5 ml ROCHE 100 mcg/0,5 ml FA vd, inc,+ amp, dil, 0,7 ml SCHERING-PLOUGH 120 mcg/0,5 ml FA vd, inc,+ amp, dil, 0,7 ml SCHERING-PLOUGH 80 mcg/0,5 ml FA vd, inc,+ amp, dil, 0,7 ml SCHERING-PLOUGH 108 mcg, poliof,sol,inj, 1 ser, duplo compart,+dil,x 0,66ml apos SCHERING-PLOUGH rec,80 mcg/0,5ml 135 mcg, poliof,sol,inj,1ser, duplocompart,+dil,x0,66mlaposrec,100mcg/0,5 SCHERING-PLOUGH ml 162 mcg, poliof,sol, inj, 1 ser,duplocompart,+ dil, x 0,66 mlaposrec,120 SCHERING-PLOUGH mcg/0,5ml

UNIDADE Pco Unt Base A COMP 9,43 CPR 1,08 COMP 2,59 COMP 2,53 CPR 2,44 COMP 2,04 UNID 166,73 UNID 220,15 COMP 0,78 CPR 0,63 AMP 0,29 AMP 0,30 CPR 0,83 ML 0,26 G 0,13 G 0,20 G 0,94 GOTA 0,35 GOTA 0,70 GOTAS 0,34 COMP 1,28 COMP 1,18 COMP 1,38 COMP 5,12 COMP 2,76 COMP 1,36 AMP 8,22 ENV 4,78 ML 0,03 AP 33,71 CPR 15,88 UNID 1211,14 FA 1131,76 X FA 1357,58 X FA 929,84 X FA 929,84 X FA 1131,76 X FA 1357,58 X

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10689 10690 10692 10693 10694 10695 10696 10697 10698 10699 10700 10701 10702 10703 10704 10705 10706 10707 10708 10709 10710 10711 10712 10713 10714 10715 10716 10717 10718 10719 10720 10721 10722 10723 10724 10725 10726 10727

CODIGO BENEFICIO 95067590 PEGINTRON REDIPEN (ICMS 0%) 95067639 PEGINTRON REDIPEN (ICMS 0%) 95380981 PENCILIN V 95910620 PENICIGRAN V 95380990 PENICIGRAN V 95901078 PENKARON 95381023 PENKARON 95381015 PENKARON 95044744 PENTAGLOBIN 95044752 PENTAGLOBIN 95896457 PENTALAC 95663509 PENTASA 95663495 PENTASA 95073167 PENTASA ENEMA 95003592 PENTOX 95581952 PENTOX 95590722 PENTOXIFILINA - GENERICO 95300880 PENTOXIFILINA - GENERICO 95042342 PENTOXIFILINA - GENERICO 95042350 PENTOXIFILINA - GENERICO 95042369 PENTOXIFILINA - GENERICO 95044094 PENTOXIFILINA - GENERICO 95044108 PENTOXIFILINA - GENERICO 95300864 PENTOXIFILINA - GENERICO 95003606 PENTOXIFILINA - GENERICO 95059040 PENTOXIN 95977295 PENTRAL 95022651 PEN-V-CIL 95022660 PEN-V-CIL 95896465 PEN-VE-ORAL 95896473 PEN-VE-ORAL 95400818 PENVIR 95400834 PENVIR (*) 95400842 PENVIR (*) 95031766 PEPRAZOL 95031758 PEPRAZOL 95031782 PEPRAZOL 95986081 PEPTGEL

APRESENTAÇÃO Laboratorio 202,5 mcg, poliof,sol,inj, 1ser, duplocompart,+dil,x0,66 ml apos SCHERING-PLOUGH rec, 150mcg/0,5ml 67,5mcg, po liof, sol, inj,1 ser,duplo compart,+dil,x 0,66 ml apos SCHERING-PLOUGH rec, 50mcg/0,5 ml Cx, 12 cprs, TEUTO BRAS, 1200000 UI cx, 12 cprs LEGRAND 500000 UI cx, 12 cprs, LEGRAND Cx, 100 FA s/dil, ARISTON Cx, 100 FA+ dil, ARISTON Cx, 50 FA+ dil, ARISTON 0,5 g amp, 10 ml BIOTEST 5,0 g fr, 100 ml BIOTEST Xpe, fr, 120 ml UCI-FARMA 1000 mg, 15 sup, FERRING 500 mg, fr, 50 cprs, FERRING 1000 mg, cx, 7 enemas FERRING 400 mg,cx,20cprs, FARMASA Sol, inj, 5 amps, x 5 ml FARMASA 400 mg 2 bl, X 15 cprs, rev, BIOSINTETICA 400 mg cx, 2 bl, x 10 cprs, APOTEX 400 mg, 10 bl, x 6 cprs, rev, EMS 400 mg, 3 bl, x 10 cprs, rev, EMS 400 mg, 3 bl, x 10 cprs, rev, GERMED 400 mg, cprs, rev, ct, bl, al, plas, inc, x 20 SANOFI-AVENTIS 400 mg, cprs, rev, ct, bl, al, plas, inc, x 30 SANOFI-AVENTIS 400 mg, cx, 20 cprs, EMS 400mg,2bl,x10cprs, GERMED 400 mg, cx, 20 cprs, rev, TEUTO BRAS, Cx, 10 cprs, BUNKER 400,000 Ul/5 ml fr, 60 ml CIFARMA 500,000 cprs, 12 cprs, CIFARMA Oral 250 mg, susp, fr, 60 ml EUROFARMA Oral 500,000 ct, 12 cprs, EUROFARMA Labia bisn, 2 g SIGMA PHARMA 125 mg, cx, 10 cprs, SIGMA PHARMA 500 mg, bl, 14 cprs, SIGMA PHARMA 10 mg, cx, 14 caps, LIBBS 20 mg, cx, 7 caps, LIBBS 40 mg, cx, 7 caps, LIBBS Susp, 150 ml TEUTO BRAS,

UNIDADE Pco Unt Base A FA 1712,70 X FA 570,90 X CPR 0,80 CPR 1,88 CPR 0,83 FA 1,57 FA 1,69 FA 1,74 G 62,49 G 248,85 ML 0,18 UND 12,17 CPR 3,78 UNID 18,90 COMP 1,18 AP 1,56 CPR 1,01 CPR 0,94 COMP 1,09 COMP 1,09 COMP 0,95 CP 1,08 CP 1,06 CPR 1,21 COMP 0,92 COMP 1,41 CPR 1,48 ML 0,18 COMP 0,84 GOTA 0,01 COMP 1,17 G 4,03 CPR 4,68 CPR 12,51 CPR 0,94 CPR 1,88 CPR 3,39 ML 0,07

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10728 10729 10730 10731 10732 10733 10734 10735 10736 10737 10738 10739 10740 10741 10742 10743 10744 10745 10746 10747 10748 10749 10750 10751 10752 10753 10754 10755 10756 10757 10758 10759 10760 10761 10762 10763 10764 10765

CODIGO BENEFICIO 95073175 PEPTOZIL 95977309 PEPTOZIL 95977317 PEPTOZIL 95977325 PEPTULAN 95977333 PERCOF 95321225 PERENTAL 95977341 PERFER 95977350 PERFER 95977368 PERFER 95982728 PERFLUOROCTANO LIQUIDO 95003614 PERICON 95977376 PERIDAL 95033319 PERIDAL 95977392 PERIDONA 95896481 PERIDONA 95663525 PERIODONTIL 95300899 PERIPAN 95896490 PERMUT 95896503 PERMUT 95140816 PERSANTIN 95140808 PERSANTIN 95986103 PERSANTIN 95901086 PETINAN 95901094 PETINAN 95901108 PETINAN 95977414 PHARMATON 95977422 PHARMATON 95083227 PHOSFOENEMA 95600299 PIDOMAG 95046909 PIELSANA LOCAO HIDRATANTE 95046879 PIELSANA OLEO DERMOPROTETOR 95046887 PIELSANA OLEO DERMOPROTETOR 95046895 PIELSANA OLEO DERMOPROTETOR 95520732 PILEM 95977430 PILOCAN 95977449 PILOCAN 95720286 PILOCARPINA 95720260 PILOCARPINA

APRESENTAÇÃO Fr, 120 ml, Fracao - 1 bl, x 4 cprs, mast, Fracao - 1 bl, x 6 cprs, mast, 120 mg, cx, 28 cprs, Xpe,fr,120ml, 400 mg, 50 cprs, Fr, 100 ml, Fr, 50 drags, Gts, 30 ml, FR C/ 5 ML 300 mg fr, 45 caps, 10 mg, 2 bl, x 15 cprs, Susp, fr, 100 ml Cx, 20 cprs, Susp, oral fr, 100 ml 250 mg, cx, 20 cprs, 400 cx, 20 cprs, Creme derm, bisn, 10 g Pom, derm, bisn, 10 g 100 mg, 50 drags, 75 mg, fr, 40 drags, Inj, 5 amps, 2 ml, 50 mg/ml sol, inj, cx, 25 amps, vd, x 2 ml 50 mg/ml sol, inj, cx, 5 amps, vd, x 2 ml 50 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml Fr, 100 caps, Fr, 30 caps, Cx, 12 fr, 130 ml Cx, 12 flaconetes Frasco-tampa Flip-Top - 30 ml (IPI incluso) Almotolia 100 ml (IPI incluso) Almotolia 20 ml (IPI incluso) Almotolia 50 ml (IPI incluso) 0,75 mg, cx, 2 cprs, 2% fr, 10 ml 4% fr, 10 ml 1% fr, 10 ml, 2% fr, 10 ml,

Laboratorio COSMED COSMED COSMED FARMASA EUROFARMA MEIZLER LUPER LUPER LUPER ALCON LEGRAND MEDLEY MEDLEY UCI-FARMA UCI-FARMA SANOFI-AVENTIS MEPHA EUROFARMA EUROFARMA BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BIOCHIMICO BIOCHIMICO BIOCHIMICO BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM CRISTALIA BALDACCI DBS DBS DBS DBS UNIAO QUIMICA LATINOFARMA LATINOFARMA ALLERGAN ALLERGAN

UNIDADE Pco Unt Base A ML 0,10 CPR 0,45 CPR 0,63 CPR 1,87 ML 0,15 CPR 1,53 ML 0,05 CPR 0,14 GOTAS 0,01 FR 160,01 CAPS 0,77 CPR 0,37 GOTA 0,01 CPR 0,46 ML 0,33 CPR 2,07 CPR 1,30 GRAMA 0,74 G 0,79 CPR 0,29 CPR 0,15 AMP 0,65 AMP 2,15 AMP 2,15 AMP 2,15 CPR 1,27 CAPS 1,50 UNID 7,75 UND 2,02 UND 11,25 UND 37,58 UND 10,35 UND 22,80 CPR 7,29 GOTAS 0,09 GOTAS 0,10 GOTAS 0,06 GOTAS 0,09

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10766 10767 10768 10769 10770 10771 10772 10773 10774 10775 10776 10777 10778 10779 10780 10781 10782 10783 10784 10785 10786 10787 10788 10789 10790 10791 10792 10793 10794 10795 10796 10797 10798 10799 10800 10801 10802 10803

CODIGO BENEFICIO APRESENTAÇÃO 95720278 PILOCARPINA 4% fr, 10 ml, 95039929 PILOSOL 40 mg/ml sol, oft, fr, plast, got, x 10 ml 95039937 PILOSOL (*) 20 mg/ml sol, oft, fr, plast, got, x 10 ml 95850392 PIODREX PERMETRINA 1% fr, 60 ml, 95126015 PIPERACILINA + TAZOBACTAM - GENERICO 2 g+ 0,25 g po liof, sol, inj, IV FA vd, x 30 ml 95126023 PIPERACILINA + TAZOBACTAM - GENERICO 4 g+ 0,5 g po liof, sol, inj, IV FA vd, x 40 ml 95125370 PIPERACILINA + TAZOBACTAM - GENERICO (Restrito Hosp,) 2,25 g ct c/10 FA 95125388 PIPERACILINA + TAZOBACTAM - GENERICO (Restrito Hosp,) 4,50 g ct c/10 FA 95042377 PIPERACILINA SODICA + TAZOBACTAM - GENER 4 g+ 0,5 g po liof, inj, p/sol, inj, IV ct, 1 FA vd, x 20 m 95084215 PIPERACILINA SODICA + TAZOBACTAM - GENERICO 4 g+ 0,5 g po liof, sol, inj, IV cx, 25 FA vd, x 20 ml (hosp,) 95067663 PIPERAZAM 4 g+ 500 mg, po liof, inj, FA vd, x 50 ml 95280561 PIPORTIL 10 mg, est, 20 cprs, 95280588 PIPORTIL L-4 100 mg, est, 1 amp, 4 ml, 95280570 PIPORTIL L-4 est, 3 amps, 1 ml, 25 mg, 95381139 PIPRAM 400 mg, est, 20 caps, 95381155 PIPUROL 200 mg, caps, gel, dura 2 bl x 10 95381147 PIPUROL 400 mg, caps, gel, dura 2 bl x 10 95381163 PIPUROL Xpe, fr, vd, x 120 ml, 95300902 PIRACETAM - GENERICO 800 mg, 30 cprs, 95986120 PIROGINA 500 mg, cx, 100 cprs, 95986138 PIROGINA Sodica sol,fr,gts,10ml, 95045589 PIROGINA Sol, inj, 500 mg/ml 100 amps, 2 ml 95663541 PIROXENE 20 mg, cx, 15 cprs, revestidos 95896511 PIROXICAM - GENERICO 0,5 mg/g gel bisn, 30 g 95896520 PIROXICAM - GENERICO 0,5 mg/g gel bisn, 30 g 95896538 PIROXICAM - GENERICO 0,5% gel bisn, 30 g 95663614 PIROXICAM - GENERICO 20 mg cx, 1 bl, x 10 caps, 95663606 PIROXICAM - GENERICO 20 mg cx, 1 bl, x 15 caps, 95977457 PIROXICAM - GENERICO 20 mg, 1 bl, x 10 caps, 95977465 PIROXICAM - GENERICO 20 mg, 1 bl, x 15 caps, 95896546 PIROXICAM - GENERICO 20 mg, 10 caps, gel, 95033327 PIROXICAM - GENERICO 20 mg, 10 cprs, 95896554 PIROXICAM - GENERICO 20 mg, 10 cprs, 95059067 PIROXICAM - GENERICO 20 mg, 10 cprs, sol, 95896562 PIROXICAM - GENERICO 20 mg, 15 caps, gel, 95033335 PIROXICAM - GENERICO 20 mg, bl, 10 caps, gel, dura 95033343 PIROXICAM - GENERICO 20 mg, bl, 15 caps, gel, dura 95033351 PIROXICAM - GENERICO 20 mg, bl, 300 caps, gel, dura

Laboratorio ALLERGAN OPHTHALMOS OPHTHALMOS BUNKER AUROBINDO PHARMA AUROBINDO PHARMA EUROFARMA EUROFARMA NOVAFARMA NOVAFARMA LIBRA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS ZAMBON ZAMBON ZAMBON HEXAL TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, SOLVAY FARMA EMS GEN - LEGRAND GERMED APOTEX APOTEX RANBAXY RANBAXY MEDLEY SANDOZ HEXAL SANDOZ MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI

UNIDADE Pco Unt Base A GOTAS 0,13 GOTA 0,07 GOTA 0,04 ML 0,24 FA 41,81 FA 66,96 FA 40,97 FA 65,44 FA 64,21 FA 60,62 FA 90,36 CPR 2,17 AP 40,61 AP 11,71 CPR 0,77 CPR 0,67 CPR 1,32 ML 0,16 CPR 0,34 COMP 0,30 GOTAS 0,02 AMP 0,39 CPR 0,69 GRAMA 0,39 GRAMA 0,37 GRAMA 10,19 CPR 0,65 CPR 0,57 CPR 0,59 CPR 0,52 CAPS 0,70 CPR 0,58 COMP 0,61 COMP 0,81 CAPS 0,72 CAPS 0,66 CAPS 0,71 CAPS 0,34

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10804 10805 10806 10807 10808 10809 10810 10811 10812 10813 10814 10815 10816 10817 10818 10819 10820 10821 10822 10823 10824 10825 10826 10827 10828 10829 10830 10831 10832 10833 10834 10835 10836 10837 10838 10839 10840 10841

CODIGO BENEFICIO 95039988 PIROXICAM - GENERICO 95663568 PIROXICAM - GENERICO 95039970 PIROXICAM - GENERICO 95033360 PIROXICAM - GENERICO 95663592 PIROXICAM - GENERICO 95059075 PIROXICAM - GENERICO 95067680 PIROXICAM - GENERICO 95039961 PIROXICAM - GENERICO 95977473 PIROXICAM - GENERICO 95896570 PIROXICAM - GENERICO 95896589 PIROXICAM - GENERICO 95022805 PIROXICAM - GENERICO (*) 95040358 PIROXICAM - GENERICO (*) 95022783 PIROXICAM - GENERICO (*) 95083235 PIROXICAM - GENERICO (*) 95022775 PIROXICAM - GENERICO (*) 95896597 PIROXICAM - GENERICO (*) 95022791 PIROXICAM - GENERICO (*) 95039996 PIROXICAM - GENERICO (*) 95022767 PIROXICAM - GENERICO (*) 95040366 PIROXICAM - GENERICO (*) 95022813 PIROXIN 95022821 PIROXIN 95040374 PIROXIN 95977490 PIROXINID 95977503 PIROXINID 95321233 PLAGEX 95321241 PLAGEX 95033378 PLAGEX 95059083 PLAGREL 95059091 PLAGREL 95977511 PLAKETAR 95160523 PLAKETAR 95321314 PLAMET 95321268 PLAMET 95321284 PLAMET 95321292 PLAMET 95321306 PLAMET

APRESENTAÇÃO 20 mg, cap gel, dura ct, bl, al, plas, inc, x 10 20 mg, caps, gel, dura bl, al, plast, x 15 20 mg, cx, 10 caps, 20 mg, cx, 15 caps, 20 mg, fr, 20 caps, 20 mg, str, 15 cprs, sol, 20 mg/ml sol, inj, ct, 2 amps, vd, amb, x 2 ml 5 mg/g gel bisn, 30 g Cprs, sol, 20 mg, 1 bl, x 10 caps, Gel bisn,30 g Gel, 5 mg/g bisn, 30 g 20 mg, 1 bl, x 15 caps, 20 mg, 1 bl, x 15 caps, 20 mg, 10 bl, x 6 caps, 20 mg, bl, 20 cprs, sol, 20 mg, cx, 15 cprs, 20 mg/ml sol, inj, ct, 2 amps, vd, amb, x 2 ml 20mg,1bl,x10caps, 20mg,1bl,x10caps, 20mg,cx,10cprs, Cprs, sol, 20 mg, 1 bl, x 10 cprs, 10 mg, 15 caps, 20 mg, 15 caps, 20 mg, cx, 15 cprs, 10mg,cx,1bl,x15caps, 20 mg, cx, 1 bl, x 15 caps, 20 cprs, Gts, 10 ml Sol, inj, 10 mg/2 ml cx, 100 amps, x 2 ml 75mg, bl,14cprs,rev, 75mg, bl,28cprs,rev, 250 mg, 30 cprs, rev, 250 mg, cx, 20 cprs, rev, 4 mg/ml gts,ped, fr, 20 ml, Cx, 20 cprs, Cx, 5 amps, Sol, fr, 120 ml, Sol, inj, cx, 50 x 2 ml,

Laboratorio PRATI DONADUZZI BIOSINTETICA NEO QUIMICA NEO QUIMICA MERCK SANDOZ ATIVUS EMS RANBAXY ATIVUS RANBAXY GERMED RANBAXY EMS GEN - LEGRAND EMS ATIVUS GERMED RANBAXY EMS RANBAXY CIFARMA CIFARMA CIFARMA DUCTO DUCTO TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, SANDOZ SANDOZ BIOLAB SANUS BIOLAB SANUS LIBBS LIBBS LIBBS LIBBS LIBBS

UNIDADE Pco Unt Base A CP 0,73 CPR 0,83 CP 0,81 CAPS 0,85 CPR 0,56 COMP 0,81 AMP 3,22 G 0,43 CPR 0,77 G 0,30 G 0,30 CAPS 0,71 CP 0,55 COMP 0,83 COMP 0,39 COMP 0,85 AMP 3,34 CAPS 0,76 CP 0,59 COMP 0,60 CP 0,80 COMP 0,32 COMP 0,34 CP 0,40 CPR 0,24 CPR 0,38 CPR 0,28 GOTAS 0,03 AMP 0,30 COMP 3,20 COMP 3,20 CPR 1,32 CPR 1,33 GOTAS 0,05 CPR 1,04 AP 6,08 ML 0,23 AP 4,78

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10842 10843 10844 10845 10846 10847 10848 10849 10850 10851 10852 10853 10854 10855 10856 10857 10858 10859 10860 10861 10862 10863 10864 10865 10866 10867 10868 10869 10870 10871 10872 10873 10874 10875 10876 10877 10878 10879

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95321330 PLAMIVON Cx, 100 cprs, BUNKER 95321349 PLAMIVON Cx, 12 cprs, BUNKER 95321322 PLAMIVON Gts, fr, 10 ml, BUNKER 95075941 PLAQUEMAX 5 mg, po liof, inj, ct, 1 FA+ 1 amp, dil, x 1 ml BERGAMO 95022830 PLAQUINOL 400 mg, 2 x 15 cprs, SANOFI-AVENTIS 95080473 PLASIL Cx, 20 cprs, SANOFI-AVENTIS 95080503 PLASIL Inj, cx, 100 amps, emb, mult, SANOFI-AVENTIS 95080490 PLASIL Ped, sol, fr, 10 ml, SANOFI-AVENTIS 95080481 PLASIL Sol, fr, 100 ml, SANOFI-AVENTIS 95136584 PLASIL (Restrito Hosp,) 5 mg/ml sol, inj, cx, 100 amps, x 2 ml SANOFI-AVENTIS 95080511 PLASIL ENZIMATICO Cx, 30 drags, SANOFI-AVENTIS 95136592 PLASMIN 450/0,7 (HIDROXIETILAMINO 6%) SOLUFLEX - SIST,Bolsa FECHADO(Restrito 500 ml Hosp,) HALEX ISTAR 95542434 PLATAMINE (CARBOPLATINA) 150 mg, sol, inj, cx, 1 FA PFIZER 95542442 PLATAMINE (CARBOPLATINA) 450 mg, sol, inj, cx, 1 FA PFIZER 95542450 PLATAMINE (CARBOPLATINA) 50 mg, sol, inj, cx, 1 FA PFIZER 95542493 PLATINIL Inj, 10 mg/20 ml cx, 1 fr, QUIRAL 95542485 PLATINIL Inj, 50 mg/100 ml cx, 1 fr, QUIRAL 95542523 PLATISTINE (CISPLATINA) 10 mg, sol, inj, 5 FA plast, PFIZER 95542540 PLATISTINE (CISPLATINA) 100 mg, sol, inj, FA plast, PFIZER 95542531 PLATISTINE (CISPLATINA) 50 mg, sol, inj,FA plast, PFIZER 95084886 PLAVIX 300 mg, bl, 4 cprs, rev, SANOFI-AVENTIS 95022848 PLAVIX 75 mg, 1 x 14 cprs, SANOFI-AVENTIS 95022856 PLAVIX 75 mg, 28 cprs, SANOFI-AVENTIS 95022864 PLAVIX 75 mg, 98 cprs, SANOFI-AVENTIS 95112820 PLAVIX PROTECT 75 mg, bl, al/al x 14 cprs, rev, + 100 mg, bl, al/al x 14 cprs, rev, SANOFI-AVENTIS 95112839 PLAVIX PROTECT 75 mg, bl, al/al x 28 cprs, rev, + 100 mg, bl, al/al x 28 cprs, rev, SANOFI-AVENTIS 95067710 PLAXEL 6 mg/ml sol, inj, FA x 17 ml LIBRA 95067728 PLAXEL 6 mg/ml sol, inj, FA x 5 ml LIBRA 95067701 PLAXEL 6 mg/ml sol, inj, FA x 50 ml LIBRA 95134735 PLENACOR 25 mg 28 cprs, BAGO 95134743 PLENACOR 50 mg 28 cprs, BAGO 95431390 PLENTY 10 mg, 3 bl, 10 caps, gel, dura MEDLEY 95431403 PLENTY 15 mg, 3 bl, 10 caps, gel, dura MEDLEY 95073183 PLESONAX 5 mg, bl, 100 drags, NEO QUIMICA 95022872 PLESONAX 5 mg, bl, 20 drags, NEO QUIMICA 95421220 PLETIL Cx, 4 cprs, PHARMACIA/PFIZER 95896600 PLURAIR 50 mcg/dose fr, spray 120 doses LIBBS 95977538 PLURAIR 50 mcg/dose fr, spray 60 doses LIBBS

UNIDADE Pco Unt Base A CPR 0,35 CPR 0,45 GOTAS 0,03 FA 493,83 X COMP 2,23 CPR 0,28 AP 1,08 GOTAS 0,03 ML 0,10 AMP 1,10 CPR 0,86 UNID 17,57 FA 120,19 FA 362,12 FA 59,48 AP 46,52 FA 217,39 FA 17,51 FA 155,22 FA 82,82 COMP 31,90 COMP 6,50 COMP 6,56 COMP 7,51 COMP 6,49 COMP 6,21 FA 202,87 FA 72,26 FA 4955,45 CPR 0,50 CPR 0,77 CPR 0,86 CPR 0,97 DRAG 0,20 DRAG 0,20 CPR 2,11 JATO 34,14 DOSE 0,36

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10880 10881 10882 10883 10884 10885 10886 10887 10888 10889 10890 10891 10892 10893 10894 10895 10896 10897 10898 10899 10900 10901 10902 10903 10904 10905 10906 10907 10908 10909 10910 10911 10912 10913 10914 10915 10916 10917

CODIGO BENEFICIO 95059105 PLURIMEC 95059113 PLURIMEC 95112847 PLURIMEC 95421254 PLURIVERM 95421262 PLURIVERM 95044116 PNEUMOCRIS 95670149 PO STOMAHESIVE 95896619 POLARAMINE 95003932 POLARAMINE 95231307 POLARAMINE 95231293 POLARAMINE 95231315 POLARAMINE 95022880 POLAREN 95022899 POLAREN 95003940 POLIBIOTIC 95896627 POLIBIOTIC 95896635 POLIBIOTIC 95896643 POLIBIOTIC 95381341 POLICLAVUMOXIL 95381376 POLICLAVUMOXIL 95381368 POLICLAVUMOXIL 95381333 POLICLAVUMOXIL 95510966 POLIGINAX 95510974 POLIGINAX 95381384 POLIMOXIL 95896651 POLIMOXIL 95740279 POLIPRED 95640401 POLIREUMIN 95003983 POLIVITAMINICOS 95612653 POLY-VI-FLUOR 95870202 POMADERME 95977546 PONDERA 95022910 PONDERA 95291172 PONDERA 95022902 PONDERA 95291199 PONDERA 95977554 PONDERA 95977562 PONDUSVITAM

APRESENTAÇÃO 6 mg, str, x 2 cprs, 6 mg, str, x 4 cprs, 6 mg, str, x 8 cprs, Cx, 6 cprs, Susp, vd, 30 cc 2 mg/ml - 50 frs, 120 ml Fr com 28,3 g 2,8 mg/ml sol, oral fr, plast, x 20 ml Cx, 20 cprs, Expect, fr, 120 ml, Liq, fr, 120 ml, Repetabs, est, 12 2 mg, 20 cprs, Sol, oral 100 ml 250 mg, 300 cprs, 40 mg/ml susp, or, cx, 50 fr, plast, x 80 ml (hosp,) 40 mg/ml susp, or, cx, 50 fr, vd, x 80 ml (hosp,) 40 mg/ml susp, or, fr, plast, x 80 ml 500 mg 2 bl, x 6 cprs, BD - 875 mg cx, 12 cprs, BD - susp, 400 mg fr, 70 ml Susp, 250 mg/5 ml fr, 75 ml, Bisn 60 g+ aplic, Cx, 12 ovls,+ aplic, 500 mg, 12 caps, Susp, fr, po 150 ml Fr, 5 ml 20 mg, cx, 1 FA 2 ml CERNE-12 Multivit, liof, - po liof, cx, 10 FA vd, x 5 ml Sol, oral ct c/fr, plast, x 30 ml Pom, 1 x 45 g 10 mg, cx, 20 cprs, 15 mg, 20 cprs, 20 mg, 20 cprs, 25 mg, 20 cprs, 30 mg, 30 cprs, 40 mg, cx, 20 cprs, Cx, 5 bl,4 cprs,

Laboratorio BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS MEDLEY MEDLEY CRISTALIA MANTECORP MANTECORP SCHERING PLOUGH MANTECORP MANTECORP CIFARMA CIFARMA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI EMS EMS EMS EMS SOLVAY FARMA SOLVAY FARMA LEGRAND LEGRAND ALLERGAN TRB-PHARMA BAXTER B-MS LEGRAND EUROFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA IQB

UNIDADE Pco Unt Base A COMP 4,71 COMP 6,75 COMP 2,43 CPR 0,58 ML 0,11 ML 0,20 G 1,87 GOTA 0,04 COMP 0,53 ML 0,14 ML 0,11 CPR 0,99 COMP 0,29 ML 0,09 COMP 0,07 ML 0,02 ML 0,02 ML 0,02 CPR 3,53 CPR 5,05 ML 0,50 ML 0,45 G 0,87 CPR 3,75 CPR 1,76 GOTA 0,01 GOTAS 0,21 FA 229,43 X F,A, 18,53 GOTAS 0,03 G 0,23 CPR 1,38 COMP 1,38 CPR 2,82 COMP 2,82 CPR 4,23 CPR 5,64 CPR 0,67

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10918 10919 10920 10921 10922 10923 10924 10925 10926 10927 10928 10929 10930 10931 10932 10933 10934 10935 10936 10937 10938 10939 10940 10941 10942 10943 10944 10945 10946 10947 10948 10949 10950 10951 10952 10953 10954 10955

CODIGO BENEFICIO 95022929 PONSDRIL 95977570 PONSTAN 95542574 POSIDON 95896660 POSTINOR UNO 95896678 POZATO UNI 95830448 PRACAP 95073191 PRADAXA 95073205 PRADAXA 95112855 PRADAXA 95112863 PRADAXA 95112871 PRADAXA 95112880 PRADAXA 95073213 PRADAXA 95073221 PRADAXA 95120971 PRADINOLOL 95977597 PRAMIDALIN 95977600 PRAMINAN 95431411 PRANDIN 95431420 PRANDIN 95431438 PRANDIN 95977619 PRANOLAL 95977627 PRANOLAL 95977635 PRANOLAL 95977643 PRATAZINE 95977651 PRATAZINE 95977660 PRATAZINE 95977678 PRATAZINE 95381465 PRATICILIN 95040404 PRATICILIN 95896686 PRATIDERM 95040412 PRATIDERM 95040420 PRATIGLOS 95040439 PRATIGLOS 95003991 PRATIPRAZOL 95022953 PRATIPRAZOL 95896694 PRATIPRAZOL 95040471 PRATIPRAZOL 95040447 PRATIPRAZOL

APRESENTAÇÃO Laboratorio 500 mg, 24 cprs, LEGRAND 500 mg, 2bl,x12cprs, PFIZER Sol, inj, 100 mg cx, 10 FA DARROW 1,5 mg, bl, 1 cpr, ACHE 1,5 mg, bl, 1 cpr, LIBBS Cx, 30 cprs, DARROW 110 mg, bl, 10 caps, dura BOEHRINGER INGELHEIM 110 mg, bl, 30 caps, dura BOEHRINGER INGELHEIM 110 mg, bl, 60 caps, dura BOEHRINGER INGELHEIM 150 mg, bl, 10 caps, dura BOEHRINGER INGELHEIM 150 mg, bl, 30 caps, dura BOEHRINGER INGELHEIM 150 mg, bl, 60 caps, dura BOEHRINGER INGELHEIM 75 mg, bl, 10 caps, dura BOEHRINGER INGELHEIM 75 mg, bl, 30 caps, dura BOEHRINGER INGELHEIM 80 mg cx, 2 bl, x 10 cp, DUCTO 250 mg, cx, 3 bl, x 10 cprs, DUCTO 25 mg, cx, 20 cprs, CAZI 0,5 mg, 2 bl, x 15 cprs, MEDLEY 1,0 mg, 2 bl, x 15 cprs, MEDLEY 2,0 mg, 2 bl, x 15 cprs, MEDLEY 10 mg, cx, 50 cprs, CAZI 40 mg, cx, 50 cprs, CAZI 80 mg, cx, 20 cprs, CAZI Creme bisn, 20 g JOSPER Creme bisn, 50 g JOSPER Creme pote 100 g JOSPER Creme pote 400 g JOSPER 250 mg susp, 60 ml 50 fr, PRATI DONADUZZI 500 mg, cap gel, dura ct, 25 bl, al, plas, inc, x 12 PRATI DONADUZZI 100,000 UI/g+ 200 mg/g pom, derm, bisn, 60 g PRATI DONADUZZI 100,000 UI/g+ 200 mg/g pom, derm, ct, bg, al, x 60 g PRATI DONADUZZI 5,000 UI/g+ 900 UI/g+ 150 mg/g pom, derm, ct, bg, al, x 45 PRATI DONADUZZI 5,000 UI/g+ 900 UI/g+ 150 mg/g pom, derm, cx, 50 bg, al, xPRATI DONADUZZI 10 mg, 14 caps, PRATI DONADUZZI 10 mg, 3 bl, x 10 caps, gel, dura PRATI DONADUZZI 10 mg, 30 bl, x 10 caps, gel dura (Hosp,) PRATI DONADUZZI 10 mg, cap gel, dura microg, ct, 3 bl, al, plas, inc, x 10 PRATI DONADUZZI 10 mg, cap gel, dura microg, ct, fr, plas, opc, x 14 PRATI DONADUZZI

UNIDADE Pco Unt Base A COMP 0,58 CPR 0,73 FA 45,49 COMP 20,33 COMP 16,94 CPR 2,02 CAPS 3,29 CAPS 3,29 CAPS 3,29 CAPS 3,29 CAPS 3,29 CAPS 3,29 CAPS 3,29 CAPS 3,29 X CPR 0,20 CPR 0,26 CPR 0,23 CPR 1,44 CPR 1,80 CPR 2,07 CPR 0,08 CPR 0,13 CPR 0,25 G 0,66 G 0,44 G 0,37 G 0,18 ML 0,04 CP 0,30 GRAMA 19,53 G 0,48 G 0,18 G 0,12 CAPS 1,06 CAPS 1,04 CAPS 0,51 CP 1,18 CP 1,14

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10956 10957 10958 10959 10960 10961 10962 10963 10964 10965 10966 10967 10968 10969 10970 10971 10972 10973 10974 10975 10976 10977 10978 10979 10980 10981 10982 10983 10984 10985 10986 10987 10988 10989 10990 10991 10992 10993

CODIGO BENEFICIO 95022961 PRATIPRAZOL 95004009 PRATIPRAZOL 95896708 PRATIPRAZOL 95896716 PRATIPRAZOL 95004017 PRATIPRAZOL 95040455 PRATIPRAZOL 95040463 PRATIPRAZOL 95040480 PRATIPRAZOL 95073230 PRATIPRAZOL 95896724 PRATIPRAZOL 95004025 PRATIPRAZOL 95022970 PRATIPRAZOL 95023003 PRATI-SAL 95022988 PRATI-SAL 95022996 PRATI-SAL 95112898 PRATI-SAL 95040498 PRATI-SAL 95073248 PRATI-SAL 95059130 PRATSORIN-H 95059121 PRATSORIN-H 95180630 PRAVACOL 95180656 PRAVACOL 95180664 PRAVACOL 95023020 PRAVASTATINA SODICA - GENERICO 95023011 PRAVASTATINA SODICA - GENERICO 95059164 PRAVASTATINA SODICA - GENERICO 95896732 PRAVASTATINA SODICA - GENERICO 95059180 PRAVASTATINA SODICA - GENERICO 95086048 PRAVASTATINA SODICA - GENERICO 95004033 PRAVASTATINA SODICA - GENERICO 95977694 PRAVASTATINA SODICA - GENERICO 95023038 PRAVASTATINA SODICA - GENERICO 95059172 PRAVASTATINA SODICA - GENERICO 95896740 PRAVASTATINA SODICA - GENERICO 95059156 PRAVASTATINA SODICA - GENERICO 95086056 PRAVASTATINA SODICA - GENERICO 95004041 PRAVASTATINA SODICA - GENERICO 95977708 PRAVASTATINA SODICA - GENERICO

APRESENTAÇÃO Laboratorio 20 mg, 25 bl, x 14 caps, gel, dura (hosp,) PRATI DONADUZZI 20 mg, 28 caps, PRATI DONADUZZI 20 mg, 3 bl, x 10 caps, gel, dura PRATI DONADUZZI 20 mg, 300 caps, PRATI DONADUZZI 20 mg, 7 caps, PRATI DONADUZZI 20 mg, cap gel, dura microg, ct, fr, plas, opc, x 28 PRATI DONADUZZI 20 mg, cap gel, dura microg, ct, fr, plas, opc, x 7 PRATI DONADUZZI 20 mg, cap gel, dura microg, cx, 100 fr, plas, opc, x 14 (em PRATI DONADUZZI 20 mg, cap, gel, dura microg, ct, bl, al, plas, inc, x 280 PRATI DONADUZZI 20 mg, fr, 14 caps, gel, dura PRATI DONADUZZI 40 mg, 7 caps, PRATI DONADUZZI 40 mg, bl, x 10 caps, gel, dura PRATI DONADUZZI 3,5 g - 1,5 g - 2,9 g+ 20 g po p/sol, ext, 200 saches x 27, PRATI DONADUZZI 3,5 g - 1,5 g - 2,9 g+ 20 g po p/sol, ext, 4 saches x 27,9 PRATI DONADUZZI 3,5 g - 1,5 g - 2,9 g+ 20 g po p/sol, ext, 50 saches x 27,9 PRATI DONADUZZI 3,5 g + 1,5 g + 2,9 g + 20 g po p/ sol extemp, ct, 100 sach xPRATI 27,9 g DONADUZZI sabor trad, 3,5 g+ 1,5 g+ 2,9 g+ 20 g po p/ sol extemp, ct, 4 sach x PRATI DONADUZZI 3,5 g+ 1,5 g+ 2,9 g+ 20,0 g po p/ sol extemp, ct, 50 sach x 28,84 PRATIg DONADUZZI 30 mg/ml sol, nas, ct, fr, pet, amb, spr, x 60 ml PRATI DONADUZZI 30 mg/ml sol, nas, cx, 50 ct, fr, pet amb, spr, x 60 ml PRATI DONADUZZI 10 mg, 1 blister al/al x 10 cprs, B-MS 20 mg 3 blister al/al x 10 cprs, B-MS 40 mg, fr, 30 cprs, B-MS 10 mg, 3 bl, x 10 cprs, MEPHA-RATIOPHARM 10 mg, bl, 10 cprs, RATIOPHARM 10 mg, bl, 10 cprs, ACCORD 10 mg, bl, 3 x 10 cprs, RANBAXY 10 mg, bl, 30 cprs, ACCORD 10 mg, bl, al/al 30 cprs, MEDLEY 10 mg, c/30 ARROW 10 mg, fr, plast, 30 cprs, APOTEX 20 mg, 3 bl, x 10 cprs, MEPHA-RATIOPHARM 20 mg, bl, 10 cprs, ACCORD 20 mg, bl, 3 x 10 cprs, RANBAXY 20 mg, bl, 30 cprs, ACCORD 20 mg, bl, al/al 30 cprs, MEDLEY 20 mg, c/30 ARROW 20 mg, fr, plast, 30 cprs, APOTEX

UNIDADE Pco Unt Base A CAPS 0,63 CAPS 1,12 CAPS 1,65 CAPS 0,88 CAPS 1,95 CP 1,20 CP 2,10 CP 0,51 CAPS 0,59 CAPS 1,35 CAPS 3,44 CAPS 2,95 ENV 1,46 ENV 1,60 ENV 1,60 ENV 1,70 UND 1,78 ENV 1,51 GOTA 0,35 GOTA 0,01 CPR 1,91 CPR 2,54 CPR 4,83 COMP 1,12 COMP 0,87 COMP 1,18 COMP 0,69 COMP 1,05 CPR 1,05 COMP 0,80 CPR 0,73 COMP 1,62 COMP 1,57 COMP 1,02 COMP 1,54 CPR 1,54 COMP 1,17 CPR 1,05

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 10994 10995 10996 10997 10998 10999 11000 11001 11002 11003 11004 11005 11006 11007 11008 11009 11010 11011 11012 11013 11014 11015 11016 11017 11018 11019 11020 11021 11022 11023 11024 11025 11026 11027 11028 11029 11030 11031

CODIGO BENEFICIO 95059199 PRAVASTATINA SODICA - GENERICO 95059148 PRAVASTATINA SODICA - GENERICO 95086064 PRAVASTATINA SODICA - GENERICO 95004050 PRAVASTATINA SODICA - GENERICO 95031855 PRAZOL 95977716 PRAZOL 95004068 PRAZOL 95126325 PRECEDEX

APRESENTAÇÃO 40 mg, bl, 10 cprs, 40 mg, bl, 30 cprs, 40 mg, bl, al/al 30 cprs, 40 mg, c/30 15 mg, caps, gel, 2 bl, inc, x 7 30 mg, caps, gel, 1 bl, inc, x 14 30 mg, caps, gel, bl, inc, x 7 2 ml cx, 5 FA

Laboratorio ACCORD ACCORD MEDLEY ARROW MEDLEY MEDLEY MEDLEY HOSPIRA

95977759 PRECORTIL 95977767 PRECORTIL 95450947 PRED FORT 95450955 PRED MILD COLIRIO 95042385 PREDI-MEDROL 95450980 PREDINIS 95450998 PREDINIS 95004076 PREDMETIL 95451021 PREDMICIN 95451030 PREDNISOLON 95451056 PREDNISON 95451048 PREDNISON 95977783 PREDNISONA - GENERICO 95004084 PREDNISONA - GENERICO 95977791 PREDNISONA - GENERICO 95023046 PREDNISONA - GENERICO 95033408 PREDNISONA - GENERICO 95059202 PREDNISONA - GENERICO 95083251 PREDNISONA - GENERICO 95977805 PREDNISONA - GENERICO 95083243 PREDNISONA - GENERICO 95073264 PREDNISONA - GENERICO 95073272 PREDNISONA - GENERICO 95073299 PREDNISONA - GENERICO 95977813 PREDNISONA - GENERICO 95896759 PREDNISONA - GENERICO 95896767 PREDNISONA - GENERICO 95977821 PREDNISONA - GENERICO 95044124 PREDNISONA - GENERICO 95977830 PREDNISONA - GENERICO

20 mg, cx, 20 cprs, 5 mg, cx, 20 cprs, Fr, 5 ml Fr, 10 ml 40 mg/ml susp, inj, FA x 2 ml 20 mg, 10 cprs, 5 mg 20 cprs, 500 mg, po liof, sol, inj, 50 FA vd,+ 50 amps, dil, x 8 ml Pom 15 g, Vd, com 100 ml, 20 mg, 20 cprs 5 mg, 20 cprs 20 mg, 1 bl, x 10 20 mg, 1 bl, x 10 cprs, 20 mg, 1 bl, x 10 cprs, 20 mg, 3 bl, x 10 cprs, 20 mg, bl, 10 cprs, 20 mg, bl, 10 cprs, 20 mg, bl, 10 cprs, 20 mg, bl, 10 cprs, 20 mg, bl, 30 cprs, 20 mg, com, ct, bl, al plas, inc, x 10 20 mg, com, ct, bl, al plas, inc, x 20 20 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) 20 mg, ct, c/10 cprs, 20 mg, cx, 10 cprs, 20 mg, cx, 20 cprs, 5 mg, 2 bl, x 10 5 mg, 2 bl, x 10 cprs, 5 mg, 2 bl, x 10 cprs,

CAZI CAZI ALLERGAN ALLERGAN UNIAO QUIMICA LEGRAND LEGRAND EUROFARMA EMS SANOFI-AVENTIS UNIAO QUIMICA UNIAO QUIMICA GERMED GEN - LEGRAND EMS EMS UNIAO QUIMICA MEPHA-RATIOPHARM MEDLEY BRAINFARMA MEDLEY PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI EUROFARMA NEO QUIMICA NEO QUIMICA GERMED GEN - LEGRAND EMS

UNIDADE Pco Unt Base A COMP 2,98 COMP 2,98 CPR 3,09 COMP 2,34 CPR 1,02 CPR 1,78 CAPS 2,04 FA 113,83 CPR CPR GOTAS GOTAS FA CPR CPR F,A, G ML CPR CPR CPR COMP CPR COMP CPR COMP COMP CPR COMP UNID UNID UNID CPR COMP COMP CPR CP CPR

0,68 0,53 0,25 0,13 9,31 0,93 0,27 41,26 1,31 0,21 0,67 0,39 1,04 0,93 1,14 0,96 1,16 1,14 1,14 0,85 1,16 1,11 1,51 0,32 1,05 1,06 1,00 0,36 0,38 0,39

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11032 11033 11034 11035 11036 11037 11038 11039 11040 11041 11042 11043 11044 11045 11046 11047 11048 11049 11050 11051 11052 11053 11054 11055 11056 11057 11058 11060 11061 11062 11063 11064 11065 11066 11067 11068 11069 11070

CODIGO BENEFICIO 95004106 PREDNISONA - GENERICO 95023054 PREDNISONA - GENERICO 95033416 PREDNISONA - GENERICO 95059210 PREDNISONA - GENERICO 95083260 PREDNISONA - GENERICO 95977848 PREDNISONA - GENERICO 95073256 PREDNISONA - GENERICO 95073280 PREDNISONA - GENERICO 95977856 PREDNISONA - GENERICO 95896775 PREDNISONA - GENERICO 95231366 PREDSIM 95231331 PREDSIM 95231340 PREDSIM 95059229 PREDSIM 95044140 PREDSON 95044132 PREDSON 95977864 PREFEST 95040501 PRE-FOLIC 95067744 PREG-LESS 95149171 PREGNOLAN 95089705 PRELONE 95089713 PRELONE 95031847 PRELONE 95451099 PRELONE 95451110 PRELONE FOSFATO 95023062 PREMARIN 95977872 PRE-MENS 95977899 PRESMIN 95134760 PRESSAT 95059237 PRESSAT 95134778 PRESSAT 95134794 PRESSAT 95134808 PRESSEL 95134824 PRESSEL 95134816 PRESSEL 95004122 PRESSOFLUX 95004130 PRESSOFLUX 95004149 PRESSOMED

APRESENTAÇÃO 5 mg, 2 bl, x 20 cprs, 5 mg, 6 bl, x 10 cprs, 5 mg, bl, 20 cprs, 5 mg, bl, 20 cprs, 5 mg, bl, 20 cprs, 5 mg, bl, 20 cprs, 5 mg, com, ct, bl, al plas, inc, x 20 5 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) 5 mg, ct, c/20 cprs, 5 mg, cx, 20 cprs, 20 mg, 1 x 10 cprs, 3 mg/ml sol, oral fr, plast, transp, x 60 ml, pipeta dos, 5 mg, 1 x 10 cprs, Gts, 11 mg/ml ct, fr, plast, opc, x 20 ml 20 mg, 20 bl, 10 cps, 5 mg, 20 bl, 10 cps, 2 mg, bl, 30 cprs, Cx,4 x 5 cprs, Inj, 150mg,1amp,1ml 150 mg/ml + 10 mg/ml sol inj ct amp vd amb x 1 ml 11 mg/ml fr, plast, got, x 10 ml 11 mg/ml fr, plast, got, x 20 ml 20 mg, cx, 10 cprs, 5 mg, cx, 20 cprs, 3 mg/ml fr, 60 ml+ pip, dos, Creme vag, 1 bisn, x 26 g+ aplic, 2 bl, x 10 cprs, rev, Fr, 5 ml 10 mg, cx, 20 cprs, 2,5 mg, cx, 30 cprs, 5 mg, cx, 20 cprs, 5 mg, cx, 30 cprs, 10 mg, cx, 30 cprs, 20 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 40 mg, cx, 40 cprs, 80 mg, cx, 20 cprs, 10,0 mg, cx, 30 cprs,

Laboratorio EUROGENUS - LEGRAND EMS UNIAO QUIMICA MEPHA-RATIOPHARM MEDLEY BRAINFARMA PRATI DONADUZZI PRATI DONADUZZI EUROFARMA NEO QUIMICA MANTECORP MANTECORP MANTECORP MANTECORP CRISTALIA CRISTALIA JANSSEN - CILAG ELOFAR SIGMA PHARMA MABRA ACHE ACHE ACHE ACHE ACHE WYETH SIGMA PHARMA LATINOFARMA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS LEGRAND LEGRAND LEGRAND MEDQUIMICA MEDQUIMICA MEDQUIMICA

UNIDADE Pco Unt Base A COMP 0,27 COMP 0,33 CPR 0,40 COMP 0,39 COMP 0,26 CPR 0,30 UNID 0,30 UNID 0,14 CPR 0,36 COMP 0,36 CPR 1,63 ML 0,25 CPR 0,56 GOTA 0,05 CP 0,51 CP 3,45 CPR 0,99 CP 0,27 AMP 6,80 AMP 9,36 ML 0,67 ML 0,87 CPR 1,34 CPR 0,52 ML 0,21 GRAMA 1,05 CPR 1,36 GOTAS 0,16 CPR 2,30 COMP 0,54 CPR 1,22 CPR 1,03 CPR 0,60 CPR 0,67 CPR 0,39 COMP 0,15 COMP 0,22 COMP 0,44

289

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11071 11072 11073 11074 11075 11076 11077 11078 11079 11080 11081 11082 11083 11084 11085 11086 11087 11088 11089 11090 11091 11092 11093 11094 11095 11096 11097 11098 11099 11100 11101 11102 11103 11104 11105 11106 11107 11108

CODIGO BENEFICIO 95004157 PRESSOMED 95004165 PRESSOMED 95134832 PRESSOTEC 95134859 PRESSOTEC 95134840 PRESSOTEC 95988912 PRESSTOPRIL 95988920 PRESSTOPRIL 95988939 PRESSTOPRIL 95988947 PRESSTOPRIL 95571523 PREVAX (FOLINATO CALCICO) 95571531 PREVAX (FOLINATO CALCICO) 95571540 PREVAX (FOLINATO CALCICO) 95977902 PREVENCOR 95977910 PREVENCOR 95977929 PREVENCOR 95977937 PREVIANE 95040510 PREVIANE 95004173 PREVIDEZ 2 95059245 PREZISTA 95021027 PRIDECIL 95021035 PRIDECIL 95134875 PRILCOR 95134867 PRILCOR 95977953 PRILCOR 95134883 PRILCOR 95134891 PRILCOR 95134905 PRILPRESSIN 95134913 PRILPRESSIN 95023119 PRIMACOR 95094539 PRIMACOR (REST, HOSPITAL 95023127 PRIMERAL 95059261 PRIMID 95059253 PRIMID 95134921 PRINIVIL 95134948 PRINIVIL 95134930 PRINIVIL 95134956 PRINZIDE 95134964 PRINZIDE

APRESENTAÇÃO 20,0 mg, cx, 30 cprs, 5,0 mg, cx, 30 cprs, 10 mg, 30 cprs, 20 mg, 30 cprs, 5 mg, 30 cprs, 12,5 mg, cx, 16 cprs, 25,0 mg, cx, 16 cprs, 25,0 mg, cx, 28 cprs, 50,0 mg, cx, 16 cprs, 15 mg, cx, 10 cprs, 3 mg/ml inj, 6 amps, 1 ml, 50 mg, inj, cx, 1 FA+ dil, 5 ml 100 mg, cprs,+ 10 mg, cprs, rev, 6 bl, al,pvc/pvdcinc, 100 mg, cprs,+ 20 mg, cprs, rev, 6 bl, al, pvc/pvdc inc, x 100 mg, cprs,+ 40 mg, cprs, rev, 6 bl, al, pvc/pvdc inc, x 1 bl, x 21 cprs, 3 bl, x 21 cprs, 0,75 mg, bl, x 2 cprs, 300 mg, ct, fr, plas, opc 120 cprs, rev, Cx, 20 caps, Gts, 10 ml, 10 mg 30 cprs, rev, 20 mg 30 cprs, rev, 30 mg 2 bl, x 10 cprs, 30 mg 30 cprs, rev, 5 mg 30 cprs, rev, 12,5 mg, bl, c/30 25 mg, bl, c/30 IV 20 ml 1 mg/ml sol, inj, ct, 10 amps, vd, inc, x 10 ml Cx, 20 cprs, 100 mg, cx, 100 cprs, 250 mg, cx, 20 cprs, 10 mg, 30 cprs, 20 mg, 30 cprs, 5 mg, 30 cprs, 10/12,5 mg, 30 cprs, 20/12,5 mg,30 cprs,

Laboratorio MEDQUIMICA MEDQUIMICA TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, MEDQUIMICA MEDQUIMICA MEDQUIMICA MEDQUIMICA BIOSINTETICA BIOSINTETICA BIOSINTETICA MEDLEY MEDLEY MEDLEY LEGRAND LEGRAND EMS JANSSEN - CILAG CHIESI CHIESI SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA LEGRAND LEGRAND SANOFI-AVENTIS SANOFIS-AVENTIS SANOFI-AVENTIS APSEN APSEN MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME

UNIDADE Pco Unt Base A COMP 0,67 COMP 0,27 CPR 0,57 CPR 0,89 CPR 0,36 COMP 0,34 COMP 0,52 COMP 0,33 COMP 0,83 CPR 7,38 AP 8,66 FA 53,72 CPR 6,34 CPR 8,64 CPR 11,54 CPR 0,78 CP 0,61 COMP 8,52 COMP 12,03 CPR 0,75 GOTAS 0,05 CPR 0,72 CPR 1,22 CPR 1,86 CPR 1,60 CPR 0,46 CPR 0,35 CPR 0,42 AMP 92,74 FA 47,99 COMP 0,61 COMP 0,37 COMP 0,87 CPR 2,05 CPR 2,87 CPR 0,92 CPR 1,53 CPR 2,92

290

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11109 11110 11111 11112 11113 11114 11115 11116 11117 11118 11119 11120 11121 11122 11123 11124 11125 11126 11127 11128 11129 11130 11131 11132 11133 11134 11135 11136 11137 11138 11139 11140 11141 11142 11143 11144 11145 11146

CODIGO BENEFICIO 95070168 PRISTIQ 95117164 PRISTIQ 95076115 PRISTIQ 95070150 PRISTIQ 95117172 PRISTIQ 95134972 PRITOR 95134999 PRITOR 95750487 PRIVINA 95612696 PROCAVIT PREMIUM 95612700 PROCAVIT PREMIUM 95978003 PROCIMAX 95978011 PROCIMAX 95896805 PROCIMAX 95896813 PROCIMAX 95059288 PROCSIM 95059270 PROCSIM 95059300 PROCSIM 95059296 PROCSIM 95040528 PROCTO GLYVENOL 95060146 PROCTO GLYVENOL 95060138 PROCTO GLYVENOL 95089721 PROCTYL 95060162 PROCTYL 95073302 PROCTYL 95060170 PROCTYL 95060154 PROCTYL 95135006 PRODIL 95135014 PRODIL 95135022 PRODIL 95059318 PROFENID 95663762 PROFENID (*) 95663770 PROFENID (*) 95663754 PROFENID (*) 95663797 PROFENID (*) 95663720 PROFENID (*) 95663789 PROFENID (*) 95986189 PROFERGAN 95663800 PROFLAM

APRESENTAÇÃO 100 mg, bl, pvc/aclar/al, x 14 cprs, rev, lib, cont, 100 mg, bl, pvc/aclar/al, x 28 cprs, rev, lib, cont, 50 mg, bl, pvc/aclar/al, x 14 cprs, rev, lib, cont, 50 mg, bl, pvc/aclar/al, x 28 cprs, rev, lib, cont, 50 mg, bl, pvc/aclar/al, x 7 cprs, rev, lib, cont, 40 mg, cx, 14 cprs, 80 mg, cx, 28 cprs, Sol, 1% 15 ml, 30 cprs, 60 cprs, 20 mg 14 cprs, 20 mg 28 cprs, 40 mg, 14 cprs, 40 mg, 28 cprs, 250 mg, 14 cprs, rev, bl, 250 mg, 6 cprs, rev, bl, 500 mg, 14 cprs, rev, bl, 500 mg, 6cprs,rev,bl, 10 supositOrios 15 g, 5 supositorios 50 mg/g+ 10 mg/g pom, ret, 5 bisn, x 3 g+ 5 aplic, Cx, 10 sups, Cx, 15 sups, Pom, 10 bisn, x 3 g+ 10 aplic, Pom, 30 g, 1 mg, 1 bl, x 10 cprs, 2 mg, 1 bl, x 10 cprs, 4 mg, 1 bl, x 10 cprs, 1 mg/ml xpe, fr, vd, 150 ml 100 mg, est, 10 suposits, 200 mg, retard est, 10 cprs, 50 mg, est, 24 caps, Bi-profenid 150 mg, cx, 1 bl, x 10 cprs, Enterico 100 mg, 20 cprs, IV 100 mg, po liof, inj, cx, 50 FA 25 mg, cx, 20 cprs, 100 mg 1 bl, x 12 cprs,

Laboratorio WYETH WYETH WYETH WYETH WYETH GLAXOSMITHKLINE GLAXOSMITHKLINE NOVARTIS EMS EMS LIBBS LIBBS LIBBS LIBBS MANTECORP MANTECORP MANTECORP MANTECORP NOVARTIS NOVARTIS NOVARTIS NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA FARMASA FARMASA FARMASA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS TEUTO BRAS, EUROFARMA

UNIDADE Pco Unt Base A COMP 4,60 COMP 4,27 COMP 3,88 COMP 3,88 COMP 3,83 CPR 2,29 CPR 2,94 GOTAS 0,02 CPR 0,79 CPR 0,72 CPR 2,00 CPR 1,35 COMP 2,95 COMP 2,59 COMP 1,53 COMP 2,85 COMP 5,49 COMP 2,15 UND 1,78 G 0,43 UND 1,81 UNID 3,15 UND 2,26 UNID 2,34 G 1,09 G 1,09 CPR 1,63 CPR 2,57 CPR 3,52 ML 0,07 UND 1,88 CPR 2,60 CPR 1,08 CPR 2,50 CPR 1,57 FA 8,29 COMP 0,24 CPR 2,50

291

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11147 11148 11149 11150 11151 11152 11153 11154 11155 11156 11157 11158 11159 11160 11161 11162 11163 11164 11165 11166 11167 11168 11169 11170 11171 11172 11173 11174 11175 11176 11177 11178 11179 11180 11181 11182 11183 11184

CODIGO BENEFICIO 95663827 PROFLAM 95978020 PROFLOX 95381554 PROFLOX 95381546 PROFLOX 95978038 PROFLOX 95004246 PROFLOX 95978046 PROFOL 95910239 PROFOLEN - PROPOFOL 95910220 PROFOLEN - PROPOFOL 95630341 PROGRAF 95470247 PROGRAF 95470239 PROGRAF 95073310 PROGRAF XL 95073329 PROGRAF XL 95340530 PROGRESSE 95340548 PROGRESSE 95542582 PROLEUKIN 95310150 PROLIFT 95350381 PROLOPA 95350365 PROLOPA 95350373 PROLOPA 95033432 PROMECLOR 95300910 PROMETAX 95986197 PROMETAX 95986200 PROMETAX 95300945 PROMETAX 95300953 PROMETAX 95044159 PROMETAZINA, CLORIDRATO DE - GENERICO 95978070 PROMETIDINE 95391606 PRONAZOL 95042393 PRONAZOL 95073337 PRONOLOL 95073353 PRONOLOL 95073345 PRONOLOL 95120998 PROPACOR 95121005 PROPACOR 95896821 PROPAN 95121048 PROPANOLON

APRESENTAÇÃO Cr, tb, 30 g, 250 mg fr, 14 cprs, 250 mg, 10 cprs, 500 mg, 10 cprs, 500 mg, fr, 14 cprs, 750mg, 1bl,x10cprs, Cart, 2 str, x 10 cprs, 20 ml, cx,5 amps, vd, inc, 20 ml, cx,50 amps, vd, inc, 1 mg, 10 bl, x 10 caps, 5 mg, 10 amp, 1 ml 5 mg, 5 bl, x 10 caps, 1 mg, 50 caps, 5 mg, 50 caps, 300 mg c/30 400 mg c/30 18,000,000 UI po liof, inj, 4 mg 20 cprs, 125 mg, fr, 30 cprs, disp, 250 mg, vd, 30 cprs, HBS 125 mg, 30 caps, 50 mg, inj, 50 amps, x 2 ml 1,5 mg 28 caps, 3,0 mg 28 caps, 3,0 mg 56 caps, 4,5 mg 28 caps, 6,0 mg 28 caps, 25 mg, cprs, rev, ct, bl, al, plas, inc, x 20 200 mg, cx, 40 cprs, 1 capsula 150 mg, 4 caps, 40 mg, cx, 20 cprs, 40 mg, cx, 40 cprs, 80 mg, cx, 20 cprs, 40 mg, cx, 20 cprs, 80 mg, cx, 20 cprs, Susp, oral fr, 100 ml 40 mg, 40 cprs,

Laboratorio EUROFARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA MEDLEY BLAUSIEGEL BLAUSIEGEL JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG BIOSINTETICA BIOSINTETICA ZODIAC PHARMACIA/PFIZER ROCHE ROCHE ROCHE EMS BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA SANOFI-AVENTIS CAZI DIFFUCAP - CHEMOBRAS DIFFUCAP - CHEMOBRAS MILIAN MILIAN MILIAN BUNKER BUNKER UCI-FARMA BRASTERAPICA

UNIDADE Pco Unt Base A G 0,68 CPR 1,53 CPR 1,80 CPR 2,89 CPR 2,35 COMP 4,27 CPR 0,66 AP 30,08 AP 32,68 CAPS 6,96 AP 342,32 CPR 34,82 CAPS 8,02 CAPS 40,11 CPR 2,72 CPR 3,44 AP 1461,29 X CPR 4,41 CPR 1,38 CPR 1,85 CPR 1,38 AMP 0,68 CPR 4,19 CAPS 4,81 CAPS 4,78 CPR 5,46 CPR 5,57 CP 0,21 CPR 0,86 CPR 17,72 COMP 12,12 COMP 0,18 COMP 0,06 COMP 0,19 CPR 0,26 CPR 0,32 ML 0,13 CPR 0,11

292

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11185 11186 11187 11188 11189 11190 11191 11192 11193 11194 11195 11196 11197 11198 11199 11200 11201 11202 11203 11204 11205 11206 11207 11208 11209 11210 11211 11212 11213 11214 11215 11216 11217 11218 11219 11220 11221 11222

CODIGO BENEFICIO 95121056 PROPANOX 95121064 PROPANOX 95059326 PROPARK 95047700 PROPESS 95059334 PROPIL (PROPILTIOURACIL) 95440097 PROPIL (PROPILTIOURACIL) 95440100 PROPILRACIL 95720294 PROPINE 95040536 PROPIONATO DE CLOBETASOL 95896830 PROPIONATO DE CLOBETASOL 95896848 PROPIONATO DE CLOBETASOL 95004289 PROPIONATO DE CLOBETASOL 95073361 PROPIONATO DE CLOBETASOL 95004297 PROPIONATO DE CLOBETASOL 95896856 PROPIONATO DE CLOBETASOL 95896864 PROPIONATO DE CLOBETASOL 95004319 PROPIONATO DE CLOBETASOL 95073370 PROPIONATO DE CLOBETASOL 95004327 PROPIONATO DE CLOBETASOL 95040544 PROPIONATO DE CLOBETASOL 95896872 PROPIONATO DE CLOBETASOL 95033440 PROPIONATO DE CLOBETASOL 95004335 PROPIONATO DE CLOBETASOL 95978100 PROPIONATO DE CLOBETASOL 95978089 PROPIONATO DE CLOBETASOL 95004343 PROPIONATO DE CLOBETASOL 95896880 PROPIONATO DE CLOBETASOL 95033459 PROPIONATO DE CLOBETASOL 95004351 PROPIONATO DE CLOBETASOL 95978119 PROPIONATO DE CLOBETASOL 95004360 PROPIONATO DE CLOBETASOL

95004378 PROPIONATO DE CLOBETASOL - GENERICO 95896899 PROPIONATO DE CLOBETASOL - GENERICO 95896902 PROPIONATO DE CLOBETASOL - GENERICO 95896910 PROPIONATO DE CLOBETASOL - GENERICO 95790861 PROPIONATO DE CLOBETASOL - GENERICO 95023186 PROPOTIL 95084231 PROPOTIL

APRESENTAÇÃO 40 mg cx, 40cprs, 80 mg cx, 20cprs, 2 mg, 3 bl, plast, x 25 cprs, 10 mg, cart, 1 pessario 100 mg, tb, 30 cprs, 100 mg, tb, 30 cprs, 100 mg, cx, 30 cprs, Sol, ocular 10 ml, 0,5 mg/g crem, derm, ct, bg, al, x 30 g 0,5 mg/g creme 30 g 0,5 mg/g creme 30 g 0,5 mg/g creme bisn, 30 g 0,5 mg/g creme bisn, 30 g 0,5 mg/g creme derm, bisn, 30 g 0,5 mg/g pom, 30 g 0,5 mg/g pom, 30 g 0,5 mg/g pom, bisn, 30 g 0,5 mg/g pom, bisn, 30 g 0,5 mg/g pom, derm, bisn, 30 g 0,5 mg/g pom, derm, ct, bg, al, x 30 g Creme 0,5 mg/g 30 g Creme 0,5 mg/g bisn, 30 g Creme bisn, 30 g Creme bisn, 30 g Creme bisn,30 g Creme derm, 30 g Pom, 0,5 mg/g 30 g Pom, 0,5 mg/g bisn, 30 g Pom, bisn 30 g Pom, bisn 30 g Pom, derm, 30 g

Laboratorio ROYTON ROYTON UNIAO QUIMICA FERRING PFIZER PHARMACIA/PFIZER BIOLAB SANUS ALLERGAN PRATI DONADUZZI GERMED GEN - LEGRAND EMS EUROFARMA PRATI DONADUZZI GERMED EUROGENUS - LEGRAND EMS EUROFARMA PRATI DONADUZZI PRATI DONADUZZI TEUTO BRAS, NEO QUIMICA EUROFARMA MEDLEY ATIVUS MERCK TEUTO BRAS, NEO QUIMICA EUROFARMA MEDLEY MERCK

Sol, capilar fr, 50 g Sol, capilar fr, 50 g Sol, capilar fr, 50 g Sol, capilar fr, 50 g Pom, bisn 30 g 10 mg/ml 25 amps, 20 ml 10 mg/ml 5 amps, 20 ml

MERCK EMS GERMED GEN - LEGRAND MEDLEY BIOCHIMICO BIOCHIMICO

UNIDADE Pco Unt Base A CPR 0,10 CPR 0,20 COMP 1,12 UNID 156,53 COMP 0,55 CPR 0,53 CPR 0,48 GOTAS 0,08 G 0,38 GRAMA 9,41 GRAMA 7,86 G 0,39 G 0,32 G 0,25 GRAMA 0,31 GRAMA 0,21 G 0,40 G 0,32 GRAMA 0,27 G 0,40 G 0,32 G 0,31 G 0,28 G 0,33 G 0,22 G 0,33 GRAMA 0,33 G 0,32 G 0,25 G 0,33 G 0,34 G GRAMA GRAMA GRAMA G AMP AMP

0,29 0,29 0,24 0,22 0,33 4,70 117,39

293

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11223 11224 11225 11226 11227 11228 11229 11230 11231 11232 11233 11234 11235 11236 11237 11238 11239 11240 11241 11242 11243 11244 11245 11246 11247 11248 11249 11250 11251 11252 11253 11254 11255 11256 11257 11258 11259 11260

CODIGO BENEFICIO 95075950 PROPOTIL 95023178 PROPOTIL 95910298 PROPOVAN 95075968 PROPOVAN 95121072 PROPRANOLOL 95121102 PROPRANOLOL 95121080 PROPRANOLOL 95121099 PROPRANOLOL 95121110 PROPRANOLOM 95023194 PROPRANOLOM 95121129 PROPRANOLOM 95023208 PROPRANOLOM 95530762 PROSCAR 95004386 PROSIGNE 95044760 PROSIGNE 95978143 PROSTAMAN 95978151 PROSTAT 95983120 PROSTAVASIN 95004394 PROSTEM 95059342 PROSTEM 95121170 PROSTIDE 95021051 PROSTIGMINE 95004416 PROSTOKOS 95004424 PROSTOKOS 95125400 PROSTOKOS (Restrito Hosp,) 95983147 PROTAMINA 1,000 UI 95291202 PROTANOL 95381589 PROTECTINA 95381600 PROTECTINA 95004432 PROTECTINA 95023216 PROTECTINA 95067752 PROTHROMPLEX 95896929 PROTOPIC 95896937 PROTOPIC 95023224 PROTOS 95023232 PROTOS 95023240 PROTOVIT 95033467 PROTOVIT

APRESENTAÇÃO 10 mg/ml cx, 50 amps, x 20 ml 10mg/ml10amps,20 ml 10 mg/ml 5 amps, 10 ml 10 mg/ml cx, 5 FA vd, x 20 ml 1 mg, cx, 10 amps, 10 mg, bl, 30 cprs, 40 mg, bl, 30 cprs, 80 mg, bl, 30 cprs, 40 mg cart, 2 bl, x 20 cprs, 40 mg, cx, 300 bl, x 20 cprs, 80 mg cart, bl, 20 cprs, 80 mg, cx, 100 bl, x 20 cprs, 5 mg, cx, 1 bl, x 15 cprs, 100 UI 50 U po liof, inj, ct, FA vd, inc, 50 mg, 20 cprs, Cx, 30 caps, 20 mcg, inj, 10 amps, 100 mg, cx, 30 caps, 50 mg, cx, 30 caps, 5 mg, bl 20 cprs, 0,5 mg/ml cx,50 amps, 1 ml, 200 mcg cx, 50 cprs, 25 mcg cx, 100 cprs, 100 mcg cx, 50 cprs, vag, 1000 UI/ml sol, inj, cx,25 amps, 5 ml, 25 mg, cx, 20 cprs, rev, 100 mg cx, bl, 15 caps, 200 mg cx, bl, 5 caps, 50 mg, cx, bl, 16 caps, 50 mg, cx, bl, 8 caps, T 600 UI FA+ dil, 0,3 mg/g pom, derm, bisn, 10 g 1 mg/g pom, derm, bisn, 10 g 14 saches 28 saches Plus 20 ml Plus 20 ml

Laboratorio BIOCHIMICO BIOCHIMICO CRISTALIA CRISTALIA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES MERCK SHARP & DOHME CRISTALIA CRISTALIA UNIAO QUIMICA MARJAN BIOSINTETICA BALDACCI BALDACCI LIBBS VALEANT HEBRON HEBRON HEBRON VALEANT TEUTO BRAS, GROSS GROSS GROSS GROSS BAXTER ROCHE ROCHE SERVIER SERVIER ROCHE BAYER

UNIDADE Pco Unt Base A AMP 23,48 AMP 23,48 FA 17,96 AMP 32,25 AP 1,84 CPR 0,14 CPR 0,22 CPR 0,36 CPR 0,15 COMP 0,12 CPR 0,18 COMP 0,18 CPR 3,65 F,A, 988,78 UI 9,89 CPR 4,81 CAPS 1,77 CPR 52,79 CAPS 2,05 COMP 1,40 CPR 5,14 AP 0,78 COMP 22,95 COMP 5,22 comp 16,01 AP 2,39 CPR 0,52 CPR 2,01 CPR 3,84 CAPS 0,73 CAPS 0,73 FR 1205,74 X GRAMA 70,02 GRAMA 72,89 ENV 4,42 ENV 4,42 GOTA 0,01 GOTA 0,01

294

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11261 11262 11263 11264 11265 11266 11267 11268 11269 11270 11271 11272 11273 11274 11275 11276 11277 11278 11279 11280 11281 11282 11283 11284 11285 11286 11287 11288 11289 11290 11291 11292 11293 11294 11295 11296 11297 11298

CODIGO BENEFICIO 95986219 PROVERA 95982744 PROVISC 95982752 PROVISC 95982760 PROVISC 95126643 PROVIVE 95126660 PROVIVE 95126651 PROVIVE 95126678 PROVIVE 95067760 PROXACIN 95381619 PROXACIN 95040552 PROXACIN 95381627 PROXACIN 95073388 PROXACIN 95291210 PROZAC 95291245 PROZAC 95291261 PROZAC DURAPAC 95291270 PROZEN 95073396 PROZEN 95978178 PRURIDOL 95040560 PRURIFEN 95231420 PRURIZIN 95231412 PRURIZIN 95231439 PRURIZIN 95081585 PSICOSEDIN 95271449 PSICOSEDIN 95271457 PSICOSEDIN 95291296 PSIQUIAL 95251740 PULMICORT 95251758 PULMICORT 95251723 PULMICORT 95251731 PULMICORT 95073400 PULMOFLUX 95251782 PULMOFLUX 95978186 PULMOSAN 95978194 PULMOSAN 95978208 PULMOSOLVAN 95978216 PULMOSOLVAN 95251812 PULMOZYME

APRESENTAÇÃO 5 mg, est, 14 cprs, SERINGA - CX C/ 1 UNID x 0,40 ML SERINGA - CX C/ 1 UNID x 0,55 ML SERINGA - CX C/ 1 UNID x 0,85 ML 10 mg/ml emu, inj, ct, 5 FA vd, inc, x 10 ml 10 mg/ml emu, inj, ct, 5 FA vd, inc, x 100 ml 10 mg/ml emu, inj, ct, 5 FA vd, inc, x 20 ml 10 mg/ml emu, inj, ct, 5 FA vd, inc, x 50 ml 2 mg/ml sol, inj, cx, 12 frs, plast, trans, x 100 ml (hosp,) 250 mg cx, 1 bl, x 6 cprs, 3,5 mg/ml sol, oft, fr, plast, opc, got, x 5 ml 500 mg cx, 1 bl, x 6 cprs, 500 mg, cx, 80 bl, x 6 cprs, rev, (hosp,) Cx, 2 blis, x 7 caps, Soluvel cx, 1 bl, x 14 cprs, 90 mg 2 bl, x 2 caps, 20 mg cx, 14 caps, 20 mg, bl, 100 caps, gel dura (hosp,) 25%sol,top,fr,100ml Xpe, 1 mg/5 ml vd, 120 ml 10 mg cx, 30 cprs, 25 mg, cx, 30 cprs, Sol, oral fr, 100 ml 10 mg, cx, 20 cprs, 10 mg, cx, 20 cprs, 25 mg, cx, 20 cprs, 20 mg, 14 cprs, Susp, 0,25 mg 2 ml 5 FA Susp, 0,50 mg 2 ml 5 FA Turbo 100 mcg, x 200 D Turbo 200 mcg, x 100 D 2 mg/5 ml xpe, cx, 50 fr, vd, amb, x 100 (hosp,) Liq, 2 mg vd, 100 ml Fr, c/120 ml adu, Fr, c/120 ml inf, Ad, 120 ml Inf, 120 ml 2,5 mg, 6 amps,

Laboratorio PHARMACIA/PFIZER ALCON ALCON ALCON CLARIS CLARIS CLARIS CLARIS NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA ELI LILLY ELI LILLY ELI LILLY TEUTO BRAS, TEUTO BRAS, CAZI NEO QUIMICA DARROW DARROW DARROW FARMASA FARMASA FARMASA MERCK ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA NEO QUIMICA NEO QUIMICA OSORIO DE MORAES OSORIO DE MORAES JOSPER JOSPER ROCHE

UNIDADE Pco Unt Base A COMP 0,56 UNID 67,73 UNID 113,16 UNID 129,00 FA 22,66 FA 27,12 FA 27,55 FA 62,09 FR 70,68 CPR 2,86 GOTA 0,14 CPR 4,39 COMP 3,05 CPR 4,02 CPR 3,48 CPR 23,50 CPR 1,30 CAPS 1,36 ML 0,11 ML 0,22 CPR 0,56 CPR 0,78 ML 0,22 COMP 0,20 CPR 0,19 CPR 0,70 CPR 1,14 FA 4,99 FA 6,24 DOSE 0,32 DOSE 0,64 ML 0,05 ML 0,06 ML 0,12 ML 0,08 ML 0,11 ML 0,08 AP 129,27

295

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11299 11300 11301 11302 11303 11304 11305 11306 11307 11308 11309 11310 11311 11312 11313 11314 11315 11316 11317 11318 11319 11320 11321 11322 11323 11324 11325 11326 11327 11328 11329 11330 11331 11332 11333 11334 11335 11336

CODIGO BENEFICIO 95086110 PURAN T4 95023275 PURAN T4 95023356 PURAN T4 95086129 PURAN T4 95086137 PURAN T4 95023313 PURAN T4 95086145 PURAN T4 95023267 PURAN T4 95086153 PURAN T4 95023321 PURAN T4 95023330 PURAN T4 95086161 PURAN T4 95086072 PURAN T4 95023283 PURAN T4 95086080 PURAN T4 95023291 PURAN T4 95086099 PURAN T4 95023305 PURAN T4 95023348 PURAN T4 95086102 PURAN T4 95004483 PUREGON PEN 95004491 PUREGON PEN 95004505 PURISOLE SM 95841504 PVPI (IODOPOVIDONA) 95841512 PVPI (IODOPOVIDONA) 95982779 PVP-I DEGERMANTE 95982787 PVP-I TINTURA 95982795 PVP-I TOPICO 95031910 PYLORID 95978240 PYLORIPAC 95978259 PYLORIPAC 95978275 PYLORIPAC IBP 95978283 PYLORITRAT 95023364 PYRIDIUM 95023372 PYRIDIUM 95149325 PYRISEPT 95149333 PYRISEPT 95421319 PYR-PAM

APRESENTAÇÃO 100 mcg bl, 28 cprs, 100 mcg, 30 cprs, 112 mcg 2 x 15 cprs, 112 mcg bl, 28 cprs, 125 mcg bl, 28 cprs, 125 mcg, 30 cprs, 150 mcg bl, 28 cprs, 150 mcg, 30 cprs, 175 mcg bl, 28 cprs, 175 mcg, 30 cprs, 200 mcg 3 x 10 cprs, 200 mcg bl, 28 cprs, 25 mcg bl, 28 cprs, 25 mcg, 30 cprs, 50 mcg bl, 28 cprs, 50 mcg, 30 cprs, 75 mcg bl, 28 cprs, 75 mcg, 30 cprs, 88 mcg 2 x 15 cprs, 88 mcg bl, 28 cprs, 300 UI 1 amp, 600 UI 1 amp, 1 x 1000 ml (sorbitol+ manitol) 10% 100 ml, fr, 10% 30 ml, fr, ALMOTOLIA C/ 100 ML ALMOTOLIA C/ 100 ML ALMOTOLIA C/ 100 ML 400 mg, 28 cprs, 10 cart, c/lanso 30 mg,+ clarit, 500 mg,+ amoxi 500 mg, 7 cart, c/lanso 30 mg,+ clarit, 500 mg,+ amoxi 500 mg, 7 cart, c/lanso 30 mg,+clarit, 500 mg,+ amoxi 500 mg,+ 30 mg,+ 500 mg,+ 500 mg, cx, 7 cart, x 8 cprs, 100 mg, x 25 drags, 200 mg, x 18 drags, 100 mg com rev ct 5 bl al plas inc x 5 200 mg com rev ct 2 bl al plas inc x 9 Cx, 6 drags,

Laboratorio SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS ORGANON ORGANON FRESENIUS KABI GEYER GEYER ASTER ASTER ASTER GLAXOSMITHKLINE MEDLEY MEDLEY MEDLEY TEUTO BRAS, ZODIAC ZODIAC MABRA MABRA UCI-FARMA

UNIDADE Pco Unt Base A CPR 0,25 COMP 0,25 COMP 0,48 CPR 0,48 CPR 0,36 COMP 0,36 CPR 0,39 COMP 0,39 CPR 0,49 COMP 0,49 COMP 0,85 CPR 0,85 CPR 0,26 COMP 0,26 CPR 0,29 COMP 0,29 CPR 0,32 COMP 0,32 COMP 0,38 CPR 0,38 AMP 640,58 AMP 1281,31 FR 16,07 ML 0,09 ML 0,23 CADA 10 ML 0,23 CADA 10 ML 0,25 CADA 10 ML 0,23 CPR 2,38 UND 16,17 UND 14,04 UND 14,43 CPR 1,78 DRAG 0,33 DRAG 0,57 DRAG 1,65 DRAG 1,14 CPR 2,62

296

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11337 11338 11339 11340 11341 11342 11343 11344 11345 11346 11347 11348 11349 11350 11351 11352 11353 11354 11355 11356 11357 11358 11359 11360 11361 11362 11363 11364 11365 11366 11367 11368 11369 11370 11371 11372 11373 11374

CODIGO BENEFICIO 95896945 PYR-PAM 95149341 PYVERM 95149350 PYVERM 95381686 QIFTRIN 95381660 QIFTRIN 95790900 QUADRIDERM CREME 95790918 QUADRIDERM POMADA 95978291 QUADRIHEXAL 95790926 QUADRILON 95790934 QUADRILON 95982809 QUELICIN 95040587 QUEMICETINA 95040579 QUEMICETINA 95381759 QUEMICETINA 95381767 QUEMICETINA 95986235 QUEMICETINA 95112901 QUEROK 95112910 QUEROK 95112928 QUEROK 95112936 QUEROPAX 95112944 QUEROPAX 95112952 QUEROPAX 95170367 QUESTRAN LIGHT 95112979 QUETIAPINA, FUMARATO DE - GENERICO 95112987 QUETIAPINA, FUMARATO DE - GENERICO 95112995 QUETIAPINA, FUMARATO DE - GENERICO 95978321 QUIFLOX 95978330 QUIFLOX 95381821 QUIMIOFRAN 95059350 QUINACRIS 95125418 QUINACRIS (Restrito Hosp,) 95004521 QUINICARDINE 95381848 QUINOFLOX 95381856 QUINOFLOX 95381929 QUINOFORM 95542604 RABINEFIL 95896970 RADIFREE 95896988 RADIFREE

APRESENTAÇÃO Susp, oral fr, 40 ml 10 mg/ml sus or ct fr vd amb x 40 ml 100 mg com rev ct bl al plas inc x 6 400/80 mg 20 caps, Susp, vd, 100 ml, 1 bisn, 20 g, 1 bisn, 20 g, Creme bisn, 20 g Creme bisn,15 g Pom, bisn,15 g 500 MG - CX C/ 25 FA 250 mg, 100 cprs, 250 mg, 20 cprs, 250 mg, cx, 20 drags, 500 mg, cx, 20 drags, Xpe, vd, 100 ml, 100 mg, 3 bl, x 10 cprs, rev, 200 mg, 3 bl, x 10 cprs, rev, 25 mg, bl, 14 cprs, rev, 100 mg, 3 bl, x 10 cprs, rev, 200 mg, 3 bl, x 10 cprs, rev, 25 mg, bl, 14 cprs, rev, Po 10 envs, 100 mg, bl, 28 cprs, rev, 200 mg, bl, 28 cprs, rev, 25 mg, bl, 14 cprs, rev, 500 mg, cx, 14 cprs, rev, 500 mg, cx, 6 cprs, rev, 8 mg, sol, inj, 5 amps 4 ml, 150 mg, cprs, rev, ct, bl, al, plas, inc, x 10 250 mg, 20 bl, 10 cprs, rev, Cx, blist, 20 cprs, 250 mg, 6 cprs, 500 mg, 6 cprs, 400 mg, cx, 14 cprs, 10 mg, cx, 1 FA 150 mg, 2 bl, x 10 caps, gel, dura 150 mg, 3 bl, x 10 caps, gel, dura

Laboratorio UCI-FARMA MABRA MABRA HEXAL HEXAL MANTECORP MANTECORP HEXAL NEO QUIMICA NEO QUIMICA ATIVUS PFIZER PFIZER PHARMACIA/PFIZER PFIZER PHARMACIA/PFIZER LEGRAND LEGRAND LEGRAND SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA B-MS SANDOZ SANDOZ SANDOZ TEUTO BRAS, TEUTO BRAS, LIBRA CRISTALIA CRISTALIA BARRENNE BIOLAB SANUS BIOLAB SANUS EMS ITACA NIKKHO NIKKHO

UNIDADE Pco Unt Base A ML 0,40 GOTA 0,02 DRAG 2,44 CPR 0,45 ML 0,08 G 1,20 G 1,21 G 0,92 G 0,91 G 0,86 FA 21,66 CP 0,49 CP 0,57 CPR 0,55 CPR 1,30 ML 0,17 comp 3,91 comp 6,51 comp 1,39 comp 3,91 comp 7,03 comp 1,39 ENV 4,78 comp 4,67 comp 8,41 comp 1,37 CPR 2,58 CPR 3,01 AP 51,06 COMP 0,58 comp 0,51 COMP 0,73 CPR 2,94 CPR 5,38 CPR 1,63 FA 57,92 COMP 1,70 COMP 1,60

297

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11375 11376 11377 11378 11379 11380 11381 11382 11383 11384 11385 11386 11387 11388 11389 11390 11391 11392 11393 11394 11395 11396 11397 11398 11399 11400 11401 11402 11403 11404 11405 11406 11407 11408 11409 11410 11411 11412

CODIGO BENEFICIO 95059369 RAMIPRESS HCT 95004548 RAMIPRIL - GENERICO 95004556 RAMIPRIL - GENERICO 95004564 RAMIPRIL - GENERICO 95004572 RAMIPRIL - GENERICO 95073426 RAMIPRIL - GENERICO 95113002 RAMIPRIL - GENERICO 95113010 RAMIPRIL - GENERICO 95986243 RAMIPRIL - GENERICO 95978437 RAMIPRIL - GENERICO 95044167 RAMIPRIL - GENERICO 95896996 RAMIPRIL - GENERICO 95897003 RAMIPRIL - GENERICO 95004580 RAMIPRIL - GENERICO 95004599 RAMIPRIL - GENERICO 95073418 RAMIPRIL - GENERICO 95978445 RAMIPRIL - GENERICO 95978453 RAMIPRIL - GENERICO 95044175 RAMIPRIL - GENERICO 95004602 RAMIPRIL - GENERICO 95004610 RAMIPRIL - GENERICO 95113029 RAMIPRIL - GENERICO 95113037 RAMIPRIL - GENERICO 95042407 RAMIPRIL + HIDROCLO, - GENERICO 95042415 RAMIPRIL + HIDROCLO, - GENERICO 95040595 RAMIPRIL + HIDROCLO, - GENERICO 95040609 RANIBLOK 95040617 RANIBLOK 95023437 RANICLOR 95023445 RANICLOR 95031995 RANIDIN 95032037 RANIDINA 95032029 RANIDINA 95032045 RANIFLEX 95032053 RANIFLEX 95032088 RANITAK 95032100 RANITAK 95989013 RANITIDIL

APRESENTAÇÃO 5+ 25 mg, 3 bl, x 10 cprs, 2,5 mg, 15 cprs, 2,5 mg, 2 str, x 15 cprs, 2,5 mg, 30 cp 2,5 mg, 30 cprs, 2,5 mg, bl, 30 cprs, 2,5 mg, bl, 30 cprs, 2,5 mg, bl, 60 cprs, 2,5 mg, ct, strip, al/al x 20 2,5 mg, ct, strip, al/al x 30 2,5 mg, str, 30 cprs, 2,5mg,2 bl, x 15 cprs, 5 mg, 2 bl, x 15 cprs, 5 mg, 2 str, x 15 cprs, 5 mg, 30 cp 5 mg, bl, 30 cprs, 5 mg, ct, strip, al/al x 20 5 mg, ct, strip, al/al x 30 5 mg, str, 30 cprs, 5,0 mg, 15 cprs, 5,0 mg, 30 cprs, 5,0 mg, bl, 30 cprs, 5,0 mg, bl, 60 cprs, 5+ 25 mg, 3 bl, x 10 cprs, 5+ 25 mg, 3 bl, x 10 cprs, 5+ 25 mg, 3 bl, x 10 cprs, rev, 150 mg, 2 str, x 10 cprs, rev, 300 mg, 2 str, x 8 cprs, rev, 150 mg, 20 cprs, 300 mg, 20 cprs, 150 mg, 20 cprs, 150 mg cx, 10 cprs, 300 mg, cx, 8 cprs, 150 mg 20 cprs, 300 mg 8 cprs, 150 mg, 10 cprs, 300 mg, 10 cprs, 150 mg, cx, 20 cprs, rev,

Laboratorio SIGMA PHARMA RATIOPHARM BRAINFARMA NOVARTIS MEPHA-RATIOPHARM SANOFI-AVENTIS MEDLEY MEDLEY BIOSINTETICA BIOSINTETICA SANDOZ RANBAXY RANBAXY BRAINFARMA NOVARTIS SANOFI-AVENTIS BIOSINTETICA BIOSINTETICA SANDOZ RATIOPHARM MEPHA-RATIOPHARM MEDLEY MEDLEY GERMED GEN - LEGRAND EMS HEXAL HEXAL CIFARMA CIFARMA UNIAO QUIMICA BUNKER BUNKER ROYTON ROYTON LUPER LUPER MEDQUIMICA

UNIDADE Pco Unt Base A COMP 1,46 COMP 0,65 COMP 0,86 COMP 0,95 COMP 0,80 COMP 0,85 COMP 1,17 COMP 0,88 COMP 1,06 CPR 0,94 CP 1,38 COMP 0,76 COMP 1,43 COMP 1,61 COMP 1,79 COMP 1,65 CPR 1,98 CPR 1,76 CP 2,62 COMP 1,22 COMP 1,51 COMP 2,20 COMP 1,41 COMP 1,60 COMP 1,65 CP 2,37 CP 0,94 CP 1,73 COMP 0,65 COMP 1,19 CPR 1,15 CPR 1,26 CPR 1,91 CPR 0,65 CPR 1,39 CPR 0,79 CPR 1,50 COMP 0,52

298

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11413 11414 11415 11416 11417 11418 11419 11420 11421 11422 11423 11424 11425 11426 11427 11428 11429 11430 11431 11432 11433 11434 11435 11436 11437 11438 11439 11440 11441 11442 11443 11444 11445 11446 11447 11448 11449 11450

CODIGO BENEFICIO 95989005 RANITIDIL 95989021 RANITIDIL 95032126 RANITIL 95073442 RANITIMOR 95073434 RANITIMOR 95032142 RANITINOL 95032134 RANITINOL 95978526 RANITRAT 95978534 RANITRAT 95550283 RAPAMUNE 95550275 RAPAMUNE 95004645 RAPAMUNE 95084240 RAPIFEN 95067817 RAPITRAM 95067825 RAPITRAM 95612769 RARICAL 95612777 RARICAL 95059377 RASILEZ 95059385 RASILEZ 95059393 RASILEZ 95059407 RASILEZ 95081607 RAZAPINA 95081615 RAZAPINA 95081593 RAZAPINA 95081623 RAZAPINA 95004653 REBATEN 95978542 REBATEN 95126040 REBIF 95126058 REBIF 95978550 RECALPLEX 95571582 RECORMON 95023453 RECORMON 95033521 REDOXON 95978569 REDOXON ZINCO 95978577 REDSAI STRESS 95978585 REDSAI STRESS 95004670 REDUCLIM 95461310 REDUCLIM

APRESENTAÇÃO 150 mg,cx,10cprs,rev, 300 mg, cx, 8 cprs, rev, 150 mg, 1 x 20 cprs, 150 mg, cx, 20 cprs, 300 mg, cx, 20 cprs, 150 mg cx,5 envs, x 4 cprs, 300 mg, cx,5 envs, x 4 cprs, 150 mg, cx, 20 cprs, 300 mg, cx, 20 cprs, 1 mg ct, 6 bl, x 10 drags, 1 mg/ml sol, oral ct, 1 fr, x 60 ml, 2 mg, ct, 3 bl, x 10 drags, 0,544 mg, 5 amps, 5 ml 50 mg/ml sol, inj, ct, 5 amps, vd, inc, x 1 ml 50 mg/ml sol, inj, ct, 5 amps, vd, inc, x 2 ml Inf, vd, 120 ml, Vd, 50 cprs, rev, 150 mg, 14 cp, 150 mg, 28 cp, 300 mg, 14 cp, 300 mg, 28 cp, 30 mg, bl, 14 cprs, ver, 30 mg, bl, 28 cprs, ver, 30 mg, bl, 7 cprs, ver, 45 mg, bl, 28 cprs, ver, 160 mg, bl, 30 caps, 80 mg, 3 bl, x 10 caps, 22 mcg/6 MUI cx, 12 ser, de liq, p/inj, c/0,5 ml, 44 mcg/12 MUI cx, 12 ser, de liq, p/inj, c/0,5 ml, Xpe, fr, 150 ml 10000 UI/0,6 ml 6 ser, preench, 30,000 UI sol, inj, ct, 1 ser, preench, x 0,6 ml+ 1 agulha Vd, 20 ml, 200 mg/ml (gotas) 1 g 10 cprs, eferv, Cx, 30 cprs, rev, Cx, 60 cprs, rev, 1,25 mg, 28 cprs, 2,5 g 28 cprs,

Laboratorio MEDQUIMICA MEDQUIMICA EMS MILIAN MILIAN DUCTO DUCTO CAZI CAZI WYETH WYETH WYETH JANSSEN - CILAG SUN SUN JANSSEN - CILAG JANSSEN - CILAG NOVARTIS NOVARTIS NOVARTIS NOVARTIS SANDOZ SANDOZ SANDOZ SANDOZ SIGMA PHARMA SIGMA PHARMA MERCK MERCK CAZI ROCHE ROCHE BAYER BAYER BUNKER BUNKER FARMOQUIMICA FARMOQUIMICA

UNIDADE Pco Unt Base A COMP 0,57 COMP 1,08 CPR 0,86 COMP 0,65 COMP 1,08 CPR 0,61 CPR 1,05 CPR 1,39 CPR 2,62 CPR 22,18 ML 22,18 DRAG 51,11 AMP 23,82 AMP 4,19 AMP 6,20 ML 0,10 CPR 0,57 COMP 3,41 COMP 3,41 COMP 3,41 COMP 3,41 COMP 2,33 COMP 2,33 COMP 2,33 COMP 3,28 CAPS 1,13 CPR 0,66 AP 548,31 AP 623,79 ML 0,06 AP 240,18 FA 694,49 GOTA 0,02 CPR 1,23 CPR 1,20 CPR 1,18 COMP 1,27 CPR 1,54

299

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11451 11452 11453 11454 11455 11456 11457 11458 11459 11460 11461 11462 11463 11464 11465 11466 11467 11468 11469 11470 11471 11472 11473 11474 11475 11476 11477 11478 11479 11480 11481 11482 11483 11484 11485 11486 11487 11488

CODIGO BENEFICIO 95040625 REDUCLIM 95083286 REDUCTIL 95083278 REDUCTIL 95059431 REDULIP 95059423 REDULIP 95059415 REDULIP 95530835 REDUSCAR 95059440 REDUSTATIN 95612882 REDVIT 95612874 REDVIT 95978593 REGENCEL 95800093 REGENOM 95600345 REHIDRAT 95600361 REHIDRAT 95600337 REHIDRAT 95978607 REIDRAMAX 95978615 RELAPAX 95978623 RELAPAX 95073450 RELESTAT 95033548 RELESTAT 95125426 RELISTOR (Restrito Hosp,) 95149562 REMERON 95149570 REMERON 95004726 REMERON 95149589 REMERON 95989056 REMETIN 95989064 REMETIN 95067833 REMICADE 95897011 REMILEV 95301003 REMINYL 95300988 REMINYL 95300996 REMINYL 95897020 REMINYL ER 95023470 REMINYL ER 95897038 REMINYL ER 95897046 REMOTIV 95040633 RENAGEL 95530916 RENAGEL

APRESENTAÇÃO 2,5 mg, 84 cprs, 10 mg, 3 bl, x 10 caps, 15 mg, 3 bl, x 10 caps, 10 mg, bl, 30 caps, gel dura 15 mg, bl, 10 caps, gel, dura 15 mg, bl, 30 caps, gel dura Cx, 30 cprs, 20 mg, 30 cprs, Fr, 50 drags, Liq, fr, 100 ml, Bisn, 3,5 g Pom, 3,5 g 50 laranja 4 envs, x 7,625 g 50 natural 4 envs, x 7,337 g 90 natural 4 envs, x 13,95 g Po p/sol, oral cx, 2 envs, x 27,9 g 10 mg, cx, 20 cprs, 5 mg, cx, 20 cprs, Fr, 10 ml Fr, 5 ml 20 mg/ml sol, inj, FA vd, x 0,6 ml SolTab 15 mg. 30 cprs. SolTab 30 mg. 30 cprs. SolTab 45 mg, 30 cprs, SolTab 45 mg. 30 cprs. 5 mg/ml sol, inj, cx, 12 amps, plast, transp, x 2 ml 5 mg/ml sol, inj, cx, 120 amps, plast, transp, x 2 ml 10 mg/ml po liof, FA vd, x 10 ml 2 bl, x 10 cprs, rev, 12 mg bl, 56 cprs, rev, 4 mg bl, 14 cprs, rev, 8 mg bl, 56 cprs, rev, 16 mg, bl, 28 caps, 24 mg, bl, 28 caps, 8 mg, bl, 7 caps, 2 bl, x 10 cprs, rev, 400 mg, fr, 360 caps, 800 mg fr, 180 cprs,

Laboratorio FARMOQUIMICA ABBOTT ABBOTT SANDOZ SANDOZ SANDOZ UCI-FARMA BIO MACRO BUNKER BUNKER LATINOFARMA UNIAO QUIMICA EUROFARMA EUROFARMA EUROFARMA CAZI CAZI CAZI ALLERGAN ALLERGAN WYETH SCHERING-PLOUGH SCHERING-PLOUGH ORGANON SCHERING-PLOUGH CLARIS CLARIS SCHERING-PLOUGH ACHE JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG ACHE GENZYME DO BRASIL GENZYME DO BRASIL

UNIDADE Pco Unt Base A CP 1,49 CAPS 0,81 CAPS 0,97 CAPS 0,66 CAPS 1,18 CAPS 0,66 CPR 2,68 COMP 1,18 CPR 0,63 ML 0,13 G 2,23 G 2,23 ENV 3,48 ENV 3,56 ENV 4,50 ENV 6,09 CPR 0,20 CPR 0,17 GOTA 0,36 GOTA 0,36 FA 87,07 CPRS 2,50 CPRS 5,00 COMP 8,44 CPRS 7,11 AMP 0,37 AMP 0,37 FA 2728,77 X COMP 1,72 CPR 5,67 CPR 4,58 CPR 5,27 CAPS 12,50 COMP 13,44 CAPS 10,86 COMP 2,21 CP 1,70 CPR 4,39

300

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11489 11490 11491 11492 11493 11494 11495 11496 11497 11498 11499 11500 11501 11502 11503 11504 11505 11506 11507 11508 11509 11510 11511 11512 11513 11514 11515 11516 11517 11518 11519 11520 11521 11522 11523 11524 11525 11526

CODIGO BENEFICIO 95135030 RENALAPRIL 95135049 RENALAPRIL 95135057 RENALAPRIL 95978658 RENIPRESS 95978666 RENIPRESS 95978674 RENIPRESS 95986251 RENITEC 95986260 RENITEC 95986278 RENITEC 95135090 RENITEC 95160574 REOPRO 95040650 REPARIL 95040641 REPARIL 95978682 REPOCAL 95978690 REPOCAL 95073469 REPOCAL D 95084894 REPOCAL D 95040668 REPOFLOR 95040315 REPOFLOR 95978704 REPOPIL 95023488 REPRIL 95040676 REPRIL 95004734 REQUIP 95004742 REQUIP 95004750 REQUIP 95004769 REQUIP 95004777 REQUIP 95740295 RESCULA 95571604 RESCUVOLIN 95571612 RESCUVOLIN 95040684 RESFRY 95040692 RESFRY 95978712 RESFRY NEO 95978720 RESFRY NEO 95381945 RESPEXIL 95978739 RESPIDON 95978755 RESPIDON 95033556 RESPRIN

APRESENTAÇÃO 10 mg cx, 3 envs, al, x 10 cprs, 20 mg cx, 3 envs, al,x 10 cprs, 5 mg cx, 3 envs, al, x 10 cprs, 10 mg, cx, 30 cprs, 20 mg, cx, 20 cprs, 5 mg, cx, 30 cprs, 10 mg, fr, 30 cprs, 20 mg, 30 cprs, 20 mg, emb, 10 cprs, 5 mg, fr, 30 cprs, 10 mg, 1 fr, 5 ml Gel, bisn, 100 g, Gel, bisn, 30 g, 250 mg po oral inst, 15 envs, 3,5 g 500 mg po oral inst, 15 envs, 7,0 g 500 mg,+ 200 UI fr, 75 cprs, rev, Fr, 60 cprs, rev, 200 mg, fr, 6 caps, Fr, 12 caps, 1 bl, x 21 drags, 25 mg, 50 bl, x 10 cprs, 25 mg, 500 cprs, 0,25 mg, 126 cprs, 0,25 mg, 21 cprs, 1 mg, 21 cprs, 2 mg, 21 cprs, 5 mg, 21 cprs, 5 ml, 15 mg, cx, 10 cprs, 50 mg, cx, 1 FA Cx, 2 bl, x 10 cprs, Cx, 25 bl, x 4 cprs, 400 mg, cap, fr, c/20 Sol, oral fr, 100 ml 400 mg, 6 cprs, 1 mg,cx, 20 cprs, 3 mg cx, 20 cprs, Fracao 4 cprs,

Laboratorio UNIDADE Pco Unt Base A NEO QUIMICA CPR 0,62 NEO QUIMICA CPR 0,98 NEO QUIMICA CPR 0,39 CAZI CPR 0,88 CAZI CPR 1,46 CAZI CPR 0,62 MERCK SHARP & DOHME COMP 1,04 MERCK SHARP & DOHME COMP 1,04 MERCK SHARP & DOHME COMP 0,83 MERCK SHARP & DOHME CPR 0,53 ELI LILLY FA 1670,00 X NYCOMED PHARMA G 0,32 NYCOMED PHARMA G 0,40 SIGMA PHARMA ENV 1,28 SIGMA PHARMA ENV 2,00 LEGRAND COMP 0,69 LEGRAND COMP 0,66 LEGRAND CP 3,44 LEGRAND CPR 1,68 LEGRAND CPR 0,57 CELLOFARM COMP 0,33 CELLOFARM CP 0,38 GLAXOSMITHKLINE COMP 0,74 GLAXOSMITHKLINE COMP 0,74 GLAXOSMITHKLINE COMP 2,26 GLAXOSMITHKLINE COMP 3,32 GLAXOSMITHKLINE COMP 4,83 NOVARTIS GOTAS 0,39 ASTA MEDICA ONCOLOGIA CPR 8,27 ASTA MEDICA ONCOLOGIA FA 66,30 NEO QUIMICA CP 0,42 NEO QUIMICA CP 0,30 NEO QUIMICA CPR 0,78 NEO QUIMICA ML 0,20 MERCK SHARP & DOHME CPR 3,37 TORRENT CPR 1,03 TORRENT CPR 1,03 JOHNSON & JOHNSON CPR 0,78

301

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11527 11528 11529 11530 11531 11532 11533 11534 11535 11536 11537 11538 11539 11540 11541 11542 11543 11544 11545 11546 11547 11548 11549 11550 11552 11553 11554 11555 11556 11557 11558 11559 11560 11561 11562 11563 11564 11565

CODIGO BENEFICIO 95073477 RESTASIS 95978763 RESTASIS 95530940 RETEMIC 95530924 RETEMIC 95004785 RETEMIC UD 95040706 RETIN A MICRO 95400923 RETROVIR (ICMS 0%) 95400907 RETROVIR (ICMS 0%) 95400915 RETROVIR (ICMS 0%) 95040714 REUMAZINE 95004793 REUPLEX 95978771 REUQUINOL 95978780 REUTREXATO 95073485 REUTRITE 95138129 REVANGE 95138137 REVANGE 95170375 REVASTIN 95897054 REVATIO 95251847 REVENIL 95251820 REVENIL 95251839 REVENIL 95360107 REVIA 95400940 REVIRAX - ZIDOVUDINA 95400931 REVIRAX - ZIDOVUDINA 95059466 RHEUMAFIM 95059458 RHEUMAFIM 95040722 RHOPHYLAC 95400958 RIBAV (RIBAVIRINA) 95391703 RICONAZOL 95381970 RIFALDIN 95381953 RIFALDIN 95381961 RIFALDIN 95978798 RIFAMICINA - GENERICO 95897062 RIFAMICINA SV SODICA - GENERICO 95382046 RIFOCINA 95382038 RIFOCINA 95382054 RIFOCINA 95750525 RILAN

APRESENTAÇÃO Emulsao oft, cx, 30 flac, Emulsao oft, cx, 32 flac, 1 mg/ml xpe, fr, 120 ml 5 mg, 30 cprs, 10 mg, cx, 30 cprs, 1 mg/g gel bisn, 20 g 10 mg, sol, oral 200 ml, 100 mg, 100 caps, 250 mg, 40 caps Cx, 20 caps, 200 mg, cx,20 cprs, 400 mg 30 cprs, rev, 2,5 mg 24 cprs, 50 mg, cx, 20 cprs, (37,5 + 325) mg. bl. al. x 10 cprs. rev. (37,5 + 325) mg. bl. al. x 20 cprs. rev. 10 mg cx, 3 bl, x 10 cprs, 20 mg, 90 cprs, Dospan 12 cprs, Exp, 100 ml, Xpe, 100 ml , 50 mg, cx, 1 fr, 30 cprs, 100 mg, fr, 100 caps, 250 mg, fr, 40 caps, Cx, 10 cprs, ver, Cx, 20 cprs, ver, 300 mcg, sol, inj, ct, ser, preench, x 2 ml 250 mg, 30 cprs, 150 mg, cx, 1 cap, 20 mg/ml susp, oral fr, vd, amb, x 100 ml 300 mg, cx, 6 caps, Sol, ped, fr, 5 ml, Spray 20 ml Sol, top, 10 mg/ml fr, 20 ml 75 mg, inj, 5 amps, IV 500 mg, 10 amps, M - 150 mg, 5 amps, Sol, nasal 4% fr, dos, 13 ml

Laboratorio ALLERGAN ALLERGAN APSEN APSEN APSEN JANSSEN - CILAG/J&J GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE LUPER FARMASA APSEN APSEN MILIAN ACHE ACHE NEO QUIMICA PFIZER AVENTIS PHARMA AVENTIS PHARMA AVENTIS PHARMA CRISTALIA BLAUSIEGEL BLAUSIEGEL CATAFARMA CATAFARMA MEIZLER BIOSINTETICA BUNKER SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS EUROFARMA NEO QUIMICA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS UCI-FARMA

UNIDADE Pco Unt Base A UNID 4,32 CPR 4,04 ML 0,22 CPR 0,65 COMP 1,96 G 2,32 ML 0,19 CPR 1,06 CPR 2,73 CP 0,56 COMP 0,40 CPR 1,67 CPR 0,63 COMP 0,32 COMP 1,33 COMP 1,37 CPR 1,33 COMP 23,00 CPR 0,81 ML 0,08 ML 0,07 CPR 7,17 CPR 1,98 CPR 3,44 COMP 1,36 COMP 1,36 FA 146,40 CPR 2,79 CPR 14,54 ML 0,17 CPR 1,85 GOTAS 0,07 DOSE 0,03 GOTA 0,02 AP 2,00 AP 10,91 AP 2,90 GOTAS 0,10

302

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11566 11567 11568 11569 11570 11571 11572 11573 11574 11575 11576 11577 11578 11579 11580 11581 11582 11583 11584 11585 11586 11587 11588 11589 11590 11591 11592 11593 11594 11595 11596 11597 11598 11599 11600 11601

CODIGO BENEFICIO 95750517 RILAN 95350390 RILUTEK 95582088 RINGER LACTATO 95983341 RINGER LACTATO 95582070 RINGER LACTATO 95582045 RINGER SIMPLES 95978801 RINIGRAN 95978810 RINIGRAN 95750533 RINISONE 95750541 RINO-AZETIN 95978828 RINOBEN 95750568 RINOFLUIMICIL 95750584 RINO-LASTIN 95978836 RINOLON 95978844 RINOLON 95978860 RINOS-A 95978895 RINOSORO 95978909 RINOSORO 95750622 RINOSORO 95059474 RINOSORO SIC 95011609 RIOPAN 95011587 RIOPAN 95073493 RIOPAN PLUS 95073507 RIOPAN PLUS 95040749 RISEDROSS 95040730 RISEDROSS 95897070 RISPERDAL 95897089 RISPERDAL 95983350 RISPERDAL 95280618 RISPERDAL 95280596 RISPERDAL 95280600 RISPERDAL 95073523 RISPERDAL CONSTA 95073531 RISPERDAL CONSTA 95073540 RISPERDAL CONSTA 95073515 RISPERDAL CONSTA

11602 95073566 RISPERIDON 11603 95059490 RISPERIDON

APRESENTAÇÃO Sol, nasal fr, 15 ml 50 mg, 4 bl, x 14 cprs, rev, Fr com 1000 ml Fr com 250 ml Fr com 500 ml Fr com 500 ml Ad,0,10%gotasfr,10ml Inf,0,05%gotasfr,10ml Fr, 15 ml, sol, nasal Sol, nasal fr, dosim, 10 ml Sol, fis, fr, 30 ml Sol, nasal, fr, vd, cgt x 12 ml, Fr, spray nasal 10 ml, Ad, fr, 10 ml Ped, fr, 10 ml Gts, fr, 25 ml 3% sol, nasal fr, 60 ml Neb, fr, 30 ml Sol, nasal fr, plast, 30 ml+ ct, gts, 9,0 mg/ml sol, nasal gotas x 50 ml Plus, cx, 20 cprs, Susp, 240 ml, Cx, 20 cprs, Gel fr, 240 ml 35 mg, 2 cprs, rev, 35 mg, 4 cprs, rev, 0,25 mg, bl, 10 cprs, 0,50 mg, bl, 10 cprs, 1 mg sol, oral vd, 30 ml, 1 mg, 2 bl, 10 cprs, 2 mg, 2 bl, 10 cprs, 3 mg, 2 bl, 10 cprs, 1 FA 25 mg, c/1 ser,+ 1 disp,+ 1 agulha 1 FA 37,5 mg, c/1 ser,+ 1 disp,+ 1 agulha 1 FA 50 mg, c/1 ser,+ 1 disp,+ 1 agulha 50 mg, inj, FA

Laboratorio UCI-FARMA SANOFI-AVENTIS FRESENIUS JP FRESENIUS FRESENIUS LEGRAND LEGRAND MEDLEY UCI-FARMA CAZI ZAMBON ACHE FARMASA FARMASA FARMASA FARMASA FARMASA FARMASA FARMASA ALTANA PHARMA NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA SIGMA PHARMA SIGMA PHARMA JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG

1 mg, 3 bl, x 10 cprs, 1 mg, c/6 cps,

CRISTALIA CRISTALIA

UNIDADE Pco Unt Base A GOTAS 0,05 CPR 22,89 FR 6,92 ML 0,02 FR 4,61 FR 4,37 GOTAS 0,04 GOTAS 0,04 GOTAS 0,04 GOTAS 0,12 GOTAS 0,01 GOTAS 0,03 DOSE 0,15 GOTAS 0,05 GOTAS 0,04 GOTAS 0,02 GOTAS 0,01 GOTAS 0,01 GOTAS 0,01 GOTA 0,01 CPR 0,80 ML 0,06 COMP 0,90 ML 0,08 CP 10,04 CP 10,05 COMP 0,79 COMP 1,59 GOTAS 0,14 CPR 3,12 CPR 6,46 CPR 9,62 FA 501,27 X FA 647,03 X FA 932,62 X FA 843,14 COMP COMP

1,03 1,01

303

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11604 11605 11606 11607 11608 11609 11610 11611 11612 11613 11614 11615 11616 11617 11618 11619 11620 11621 11622 11623 11624 11625 11626 11627 11628 11629 11630 11631 11632 11633 11634 11635 11636 11637 11638 11639 11640 11641

CODIGO BENEFICIO 95059482 RISPERIDON 95280642 RISPERIDON 95136606 RISPERIDON 95073574 RISPERIDON 95059504 RISPERIDON 95004858 RISPERIDON 95073558 RISPERIDON 95059512 RISPERIDON 95004866 RISPERIDON 95989161 RISPERIDONA - GENERICO 95113045 RISPERIDONA - GENERICO 95113053 RISPERIDONA - GENERICO 95042423 RISPERIDONA - GENERICO 95059547 RISPERIDONA - GENERICO 95073590 RISPERIDONA - GENERICO 95113061 RISPERIDONA - GENERICO 95073612 RISPERIDONA - GENERICO 95059520 RISPERIDONA - GENERICO 95040757 RISPERIDONA - GENERICO 95040765 RISPERIDONA - GENERICO 95004874 RISPERIDONA - GENERICO 95113070 RISPERIDONA - GENERICO 95113088 RISPERIDONA - GENERICO 95059539 RISPERIDONA - GENERICO 95073582 RISPERIDONA - GENERICO 95113096 RISPERIDONA - GENERICO 95073620 RISPERIDONA - GENERICO 95004882 RISPERIDONA - GENERICO 95113100 RISPERIDONA - GENERICO 95113118 RISPERIDONA - GENERICO 95059555 RISPERIDONA - GENERICO 95073604 RISPERIDONA - GENERICO 95113126 RISPERIDONA - GENERICO 95073639 RISPERIDONA - GENERICO 95023542 RISPERIX 95040781 RISPERIX 95023534 RISPERIX 95023550 RISPERIX

APRESENTAÇÃO 1 mg, cprs, rev, cx, 20 bl, x 10 1 mg, cx, 20 cprs, 1 mg/ml sol, oral fr, 30 ml 2 mg, 3 bl, x 10 cprs, 2 mg, cprs, rev, cx, 20 bl, x 10 2 mg, cx, 20 cprs 3 mg, 3 bl, x 10 cprs, 3 mg, cprs, rev, cx, 20 bl, x 10 3 mg, cx, 20 cprs 1 mg, 20 ce 1 mg, 20 cprs, 1 mg, 20 cprs, rev, 1 mg, 60 ce 1 mg, bl, 20 cprs, rev, 1 mg, bl, 20 cprs, rev, 1 mg, bl, 20 cprs, rev, 1 mg, bl, 30 cprs, rev, 1 mg, bl, 60 cprs, rev, 1 mg/ml sol, oral fr, 30 ml 1 mg/ml sol, oral fr, 30 ml 2 mg, 20 ce 2 mg, 20 cprs, 2 mg, 20 cprs, rev, 2 mg, bl, 20 cprs, rev, 2 mg, bl, 20 cprs, rev, 2 mg, bl, 20 cprs, rev, 2 mg, bl, 30 cprs, rev, 3 mg, 20 ce 3 mg, 20 cprs, 3 mg, 20 cprs, rev, 3 mg, bl, 20 cprs, rev, 3 mg, bl, 20 cprs, rev, 3 mg, bl, 20 cprs, rev, 3 mg, bl, 30 cprs, rev, 1 mg, cx, bl, 20 cprs, 1 mg, cx, bl, 20 cprs, 2 mg, cx, bl, 20 cprs, 3 mg, cx, bl, 20 cprs,

Laboratorio CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA NOVARTIS RANBAXY BIOSINTETICA NOVARTIS SANDOZ EUROFARMA NEO QUIMICA MERCK SANDOZ EMS GERMED NOVARTIS RANBAXY BIOSINTETICA SANDOZ EUROFARMA NEO QUIMICA MERCK NOVARTIS RANBAXY BIOSINTETICA SANDOZ EUROFARMA NEO QUIMICA MERCK CELLOFARM CELLOFARM CELLOFARM CELLOFARM

UNIDADE Pco Unt Base A COMP 1,29 CPR 1,42 ML 1,01 COMP 1,03 COMP 1,76 COMP 2,00 COMP 1,03 COMP 2,34 COMP 2,65 COMP 1,59 COMP 0,92 COMP 1,56 COMP 1,41 COMP 1,78 COMP 1,78 COMP 1,60 COMP 1,15 COMP 1,59 GOTA 0,10 GOTA 0,10 COMP 3,29 COMP 0,92 COMP 3,23 COMP 3,69 COMP 3,70 COMP 3,31 COMP 2,43 COMP 4,16 COMP 0,92 COMP 4,80 COMP 5,50 COMP 5,50 COMP 4,93 COMP 3,62 COMP 1,25 CP 1,44 COMP 2,53 COMP 3,42

304

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11642 11643 11644 11645 11646 11647 11648 11649 11650 11651 11652 11653 11654 11655 11656 11657 11658 11659 11660 11661 11662 11663 11664 11665 11666 11667 11668 11669 11670 11671 11672 11673 11674 11675 11676 11677 11678 11679

CODIGO BENEFICIO 95059563 RISPERIX 95113134 RISS 95073655 RISS 95113142 RISS 95073647 RISS 95073663 RISS 95033599 RITALINA 95280685 RITALINA 95004890 RITALINA LA 95004904 RITALINA LA 95004912 RITALINA LA 95034471 RITMONORM 95113150 RITMONORM 95081631 RITMONORM 95113169 RITMONORM 95059571 RITOVIR 95382070 RITROMIC 95004920 RIVOTRIL 95271503 RIVOTRIL 95271490 RIVOTRIL 95271538 RIVOTRIL 95480625 ROCALTROL 95382135 ROCEFIN 95382178 ROCEFIN 95004939 ROCEFIN 95382160 ROCEFIN 95421351 ROCHAGAN 95067884 ROCURON 95550305 ROFERON A (ICMS 0%) 95550313 ROFERON A (ICMS 0%) 95550321 ROFERON A (ICMS 0%) 95978917 ROHYDORM (B1) 95978925 ROHYDORM (B1) 95271546 ROHYPNOL 95040803 ROHYPNOL 95040811 ROHYPNOL 95901132 ROMERAN 95023585 ROPI

APRESENTAÇÃO 3 mg, cx, bl, 20 cprs, 1 mg, bl, 10 cprs, rev, 1 mg, bl, 20 cprs, rev, 2 mg, bl, 10 cprs, rev, 2 mg, bl, 20 cprs, rev, 3 mg, bl, 20 cprs, rev, 10 mg, 60 cp, 20 cprs, 20 mg, 30 cs 30 mg, 30 cs 40 mg, 30 cs 300 mg, 2 bl, x 10 cprs, rev, 300 mg, bl, 10 cprs, rev, 300 mg, bl, 30 cprs, rev, EV 3,5 mg/ml 6 amps, x 20 ml 100 mg, cap, gel, mole ct, fr, plas, opc, x 84 500 mg, 14 cprs, rev, 0,25 mg, 3 bl, x 10 cprs, sublingual Cx, 20 cprs, 0,5 mg, Cx, 20 cprs, 2 mg, Vd, 20 ml, 2,5 mg/ml (gotas) Vd, 30 caps, IM 1 g cx, 1 FA+ 1 amp, dil, x 3,5 ml, IM 250 mg, cx, 1 FA+ 1 amp, dil, x 2 ml IV 1 g cx, 1 FA+ 1 amp, dil, x 10 ml IV 500 mg, cx, 1 FA+ 1 amp, dil, x 5 ml Vd, 100 caps, 10 mg/ml sol, inj, ct, 12 FA vd, inc, x 5 ml 3 Mio UI ser, preench, 0,5 ml, 4,5 Mio UI ser, preench, 0,5 ml, 9 Mio UI ser, preench, 0,5 ml 1 mg, 20 cprs, 2 mg, 20 cprs, 1 mg, 2 bl, x 10 cprs, 1 mg, 2 bl, x 10 cprs, Clarq 1 mg, 3 bl, x 10 cprs, Clarq 50 mg, cx, 12 FA 10 mg/ml cx, 5 etj, 1 amp, 2 ml

Laboratorio CELLOFARM EUROFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS ABBOTT ABBOTT ABBOTT ABBOTT CRISTALIA CIBRAN ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE CRISTALIA ROCHE ROCHE ROCHE SIGMA PHARMA SIGMA PHARMA ROCHE ROCHE ROCHE BIOCHIMICO CRISTALIA

UNIDADE Pco Unt Base A COMP 4,06 COMP 0,71 COMP 1,23 COMP 0,71 COMP 1,23 COMP 0,71 CP 0,75 CPR 0,75 COMP 5,30 COMP 5,56 COMP 5,84 CPR 2,11 comp 2,11 COMP 2,11 amp 4,50 CAPS 2,69 CPR 4,69 COMP 0,13 CPR 0,25 CPR 0,44 GOTAS 0,03 CPR 2,82 FA 102,08 FA 33,38 F,A, 40,82 FA 27,08 CPR 0,15 FA 35,03 AP 67,10 AP 109,73 AP 184,27 CPR 0,40 CPR 0,72 CPR 0,37 CP 0,46 CP 0,46 FA 43,64 AMP 37,17

305

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11680 11681 11682 11683 11684 11685 11686 11687 11688 11689 11690 11691 11692 11693 11694 11695 11696 11697 11698 11699 11700 11701 11702 11703 11704 11705 11706 11707 11708 11709 11710 11711 11712 11713 11714 11715 11716 11717

CODIGO BENEFICIO 95023569 ROPI 95023577 ROPI 95113177 ROSUVASTATINA CALCICA - GENERICO 95113185 ROSUVASTATINA CALCICA - GENERICO 95113193 ROSUVASTATINA CALCICA - GENERICO 95113207 ROSUVASTATINA CALCICA - GENERICO 95113215 ROSUVASTATINA CALCICA - GENERICO 95113223 ROSUVASTATINA CALCICA - GENERICO 95113231 ROSUVASTATINA CALCICA - GENERICO 95986316 ROTRAM 95382216 ROTRAM 95382232 ROVAMICINA 95004947 ROXETIN 95004955 ROXETIN 95023593 ROXETIN 95004971 ROXFLAN 95135120 ROXFLAN 95004980 ROXFLAN 95978933 ROXINA 95382267 ROXITRAN 95382283 ROXITROM 95004998 ROXITROMICINA - GENERICO 95382305 ROYTRIN 95382313 ROYTRIN 95841580 ROZEX 95978968 RUBIDEX 95542612 RUBIDOX 95542620 RUBIDOX 95550364 RUBINA 95571639 RUBRAGIL 95073671 RUBRALONG 95073680 RUBRALONG DRAGEAS 95073698 RUBRALONG FOLICO 95023615 RUBRANOVA 95023607 RUBRANOVA 95073701 RUBRARGIL 500 95897097 RUBROMICIN 95897100 RUBROMICIN

APRESENTAÇÃO 2 mg/ml cx, 5 etj, 1 amp, 2 ml 7,5 mg/ml cx, 5 etj, 1 amp, 2 ml 10 mg, 3 bl, x 10 cprs, rev, 10 mg, 3 bl, x 10 cprs, rev, 10 mg, bl, 10 cprs, rev, 10 mg, bl, al,/al, x 30 cprs, rev, 20 mg, 3 bl, x 10 cprs, rev, 20 mg, 3 bl, x 10 cprs, rev, 20 mg, bl, al,/al, x 30 cprs, rev, 300 mg, 5 cprs, 300 mg, 7 cprs, 1,5 MIU 16 caps, 20 mg, 2 bl, x 10 cprs, 20 mg, 3 bl, x 10 cprs, 30 mg, 2 bl, x 10 cprs, rev, 10 mg, ct, 3 bl, al, plas opc, x 10 20 cprs, 10 mg, 5 mg, ct, bl, al, plas opc, x 30 300 mg, cx, 5 cprs, 300 mg cx, 1 bl, x 5 cprs, 300 mg, cx, 5 cprs, rev 300 mg, 5 ce Cx, 20cprs, Susp, cx, 1 fr, 50 ml, Gel, bisn, 30 g 100 mg,+ 150 mg, creme bisn, 30 g 10 mg cx, 1 FA 50 mg cx, 1 FA 10 mg FA cx, c/1 Sol, oral fr, 150 ml, 100 ml 30 drags, 30 drags, 15000 inj, amp, 2 ml 5000 inj, amp, 2 ml 500 mg, cx, 16 drags, 25 mg/ml susp, oral 60 ml 50 fr, plast, 50 mg/ml susp, oral 60 ml 50 fr, plast,

Laboratorio CRISTALIA CRISTALIA EMS GERMED EMS SANDOZ EMS GERMED SANDOZ RANBAXY RANBAXY SANOFI-AVENTIS CRISTALIA CRISTALIA CRISTALIA MERCK MERCK MERCK CAZI NEO QUIMICA BIOLAB SANUS NOVARTIS ROYTON ROYTON GALDERMA CAZI BERGAMO BERGAMO EUROFARMA IQB DOVALLE DOVALLE DOVALLE B-MS B-MS IQB PRATI DONADUZZI PRATI DONADUZZI

UNIDADE Pco Unt Base A AMP 24,20 AMP 27,59 comp 2,26 comp 2,26 comp 2,29 comp 2,26 comp 3,95 comp 3,95 comp 3,95 COMP 6,38 CPR 6,38 CPR 2,53 COMP 1,61 COMP 1,81 COMP 2,72 COMP 0,79 CPR 1,52 COMP 0,40 CPR 6,05 CPR 5,60 CPR 4,17 COMP 3,63 CPR 0,45 ML 0,14 G 1,22 G 0,42 FA 42,16 FA 123,97 FA 116,35 ML 0,09 ML 0,16 DRAG 0,51 DRAG 0,88 AMP 10,38 AMP 7,81 DRAG 0,99 ML 0,04 ML 0,06

306

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11718 11719 11720 11721 11722 11723 11724 11725 11726

CODIGO BENEFICIO 95382437 RUBROMICIN 95382445 RULID 95382453 RULID 95382470 RULID 95978976 RUPAFIN 95340556 SABRIL 95126422 SACHE DE FIBRAS E PROBIOTICOS – REGULADOR DA INTESTINAL 95073736 FLORA SACIETTE

APRESENTAÇÃO 500 mg 300 cprs, 150 mg, 2 bl, x 5 cprs, rev, 300 mg, 10 cprs, D 50 mg, 1 bl, x 10 cprs, 10 mg, bl, x 10 cprs, 6 bl, 10 cprs, SACHES DE 5,0 OU 6,0 GRAMAS

Laboratorio PRATI DONADUZZI AVENTIS PHARMA AVENTIS PHARMA AVENTIS PHARMA BIOSINTETICA SANOFI-AVENTIS

95073710 SACIETTE

10 mg, 10 caps, 10 mg, 30 caps,

GLENMARK GLENMARK

11727 95073744 SACIETTE

15 mg, 10 caps,

GLENMARK

11728 11729 11730 11731 11732 11733 11734 11735 11736 11737 11738 11739 11740 11741 11742 11743 11744 11745 11746 11747 11748 11749 11750 11751 11752 11753 11754 11755

15 mg, 30 caps, 4 U,I, cx, 1 FA po liof, p/inj,+ 1 amp, solv, 8 mg cx, 1 FA po liof, p/inj,+ 1 FA solv, Cx, 60 envs, x 5 g Po 100 g, Cx, 60 envs, 5 g Limao 100 g Tradicional 100 g Fracao 2 doses Tradicional 30 x 2's 500 mg, cx, 20 cprs, Xpe, fr, 120 ml Liq, fr, 100 ml, 100 mg, 500 cprs, Fracao de venda 100 mg, inf, cx,20 envs, x 10 cprs, 500 mg, ad, cx,20 bl, x 10 cprs, 500 mg, 100 cprs, Sol, top, oral spray 50 ml 50 ml fr, spray 40 mg, cx, 2 bl, x 10 cprs, Gts, 75 mg/ml fr, plast, 10 ml, Inj, cx, 10 amps, x 1 ml, Inj, cx, 10 amps, x 5 ml, 100 mg, bl, 50 caps, 100 mg, sol, oral fr, 50 ml 25 mg, bl, 50 caps, 50 mg, bl, 50 caps,

GLENMARK SERONO MERCK GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE CAZI LUPER BUNKER BRASTERAPICA BRASTERAPICA DUCTO DUCTO CIFARMA APSEN LIBBS DUCTO DUCTO NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS

95073728 SACIETTE 95470298 SAIZEN 95126066 SAIZEN 95011650 SAL DE ANDREWS 95011641 SAL DE ANDREWS 95011676 SAL DE FRUTA ENO 95073752 SAL DE FRUTA ENO 95978984 SAL DE FRUTA ENO 95978992 SAL DE FRUTA ENO ENV, DUPLO 95979000 SAL DE FRUTA ENO ENV, DUPLO 95979018 SALAZOPRIN 95201068 SALBURIN 95201084 SALBUTAM 95059598 SALICETIL 95059580 SALICETIL 95333975 SALICIL 95333967 SALICIL 95023623 SALITIL 95760466 SALIVAN 95979026 SALSEP 95005013 SANAGAS 95021060 SANAGAS 95382372 SANDIMMUN 95382364 SANDIMMUN 95542680 SANDIMMUN NEORAL 95542663 SANDIMMUN NEORAL 95542698 SANDIMMUN NEORAL 95542655 SANDIMMUN NEORAL

UNIDADE Pco Unt Base A CPR 0,57 CPR 3,19 CPR 6,39 CPR 1,94 CPR 3,64 CPR 18,29 Sache 5,03 CAPS 1,13 CAPS 0,76 CAPS

1,42

CAPS FA FA ENV G ENV G G DOSE DOSE CPR ML ML COMP COMP CPR CPR COMP ML DOSE COMP GOTAS AP AP CPR ML CPR CPR

0,85 172,39 732,29 0,47 0,06 0,47 0,09 0,09 0,55 0,54 1,18 0,06 0,07 0,08 0,43 0,08 0,21 0,17 0,38 0,01 0,22 0,02 13,90 62,84 6,52 6,66 1,92 3,84

307

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11756 11757 11758 11759 11760 11761 11762 11763 11764 11765 11766 11767 11768 11769 11770 11771 11772 11773 11774 11775 11776 11777 11778 11779 11780 11781 11782 11783 11784 11785 11786 11787 11788 11789 11790 11791 11792 11793

CODIGO BENEFICIO 95986324 SANDOSTATIN 95986332 SANDOSTATIN 95470344 SANDOSTATIN 95470352 SANDOSTATIN LAR 95470360 SANDOSTATIN LAR 95470379 SANDOSTATIN LAR 95042431 SANICORPORE 95042440 SANISKIN 95260510 SANTUSSAL 95897119 SARFIRAM 95663975 SCAFLAM (*) 95663940 SCAFLAM (*) 95040820 SCAFLAM (*) 95663959 SCAFLAM (*) 95663983 SCALID 95979034 SEACALCIT 95986340 SECFAR 95986359 SECFAR 95986367 SECFAR 95986391 SECFAR 95391720 SECNAXIDOL 95391738 SECNAXIDOL 95391711 SECNAXIDOL 95410465 SECNIDAL 95410422 SECNIDAL 95410457 SECNIDAL 95410449 SECNIDAL 95391754 SECNIDALIN 95391770 SECNIDALIN 95391746 SECNIDALIN 95391762 SECNIDALIN 95897127 SECNIDAZOL - GENERICO 95897135 SECNIDAZOL - GENERICO 95989188 SECNIDAZOL - GENERICO 95986405 SECNIDAZOL - GENERICO 95986413 SECNIDAZOL - GENERICO 95005021 SECNIDAZOL - GENERICO 95005030 SECNIDAZOL - GENERICO

APRESENTAÇÃO Laboratorio UNIDADE Pco Unt Base A 0,05 mg/ml sol, inj, 5 amps, 1 ml, NOVARTIS AMP 34,18 0,1 mg/ml sol, inj, 5 amps, 1 ml, NOVARTIS AMP 58,24 0,5 mg/ml sol, inj, 5 amps, 1 ml, NOVARTIS AP 220,28 X 10 mg, 1 FA NOVARTIS FA 2786,89 X 20 mg 1 FA NOVARTIS FA 4287,20 X 30 mg, 1 FA NOVARTIS FA 5787,68 X Sabonete Liquido Sanicorpore Banho no Leito - 300 ml (IPI ADVANCED in PRODUCTS DIVISAO SANIPLAN ML 0,06 Equilibrante Dermico Saniskin - 200 ml (IPI incluso) ADVANCED PRODUCTS DIVISAO SANIPLAN ML 0,18 Xpe, 120 ml, NOVARTIS ML 0,05 25 g sol, top, cx, 50 frs, 100 ml BERGAMO ML 17,81 100 mg, 12 cprs, MANTECORP CPR 2,04 Gotas fr, 15 ml, MANTECORP GOTAS 0,06 Sup, 100 mg, ct 8 MANTECORP CP 1,43 Susp, ped, fr, 60 ml, MANTECORP ML 0,29 100 mg, cx, 12 cprs UNIAO QUIMICA CPR 1,15 200 UI/dose - ct, fr, spray 2,0 ml+ neb, BERGAMO DOSE 3,20 1000 mg, cx, 2 cprs, ELOFAR COMP 6,24 1000 mg, cx, 4 cprs, ELOFAR COMP 5,76 450 mg, fr, 15 ml ELOFAR GOTA 10,67 900 mg, fr, 30 ml ELOFAR GOTA 14,96 1 g 2 cprs, EMS CPR 7,07 500 mg cx, 4 cprs, EMS CPR 2,41 Susp, 900 mg fr, 30 ml EMS ML 0,37 1000 mg, 2 cprs, SANOFI-AVENTIS CPR 10,34 500 mg, est, 4 cprs, SANOFI-AVENTIS CPR 4,35 Susp, oral 450 mg, fr, 15 ml, SANOFI-AVENTIS ML 0,79 Susp, oral 900 mg, fr, 30 ml, SANOFI-AVENTIS ML 0,55 1000 mg, cx, 1 bl, x 2 cprs, DUCTO CPR 5,67 450 mg po p/ susp, vd, 15 ml, DUCTO ML 0,57 500 mg, cx, 1 bl, x 4 cprs, DUCTO CPR 2,55 900 mg, po p/ susp, vd, 30 ml, DUCTO ML 0,37 1 g 2 cprs, TEUTO BRAS, COMP 5,80 1 g 4 cprs, TEUTO BRAS, COMP 5,44 1 g cx, 1 bl, x 2 cprs, NEO QUIMICA COMP 5,52 1000 mg 2 cprs, MEDLEY COMP 6,08 1000 mg 4 cprs, MEDLEY COMP 5,63 1000 mg, 2 cprs, MEPHA-RATIOPHARM COMP 6,06 1000 mg, 4 cprs, MEPHA-RATIOPHARM COMP 5,62

308

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11794 11795 11796 11797 11798 11799 11800 11801 11802 11803 11804 11805 11806 11807 11808 11809 11810 11811 11812 11813 11814 11815 11816 11817 11818 11819 11820 11821 11822 11823 11824 11825 11826 11827 11828 11829 11830 11831

CODIGO BENEFICIO 95897151 SECNIDAZOL - GENERICO 95059601 SECNIDAZOL - GENERICO 95059610 SECNIDAZOL - GENERICO 95044213 SECNIDAZOL - GENERICO 95044230 SECNIDAZOL - GENERICO 95044221 SECNIDAZOL - GENERICO 95897143 SECNIDAZOL - GENERICO 95005048 SECNIDAZOL - GENERICO 95005056 SECNIDAZOL - GENERICO 95897178 SECNIDAZOL - GENERICO 95897160 SECNIDAZOL - GENERICO 95044183 SECNIDAZOL - GENERICO 95044205 SECNIDAZOL - GENERICO 95044191 SECNIDAZOL - GENERICO 95113240 SECNIDAZOL - GENERICO 95897194 SECNIDAZOL - GENERICO 95897186 SECNIDAZOL - GENERICO 95125434 SECNIDAZOL - GENERICO (Restrito Hosp,) 95125442 SECNIDAZOL - GENERICO (Restrito Hosp,) 95391797 SECNIHEXAL 95391789 SECNIHEXAL 95979107 SECNI-PLUS 95979115 SECNI-PLUS 95410546 SECNI-PLUS 95410554 SECNI-PLUS 95023631 SECNITRAT 95023640 SECNITRAT 95410562 SECNIZOL 95410619 SECNIZOL 95410597 SECNIZOL 95410570 SECNIZOL 95897208 SECNIZOL 95530959 SECOTEX 95391800 SECTIL 95410635 SECZOL 95410627 SECZOL 95334025 SEDALENE 95334041 SEDALENE

APRESENTAÇÃO 1000 mg, bl, 2 cprs, 1000 mg, bl, 2 cprs, rev, 1000 mg, bl, 4 cprs, rev, 1000 mg, com, rev, ct, bl, al, plas, inc, x 2 1000 mg, com, rev, ct, bl, al, plas, inc, x 200 (emb, hosp,) 1000 mg, com, rev, ct, bl, al, plas, inc, x 4 1000mg,2 bl, x 2 cprs, 30 mg/ml po susp, fr, x 15 ml 30 mg/ml po susp, fr, x 30 ml 450 mg/ml po susp, fr, 15 ml dil, 450mg/mlpo susp,fr, 15 ml dil, 500 mg, com, rev, ct, bl, al, plas, inc, x 4 500 mg, com, rev, ct, bl, al, plas, inc, x 400 (frac) 500 mg, com, rev, ct, bl, al, plas, inc, x 8 900 mg/ml po susp, fr, 30 ml dil, 900 mg/ml po susp, fr, 30 ml dil, 900mg/mlpo susp,fr, 30 ml susp, 100 mg, com, rev, ct, bl, al, plas, inc, x 100 (hosp,) 500 mg, com, rev, ct, bl, al, plas, inc, x 200 (hosp,) 1000 mg 2 cprs, 1000 mg 4 cprs, 1000 mg, 2 cprs,rev, 1000 mg, 4 cprs,rev, 450 mg, 15 ml, 900 mg, 30 ml, 1000 mg, cx, 2 cprs, rev, 1000 mg, cx, 4 cprs, rev, 1000 mg, 2 cprs, 1000 mg, 4 cprs, 450 mg, susp, oral 15 ml 500 mg, 4 cprs, 900mg,sol,oral30 ml 0,40 mg, 20 caps, 1000 mg, 2 cprs, Cprs, vag, ct, bl, x 7+ 7 aplic, Creme vag, bisn, 35 g+ 7 apl, Cx, 10 caps, Cx, 2 amps, 2 ml,

Laboratorio RANBAXY SANOFI-AVENTIS SANOFI-AVENTIS PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI RANBAXY EMS EMS GERMED EUROGENUS - LEGRAND PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI GEN - LEGRAND GERMED EUROGENUS - LEGRAND PRATI DONADUZZI PRATI DONADUZZI HEXAL HEXAL FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA GALLIA GALLIA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA BOEHRINGER INGELHEIM BRASTERAPICA MEDLEY MEDLEY CRISTALIA/GUNTHER CRISTALIA/GUNTHER

UNIDADE Pco Unt Base A COMP 3,63 COMP 5,51 COMP 5,02 CP 6,00 CP 2,36 CP 5,67 COMP 3,63 GOTA 0,02 GOTA 0,02 ML 0,41 ML 0,40 CP 1,98 CP 1,28 CP 1,80 ml 0,33 ML 0,32 ML 0,28 comp 2,49 comp 1,16 CPR 6,25 CPR 5,56 CPR 6,42 CPR 5,74 ML 0,69 ML 0,46 COMP 6,39 COMP 5,31 CPR 6,72 CPR 6,06 ML 0,56 CPR 2,54 ML 0,40 CPR 4,70 CPR 5,84 CPR 5,44 G 0,99 CPR 0,61 AP 2,64

309

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11832 11833 11834 11835 11836 11837 11838 11839 11840 11841 11842 11843 11844 11845 11846 11847 11848 11849 11850 11851 11852 11853 11854 11855 11856 11857 11858 11859 11860 11861 11862 11863 11864 11865 11866 11867 11868 11869

CODIGO BENEFICIO 95334033 SEDALENE 95979140 SEDALENE 95979158 SEDALENE 95126686 SEDALEX 95334084 SEDALGINA 95979166 SEDALGINA 95271562 SEDANTOL 95113258 SEDANTOL 95897216 SEDILAX 95897224 SEDILAX 95125450 SEDILAX (Restrito Hosp,) 95979190 SEDOL 95979204 SEDOL 95979212 SEDOL 95023674 SEDUSPAR 95023666 SEDUSPAR 95612971 SEIS-B 95612963 SEIS-B 95260544 SEKI 95260536 SEKI 95461329 SELECTA 95979220 SELECTOCALCIO 95023690 SELECTRIN 95023682 SELECTRIN 95005129 SELENE 95470409 SELENE 95126295 SELENIO

APRESENTAÇÃO Sol, oral fr, 10 ml Sup, ad, c/2 Sup, inf, c/2 Sol, oral gts, 20 ml Cx, 2 bl, x 10 drags, Cx, 200 drags, 20 drags, Solucao 100 ml Cx, 200 cprs, Cx, 30 cprs, Cx, bl, 200 cprs, (hosp,) 30 mg,+ 300 mg,+ 30 mg, cx, 200 cprs, Cx, 20 drags, Sol, oral gts, fr, 15 ml 10 mg, 20 cprs, 5 mg, 20 cprs, 100 mg, cx, 20 cprs, 300 mg, cx, 20 cprs, Susp, oral fr, vd, x 15 ml, Xpe, fr, vd, x120 ml, 28 cprs, Fr, 150 ml 40 mg,+ 8 mg, susp, oral 100 ml 400+ 80 mg, 20 cprs, Cart, 3 bl, x 21 cprs, Cart, bl, 21 cprs, rev, 60 MCG/ML

Laboratorio CRISTALIA/GUNTHER CRISTALIA/GUNTHER CRISTALIA/GUNTHER TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, DOVALLE DOVALLE TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, CAZI CAZI CAZI HEXAL HEXAL APSEN APSEN ZAMBON ZAMBON LIBBS EVOLABIS - SIF CIFARMA CIFARMA EUROFARMA EUROFARMA

95382488 SELIMAX 95382500 SELIMAX 95382518 SELIMAX 95005137 SELIMAX PULSO 95067906 SELOKEN 95121218 SELOKEN 95121226 SELOKEN 95135162 SELOPRESS 95135170 SELOPRESS ZOK 95135197 SELOZOK 95135200 SELOZOK

500 mg, 3 cprs, 600 mg, po p/susp, 900 mg, po p/susp, 500 mg, 9 cprs, 1 mg/ml sol, inj, 5 amps, x 5 ml Cx, 20 cprs, Duriles 200 mg, cx, 30 cprs, 100 mg, 20 cprs, Cx, 20 cprs, 100 mg, cx, 20 cprs, 25 mg cx, 20 cprs,

LIBBS LIBBS LIBBS LIBBS ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA

UNIDADE Pco Unt Base A GOTAS 0,05 UND 1,57 UND 1,38 GOTAS 0,02 CPR 0,45 CPR 0,40 CPR 0,56 ML 0,17 COMP 0,58 COMP 0,74 COMP 0,59 CPR 0,41 CPR 0,40 GOTAS 0,03 COMP 0,67 COMP 0,42 CPR 0,54 CPR 0,82 GOTAS 0,07 ML 0,15 CPR 1,25 GOTAS 0,00 ML 0,07 COMP 0,35 COMP 0,48 CPR 0,69 AMP 5,32 CPR 3,41 ML 3,31 ML 4,30 COMP 3,64 AMP 18,23 CPR 0,79 CPR 1,16 CPR 0,89 CPR 1,68 CPR 1,42 CPR 0,41

310

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11870 11871 11872 11873 11874 11875 11876 11877 11878 11879 11880 11881 11882 11883 11884 11885 11886 11887 11888 11889 11890 11891 11892 11893 11894 11895 11896 11897 11898 11899 11900 11901 11902 11903 11904 11905 11906 11907

CODIGO BENEFICIO 95135189 SELOZOK 95260552 SELVIGON 95260560 SELVIGON 95271570 SEMAP 95050523 SENAN 95040838 SENOCLIN 95040846 SENOCLIN 95334149 SENSITRAM 95334130 SENSITRAM 95382526 SEPTIOLAN 95382550 SEPTIOLAN 95530975 SEPURIN 95291350 SERCERIN 95059636 SERED 95059644 SERED 95059628 SERED 95979255 SERENATA 95084908 SERENATA 95979263 SERENUS 95201114 SERETIDE DISKUS 95201122 SERETIDE DISKUS 95201130 SERETIDE DISKUS 95201157 SERETIDE SPRAY 95201165 SERETIDE SPRAY 95201149 SERETIDE SPRAY 95201181 SEREVENT 95201173 SEREVENT 95301020 SERMION 95301011 SERMION 95113266 SEROLIFT 95023747 SEROLIFT 95542701 SEROMIDA 95897232 SERONIP 95897240 SEROQUEL 95113274 SEROQUEL 95897259 SEROQUEL 95113282 SEROQUEL 95897267 SEROQUEL

APRESENTAÇÃO 50 mg, cx, 20 cprs, Gts, fr, 10 ml, Xpe 100 ml Cx, 6 cprs, Cx, 30 caps, 150 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml 150 mg/ml sol, inj, cx, 50 amps, vd, x 4 ml 100 mg, 10 cprs, 50 mg, 10 cprs, Cx, 20 cprs, Cx, fr, 100 ml Cx, 1 bl, x 20 drags, 50 mg, 1 bl, x 10 cprs, rev, 100 mg, 14 cprs, rev, 50 mg, 14 cprs, rev, 50 mg, 28 cprs, rev, 50 mg cx, 20 cprs, 50 mg, cx, 10 cprs, Cx, 20 drags, 50/100 mcg, x 60 doses 50/250 mcg, x 60 doses 50/500 mcg, x 60 doses 25/125 mcg, 25/250 mcg, 25/50 mcg, Diskus 50 mg, 60 doses Spray 60 doses 30 mg, cprs, rev, cx, c/20 Cx, 20 drags, 10 mg, 50 mg, bl, al, plas, inc, x 30 cprs, rev, 50mg,bl, 28cprs, rev, 1000 mg, cx, 1 FA 50 mg, cx, 28 cprs, 100 mg, cprs, rev, ct, 2 bl, pvc opc al, x 14 100 mg, cprs, rev, ct, bl, pvc, opc, al, x 14 200 mg, cprs, rev, ct, 2 bl, pvc opc al, x 14 200 mg, cprs, rev, ct, bl, pvc, opc, al, x 14 25 mg, cprs, rev, ct, 1 bl, pvc opc al, x 14

Laboratorio ASTRAZENECA ACHE ACHE JANSSEN - CILAG ATIVUS NOVAFARMA NOVAFARMA LIBBS LIBBS CLIMAX CLIMAX GROSS FARMASA DR, REDDY'S DR, REDDY'S DR, REDDY'S TORRENT TORRENT BIOLAB SANUS GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE PFIZER PFIZER MERCK MERCK ITACA UCI-FARMA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA

UNIDADE Pco Unt Base A CPR 0,83 GOTAS 0,02 ML 0,06 CPR 1,14 CAPS 1,13 AMP 4,49 AMP 8,98 CPR 3,12 CPR 1,75 CPR 0,55 ML 0,08 CPR 0,64 CPR 2,89 COMP 3,29 COMP 1,64 COMP 1,65 CPR 1,51 COMP 1,51 CPR 1,08 DOSE 1,04 DOSE 1,11 DOSE 1,89 DOSE 0,55 DOSE 0,95 DOSE 0,52 DOSE 1,13 DOSE 0,05 CPR 3,79 CPR 1,25 COMP 1,21 COMP 1,27 FA 103,69 CPR 2,25 COMP 8,67 COMP 8,67 COMP 15,60 COMP 15,60 COMP 2,61

311

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11908 11909 11910 11911 11912 11913 11914 11915 11916 11917 11918 11919 11920 11921 11922 11923 11924 11925 11926 11927 11928 11929 11930 11931 11932 11933 11934 11935 11936 11937 11938 11939 11940 11941 11942 11943 11944 11945

CODIGO BENEFICIO 95113290 SEROQUEL 95113304 SEROQUEL 95059679 SEROQUEL XRO 95113312 SEROQUEL XRO 95059652 SEROQUEL XRO 95113320 SEROQUEL XRO 95059660 SEROQUEL XRO 95059687 SEROQUEL XRO 95910379 SEROTABIR 95910360 SEROTABIR 95073787 SERTERO 95073760 SERTERO 95073779 SERTERO 95897275 SERTRALIN 95059695 SERTRALIN 95291377 SERZONE 95321411 SETRONAX 95321390 SETRONAX 95321420 SETRONAX 95321403 SETRONAX 95260587 SETUX 95260579 SETUX 95073795 SETUX EXPECTORANTE 95910395 SEVOCRIS 95910387 SEVOCRIS 95067930 SEVOFLURANO - GENERICO 95067949 SEVOFLURANO - GENERICO 95067957 SEVOFLURANO - GENERICO 95023755 SEVORANE 95023763 SEVORANE 95301038 SIBELIUM 95979280 SIBLIMA 95059709 SIBUS 95059717 SIBUS 95033653 SIBUTRAN 95410643 SIDERON 95979301 SIFROL 95350403 SIFROL

APRESENTAÇÃO 300 mg, cprs, rev, ct, bl, pvc, opc, al, x 14 300 mg, cprs, rev, ct, bl, pvc, opc, al, x 28 200 mg, bl, pvc opc, al, x 30 cprs, rev, lib, prol, 200 mg, bl, pvc, opc, al, x 10 cprs, rev, lib, prol, 300 mg, bl, pvc opc, al, x 30 cprs, rev, lib, prol, 300 mg, bl, pvc, opc, al, x 10 cprs, rev, lib, prol, 50 mg, bl, pvc opc, al, x 30 cprs, rev, lib, prol, 50 mg, bl, pvc, opc, al, x 10 cprs, rev, lib,prol, 100 mg, cx, 1 FA 500 mg, cx, 1 FA 20mg,bl,10cprs,rev, 20mg,bl,20cprs,rev, 20mg,bl,30cprs,rev, 50 mg, cx, 2 bl, x 14 cprs, 50 mg, cx, 500 cprs, rev, (hosp,) 100 mg, bl, 14 cprs, 4 mg cx, 10 cprs, 4 mg, cx, 5 amps, 8 mg cx, 10 cprs, 8 mg, cx, 5 amps, Expect, 100 ml, Susp, 100 ml, Susp, oral 100 ml 1 fr, 250 ml, Fr, 100 ml Fr, vd, amb, x 50 ml Fr, vd, amb,x100ml Fr, vd, amb,x250ml Fr, 100 ml Fr, plast, 250 ml - Sevopen Blist, 30 cprs, 60/15 mg bl, 24 cprs, 10 mg, bl, 30 caps, gel, dura 15 mg, bl, 30 caps, gel, dura Cx, 30 caps, 300 mg, cx, 1 FA 0,125 mg, 3 bl, x 10 cprs, 0,25 mg, 30 cprs,

Laboratorio ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ASTRAZENECA ITACA ITACA ARROW ARROW ARROW NEO QUIMICA NEO QUIMICA B-MS CELLOFARM CELLOFARM CELLOFARM CELLOFARM AVENTIS PHARMA SANOFI-AVENTIS SANOFI-AVENTIS CRISTALIA CRISTALIA BIOCHIMICO BIOCHIMICO BIOCHIMICO ABBOTT ABBOTT JANSSEN - CILAG LIBBS EUROFARMA EUROFARMA UCI-FARMA ITACA BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM

UNIDADE Pco Unt Base A COMP 22,83 COMP 22,83 COMP 15,61 COMP 15,61 COMP 22,83 COMP 22,83 COMP 5,02 COMP 5,02 FA 14,29 FA 57,92 COMP 1,69 COMP 1,50 COMP 1,50 COMP 2,20 COMP 1,59 CPR 1,78 CPR 10,67 AP 17,14 CPR 18,04 AP 24,37 ML 0,05 ML 0,05 ML 0,06 ML 3,96 ML 4,46 ML 3,26 ML 3,18 ML 2,82 ML 5,37 ML 4,77 CPR 0,44 CPR 0,76 CAPS 0,90 CAPS 1,01 CPR 0,73 FA 164,96 CPR 0,98 CPR 2,24

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11946 11947 11948 11949 11950 11951 11952 11953 11954 11955 11956 11957 11958 11959 11960 11961 11962 11963 11964 11965 11966 11967

CODIGO BENEFICIO 95350411 SIFROL 95480641 SIGMACALCIDOL 95480650 SIGMACALCIDOL 95550380 SIGMA-CLAV 95382607 SIGMA-CLAV 95897283 SIGMA-CLAV BD 95979310 SIGMA-CLAV BD 95150340 SIGMATRIOL 95040854 SIGMAX 95023780 SILGLOS 95023771 SILGLOS 95005188 SILOMAT 95005196 SILOMAT 95260641 SILOMAT 95260633 SILOMAT 95011714 SILUDROX 95048359 SIMDAX 95011722 SIMECO PLUS 95113339 SIMECO PLUS 95073809 SIMETICONA - GENERICO 95081658 SIMETICONA - GENERICO 95083308 SIMETICONA - GENERICO

APRESENTAÇÃO 1,00 mg, 30 cprs, 0,25 mcg 30 caps, gel, mole 1,00 mcg 30 caps, gel, mole 500 mg,+ 125 mg, cx, 18 cprs, 875 mg,+ 125 mg, cx, 12 cprs, 400+ 57 mg/5 ml susp, oral fr, 70 ml 875+ 125 mg, 2 bl, x 7 cprs, 0,25 mcg fr. 30 caps. 100 mg, 4 bl, x 15 cprs, rev 1% creme derm, bisn, 30 g 1% creme derm, bisn, 50 g 4 mg/ml, xpe, 120 ml, 60 mg/ml sol, 20 ml Plus gts, fr, 20 ml, Plus xpe, fr, 120 ml Susp, 240 ml 2,5 mg/ml sol, inj, ct, FA vd, inc, x 5 ml Susp, 240 ml, Susp, oral fr, 60 ml 40 mg, bl, 20 cprs, 40 mg, bl, 20 cprs, 40 mg, bl, 20 cprs,

Laboratorio BOEHRINGER INGELHEIM SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA GERMED PHARMA SIGMA PHARMA UNIAO QUIMICA UNIAO QUIMICA BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM EUROFARMA ABBOTT EUROFARMA EUROFARMA TEUTO BRAS, SANOFI-AVENTIS SANDOZ

11968 95081640 SIMETICONA - GENERICO

40 mg, cx, 20 cprs,

NEO QUIMICA

11969 11970 11971 11972 11973 11974 11976 11977 11978 11979 11980 11981 11982 11983 11984

75 mg/ml emul, oral fr, plast, opc, got, x 15 ml SANDOZ 75 mg/ml fr, gts, 15 ml MEDQUIMICA 40 mg, com, ct, bl, al, plas, inc, x 600 (hosp,) PRATI DONADUZZI 75 mg/ml emul, oral 200 fr, x 10 ml (hosp,) TEUTO BRAS, 75 mg/ml, emul or cx, 200 fr, plas, opc, got, x 10 ml (hosp,) PRATI DONADUZZI 75 mg/ml, emul or cx, 200 fr, plas, opc, got, x 15 ml, (hosp,)PRATI DONADUZZI 20 mg, 1 FA NOVARTIS 100 mg, 1 amp, 2 ml TRB-PHARMA 20 mg, 5 amps, 2 ml TRB-PHARMA 40 mg, 5 amps, 2 ml TRB-PHARMA 27,9 mg, cx, 50 envs, BRASTERAPICA Fracao deVenda BRASTERAPICA 25/250 mg, cx, 30 cprs MERCK SHARP & DOHME 10 mg, cx, 1 bl, x 10 cprs, MERCK SHARP & DOHME 10 mg, cx, 3 bl, x 10 cprs MERCK SHARP & DOHME

95083316 SIMETICONA - GENERICO 95083294 SIMETICONA - GENERICO 95125469 SIMETICONA - GENERICO (Restrito Hosp,) 95125477 SIMETICONA - GENERICO (Restrito Hosp,) 95125485 SIMETICONA - GENERICO (Restrito Hosp,) 95125493 SIMETICONA - GENERICO (Restrito Hosp,) 95550488 SIMULECT 95301070 SINAXIAL 95301046 SINAXIAL 95301054 SINAXIAL 95059741 SINDRAT 95059733 SINDRAT 95382593 SINEMET 95231552 SINGULAIR 95231510 SINGULAIR

UNIDADE Pco Unt Base A CPR 6,74 CPR 1,98 CPR 5,01 CPR 2,20 CPR 3,61 GOTA 0,03 CPR 3,39 CPRS 1,61 CP 1,32 GRAMA 0,62 GRAMA 0,50 ML 0,06 GOTA 0,03 GOTAS 0,03 ML 0,08 ML 0,05 F,A, 3447,36 X ML 0,09 ML 0,08 COMP 0,39 COMP 0,29 COMP 0,37 COMP Gota Gota comp gotas gotas gotas FA AP AP AP ENV ENV CPR CPR CPR

0,40 0,03 0,02 0,18 0,02 0,01 0,01 4589,19 X 74,42 15,42 30,90 1,69 1,49 1,21 2,70 2,70

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 11985 11986 11987 11988 11989 11990 11991 11992 11993 11994 11995 11996 11997 11998 11999 12000 12001 12002 12003 12004 12005 12006 12007 12008 12009 12010 12011 12012 12013 12014 12015 12016 12017 12018 12019 12020 12021 12022

CODIGO BENEFICIO 95231528 SINGULAIR 95231536 SINGULAIR 95231544 SINGULAIR 95231501 SINGULAIR 95040862 SINTALGIN 95382615 SINTOMICETINA 95073825 SINUSTRAT TRADICIONAL 95073817 SINUSTRAT TRADICIONAL 95073833 SINUSTRAT VASOCONSTRITOR 95073841 SINUTAB 95059750 SINVALIP 95040900 SINVALIP 95040897 SINVALIP 95040919 SINVALIP 95040870 SINVALIP 95040889 SINVALIP 95040927 SINVALIP 95897291 SINVANE 95023801 SINVANE 95897305 SINVANE 95897313 SINVANE 95180702 SINVASCOR 95180710 SINVASCOR 95180699 SINVASCOR 95979360 SINVASCOR 95180729 SINVASCOR 95005234 SINVASCOR 95180737 SINVASTACOR 95180745 SINVASTACOR 95073850 SINVASTACOR 95005242 SINVASTACOR 95023810 SINVASTACOR 95180753 SINVASTACOR 95073868 SINVASTAMIL 95180826 SINVASTATINA - GENERICO 95033742 SINVASTATINA - GENERICO 95033750 SINVASTATINA - GENERICO 95897330 SINVASTATINA - GENERICO

APRESENTAÇÃO 4 mg, cx, 1 bl, x 10 cprs, 4 mg, cx, 3 bl, x 10 cprs, 5 mg, cx, 1 bl, x 10 cprs, 5 mg, cx, 3 bl, x 10 cprs, 100 mg, bl, 12 cprs, 250 mg, 1 bl, 10 caps, Fr, 10 ml Fr, 15 ml Fr, 10 ml Fracao de venda 10 mg, 3 bl, x 10 cprs, rev, 20 mg, 2 bl, x 15 cprs, rev, 20 mg, 7 bl, x 10 cprs, rev, 40 mg, 3 bl, x 10 cprs, rev, 40 mg, 7 bl, x 10 cprs, rev, 80 mg, 12 bl, x 6 cprs, rev, 80 mg, 3 bl, x 10 cprs, rev, 20 mg, cx, 10 cprs, 20 mg, cx, 30 cprs, 40 mg, cx, 10 cprs, 80 mg, cx, 10 cprs, 10 mg cx, 30 cprs, 20 mg cx, 30 cprs, 40 mg, cx, 10 cprs, 40 mg, cx, 30 cprs, 80 mg cx, 10 cprs, 80 mg, cx, 30 cprs, 10 mg cx, 30 cprs, 20 mg cx, 30 cprs, 20 mg, bl, 60 cprs, rev, 40 mg, cx, 10 cprs, 40 mg, cx, 30 cprs, 5 mg cx, 30 cprs, 20 mg, cx, 30 cprs, 10 mg 30 cp 10 mg, 10 cprs, 10 mg, 10 cprs, 10 mg, 3 bl, x 10 cprs,

Laboratorio MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME SOLVAY FARMA MEDLEY ZURITA ZURITA ZURITA JOHNSON & JOHNSON SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA BRASTERAPICA BRASTERAPICA BRASTERAPICA BRASTERAPICA BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI BALDACCI HEXAL HEXAL HEXAL HEXAL HEXAL HEXAL MILIAN BRAINFARMA RATIOPHARM SANDOZ RANBAXY

UNIDADE Pco Unt Base A CPR 2,70 CPR 2,70 CPR 2,70 CPR 2,70 CP 1,37 CPR 0,31 GOTA 0,05 GOTA 0,04 GOTA 0,04 COMP 1,11 COMP 0,34 CP 0,74 CP 0,51 CP 1,54 CP 1,07 CP 1,60 CP 2,31 COMP 1,63 COMP 0,88 COMP 2,11 COMP 2,15 CPR 1,49 CPR 1,49 CPR 1,56 CPR 1,50 CPR 1,89 COMP 2,01 CPR 0,33 CPR 0,63 COMP 0,62 COMP 2,15 COMP 1,68 CPR 0,73 COMP 1,54 CPR 1,04 CPR 1,15 CPR 1,22 COMP 1,30

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Orde Geral 12023 12024 12025 12026 12027 12028 12029 12030 12031 12032 12033 12034 12035 12036 12037 12038 12039 12040 12041 12042 12043 12044 12045 12046 12047 12048 12049 12050 12051 12052 12053 12054 12055 12056 12057 12058 12059 12060

CODIGO BENEFICIO 95005277 SINVASTATINA - GENERICO 95033769 SINVASTATINA - GENERICO 95033777 SINVASTATINA - GENERICO 95033785 SINVASTATINA - GENERICO 95180869 SINVASTATINA - GENERICO 95897348 SINVASTATINA - GENERICO 95033793 SINVASTATINA - GENERICO 95979433 SINVASTATINA - GENERICO 95005285 SINVASTATINA - GENERICO 95040951 SINVASTATINA - GENERICO 95180761 SINVASTATINA - GENERICO 95979379 SINVASTATINA - GENERICO 95180842 SINVASTATINA - GENERICO 95005307 SINVASTATINA - GENERICO 95033807 SINVASTATINA - GENERICO 95897356 SINVASTATINA - GENERICO 95979441 SINVASTATINA - GENERICO 95033815 SINVASTATINA - GENERICO 95059768 SINVASTATINA - GENERICO 95033823 SINVASTATINA - GENERICO 95979476 SINVASTATINA - GENERICO 95059776 SINVASTATINA - GENERICO 95033831 SINVASTATINA - GENERICO 95979484 SINVASTATINA - GENERICO 95005315 SINVASTATINA - GENERICO 95040960 SINVASTATINA - GENERICO 95180850 SINVASTATINA - GENERICO 95033840 SINVASTATINA - GENERICO 95979506 SINVASTATINA - GENERICO 95033858 SINVASTATINA - GENERICO 95897364 SINVASTATINA - GENERICO 95979514 SINVASTATINA - GENERICO 95023828 SINVASTATINA - GENERICO 95033866 SINVASTATINA - GENERICO 95033874 SINVASTATINA - GENERICO 95897372 SINVASTATINA - GENERICO 95979522 SINVASTATINA - GENERICO 95073876 SINVASTATINA - GENERICO

APRESENTAÇÃO 10 mg, 30 cp, rev, 10 mg, 30 cprs, 10 mg, 30 cprs, rev, 10 mg, 9 bl, x 10 cprs, rev, 10 mg, bl, 10 cprs, 10 mg, bl, 10 cprs, 10 mg, cx, 3 bl, x 10 cprs, rev, 10 mg, cx, 3 bl, x 10 cprs, rev, 10 mg, cx, 30 10 mg, cx, 30 10 mg, cx, 30 cprs, 10mg,bl,30cprs,rev, 20 mg 30 cp 20 mg, 10 cp, rev, 20 mg, 10 cprs, 20 mg, 3 bl, x 10 cprs, 20 mg, 3 bl, x 10 cprs, rev, 20 mg, 30 cprs, 20 mg, 30 cprs, 20 mg, 30 cprs, rev, 20 mg, 6 bl, x 10 cprs, rev, 20 mg, bl, 60 cprs, rev, 20 mg, cx, 3 bl, x 10 cprs, rev, 20 mg, cx, 3 bl, x 10 cprs, rev, 20 mg, cx, 30 20 mg, cx, 30 40 mg 10 cp 40 mg, 10 cprs, 40 mg, 10 cprs, 40 mg, 10 cprs, rev, 40 mg, 3 bl, x 10 cprs, 40 mg, 3 bl, x 10 cprs, rev, 40 mg, 30 cprs, 40 mg, 30 cprs, 40 mg, 30 cprs, rev, 40 mg, bl, 10 cprs, 40 mg, bl, 10 cprs, rev, 40 mg, bl, 30 cprs, ver,

Laboratorio NOVARTIS MEPHA-RATIOPHARM BIOSINTETICA EMS BRAINFARMA RANBAXY SANDOZ HEXAL ARROW EUROFARMA EMS MEDLEY NOVARTIS NOVARTIS SANDOZ RANBAXY MEDLEY MEPHA-RATIOPHARM BRAINFARMA BIOSINTETICA MEDLEY SANDOZ SANDOZ HEXAL ARROW EUROFARMA NOVARTIS MEPHA-RATIOPHARM BRAINFARMA BIOSINTETICA RANBAXY MEDLEY HEXAL SANDOZ BIOSINTETICA RANBAXY MEDLEY EUROFARMA

UNIDADE Pco Unt Base A COMP 1,12 CPR 1,34 CPR 1,26 CPR 1,60 CPR 1,05 COMP 0,99 CPR 1,51 CPR 1,09 COMP 1,16 CP 1,21 CPR 1,48 CPR 1,31 CPR 1,66 COMP 1,66 CPR 1,81 COMP 1,84 CPR 1,61 CPR 1,28 COMP 1,54 CPR 1,40 CPR 1,04 COMP 1,09 CPR 1,69 CPR 1,63 COMP 1,69 CP 1,44 CPR 1,84 CPR 1,99 CPR 1,54 CPR 1,86 COMP 1,50 CPR 1,99 COMP 1,36 CPR 1,52 CPR 1,69 COMP 1,92 CPR 1,83 COMP 1,66

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Orde Geral 12061 12062 12063 12064 12065 12066 12067 12068 12069 12070 12071 12072 12073 12074 12075 12076 12077 12078 12079 12080 12081 12082 12083 12084 12085 12086 12087 12088 12089 12090 12097 12098 12099 12100 12101 12102 12103 12104

CODIGO BENEFICIO 95005331 SINVASTATINA - GENERICO 95040978 SINVASTATINA - GENERICO 95033882 SINVASTATINA - GENERICO 95979530 SINVASTATINA - GENERICO 95979557 SINVASTATINA - GENERICO 95897399 SINVASTATINA - GENERICO 95979565 SINVASTATINA - GENERICO 95005340 SINVASTATINA - GENERICO 95033890 SINVASTATINA - GENERICO 95979581 SINVASTATINA - GENERICO 95033904 SINVASTATINA - GENERICO 95979590 SINVASTATINA - GENERICO 95005358 SINVASTATINA - GENERICO 95040943 SINVASTATINA - GENERICO 95033912 SINVASTATINA - GENERICO 95979620 SINVASTATINA - GENERICO 95033920 SINVASTATINA - GENERICO 95897402 SINVASTATINA - GENERICO 95897410 SINVASTATINA - GENERICO 95979603 SINVASTATINA - GENERICO 95180931 SINVATROX 95979638 SINVATROX 95170413 SINVAZ 95170421 SINVAZ 95084274 SIOCONAZOL 95023836 SIOCONAZOL (*) 95421360 SIRBEN 95421378 SIRBEN 95897429 SIRDALUD 95897437 SIRDALUD 95046658 SLENFIG 95046666 SLENFIG 95046674 SLENFIG 95046682 SLENFIG 95059784 SLOW K 95600388 SLOW K 95023844 SMOFLIPID 20% 95023852 SMOFLIPID 20%

APRESENTAÇÃO 40 mg, cx, 10 40 mg, cx, 10 40 mg, cx, 10 cprs, 40 mg, cx, 10 cprs, 5 mg, 10 cprs, 5 mg, 3 bl, x 10 cprs, 5 mg, 3 bl, x 10 cprs, rev, 5 mg, 30 cp, rev, 5 mg, 30 cprs, 5 mg, 30 cprs, 5 mg, cx, 3 bl, x 10 cprs, rev, 5 mg, cx, 3 bl, x 10 cprs, rev, 5 mg, cx, 30 5 mg, cx, 30 80 mg, 10 cprs, 80 mg, 10 cprs, 80 mg, 10 cprs, rev, 80 mg, 3 bl, x 10 cprs, 80 mg, bl, 10 cprs, 80mg,bl,10cprs,rev, 10 mg cx, 10 cprs, 20mg,3bl,x10 cprs, 20 mg cx, 30 cprs, 5 mg cx, 30 cprs, 200 mg, com, ct, bl, al, plas, inc, x 500 (hosp,) 200mg,bl, 10 cprs, Cx, 6 cprs, Susp, fr, 30 ml 2 mg, 20 cp, 2 mg, 30 cp, 10 mg, cx, 10 caps, 10 mg, cx, 30 caps, 15 mg, cx, 10 caps, 15 mg, cx, 30 caps, 600 mg, 20 dg, Cx, 20 drags, 1 x 100 ml 1 x 500 ml

Laboratorio ARROW EUROFARMA SANDOZ HEXAL RATIOPHARM RANBAXY MEDLEY NOVARTIS RATIOPHARM BRAINFARMA SANDOZ HEXAL ARROW EUROFARMA MEPHA-RATIOPHARM BRAINFARMA BIOSINTETICA RANBAXY RANBAXY MEDLEY LEGRAND LEGRAND CELLOFARM CELLOFARM PRATI DONADUZZI PRATI DONADUZZI UNIAO QUIMICA UNIAO QUIMICA NOVARTIS NOVARTIS TORRENT TORRENT TORRENT TORRENT NOVARTIS NOVARTIS FRESENIUS KABI FRESENIUS KABI

UNIDADE Pco Unt Base A COMP 1,68 CP 1,82 CPR 1,70 CPR 1,70 CPR 1,04 COMP 0,61 CPR 0,76 COMP 0,69 CPR 0,73 CPR 0,64 CPR 0,93 CPR 0,83 COMP 0,76 CP 0,76 CPR 1,99 CPR 1,70 CPR 1,76 COMP 1,41 COMP 2,12 CPR 1,94 CPR 1,82 CPR 1,10 CPR 0,68 CPR 0,39 COMP 0,28 COMP 2,77 CPR 0,99 ML 0,22 COMP 0,82 COMP 1,00 COMP 0,85 COMP 0,85 COMP 0,96 COMP 0,96 DRAG 0,42 CPR 0,40 ML 1,72 ML 0,63

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Orde Geral 12105 12106 12107 12108 12109 12110 12111 12112 12113

CODIGO BENEFICIO 95073884 SNIF 95040986 SNIF 95986421 SNIF 95979646 SOBREPIN 95005374 SOBREPIN 95251855 SOBREPIN 95023879 SOCIAN 95023860 SOCIAN 95991816 SOLUÇÃO CARDIOPLEGIA

APRESENTAÇÃO 9 mg/ml sol, nasal fr, plast, got, 30 ml Sol, 3% spray 30 mg/ml fr, plast, 45 ml Sol, nasal gts, fr, 20 ml, 100 mg, cx, 5 sup, Aerosol cx, 5 amps, x 3 ml Xpe, fr, 100 ml, 200 mg, cx, 20 cprs, 50 mg, cx, 20 cprs, AMP, 10 ML

Laboratorio EUROFARMA EUROFARMA EUROFARMA FARMASA FARMASA FARMASA SANOFI-AVENTIS SANOFI-AVENTIS

12114 95085718 SOLUCAO CLORETO DE SODIO 0,9% - BOLSAS S

100 ml - cx, c/80

SANOBIOL

BOLSA

3,71

12115 12116 12117 12118 12119 12120 12121 12122 12123 12124 12125 12126 12127 12128 12129 12130 12131 12132 12133 12134 12135 12136 12137 12138 12139 12140 12141 12142

1000 ml - cx, c/12 250 ml - cx, c/40 500 ml - cx, c/20 Sol, Inj, Uma bolsa plast, Viaflex x 1000 ml Sol, Inj, Uma bolsa plast, Viaflex x 250 ml Sol, Inj, Uma bolsa plast, Viaflex x 500 ml 1000 ml - cx, c/12 250 ml - cx, c/40 500 ml - cx, c/20 Sol, Inj, Uma bolsa plast, Viaflex x 100 ml Sol, Inj, Uma bolsa plast, Viaflex x 1000 ml Sol, Inj, Uma bolsa plast, Viaflex x 250 ml Sol, Inj, Uma bolsa plast, Viaflex x 50 ml Sol, Inj, Uma bolsa plast, Viaflex x 500 ml 1000 ml - cx, c/12 125 ml - cx, c/80 250 ml - cx, c/40 500 ml - cx, c/20 Agua esteril para irrigacao de 3000 ml Sorbitol 3% 3000 ml - 3% sol, irrig, urol, uma bolsa plast, 250 ml - cx, c/40 Sol, Inj, Uma bolsa plast, Viaflex x 250 ml Sol, Inj, Uma bolsa plast, Viaflex x 1000 ml Sol, Inj, Uma bolsa plast, Viaflex x 500 ml 1000 ml - cx, c/12 500 ml - cx, c/20 Sol, Inj, Uma bolsa plast, Viaflex x 500 ml FR C/ 20 ML

SANOBIOL SANOBIOL SANOBIOL BAXTER BAXTER BAXTER SANOBIOL SANOBIOL SANOBIOL BAXTER BAXTER BAXTER BAXTER BAXTER SANOBIOL SANOBIOL SANOBIOL SANOBIOL BAXTER BAXTER SANOBIOL BAXTER BAXTER BAXTER SANOBIOL SANOBIOL BAXTER

BOLSA BOLSA BOLSA UNID UNID UNID BOLSA BOLSA BOLSA UNID UNID UNID UNID UNID BOLSA BOLSA BOLSA BOLSA ML UND BOLSA UND UNID UNID BOLSA BOLSA UNID FR

5,22 2,95 3,55 8,00 3,92 5,64 7,69 3,62 5,20 4,02 6,11 3,54 3,77 4,49 5,87 3,68 3,24 4,12 0,00 18,84 6,91 9,12 6,96 4,63 6,68 4,45 4,38 46,01

95085726 SOLUCAO CLORETO DE SODIO 0,9% - BOLSAS S 95085734 SOLUCAO CLORETO DE SODIO 0,9% - BOLSAS S 95085742 SOLUCAO CLORETO DE SODIO 0,9% - BOLSAS S 95067990 SOLUCAO DE GLICOSE A 10% 95067973 SOLUCAO DE GLICOSE A 10% 95067981 SOLUCAO DE GLICOSE A 10% 95085750 SOLUCAO DE GLICOSE A 10% - BOLSAS SISTEM 95085769 SOLUCAO DE GLICOSE A 10% - BOLSAS SISTEM 95085777 SOLUCAO DE GLICOSE A 10% - BOLSAS SISTEM 95068015 SOLUCAO DE GLICOSE A 5% 95068040 SOLUCAO DE GLICOSE A 5% 95068023 SOLUCAO DE GLICOSE A 5% 95068007 SOLUCAO DE GLICOSE A 5% 95068031 SOLUCAO DE GLICOSE A 5% 95085785 SOLUCAO DE GLICOSE A 5% - BOLSAS SISTEMA 95085793 SOLUCAO DE GLICOSE A 5% - BOLSAS SISTEMA 95085807 SOLUCAO DE GLICOSE A 5% - BOLSAS SISTEMA 95085815 SOLUCAO DE GLICOSE A 5% - BOLSAS SISTEMA 95084282 SOLUCAO DE IRRIGACAO 95040994 SOLUCAO DE IRRIGACAO 95085823 SOLUCAO DE MANITOL 20% - BOLSAS SISTEMA 95048936 SOLUCAO DE MANITOL A 20% 95068074 SOLUCAO DE RINGER COM LACTATO DE SODIO 95068066 SOLUCAO DE RINGER COM LACTATO DE SODIO 95085831 SOLUCAO DE RINGER COM LACTATO DE SODIO 95085858 SOLUCAO DE RINGER COM LACTATO DE SODIO 95068082 SOLUCAO DE RINGER SIMPLES 95007881 SOLUCAO EURO-COLLINS "CJ"

UNIDADE Pco Unt Base A GOTA 0,01 GOTA 0,02 GOTA 0,01 UND 2,61 AMP 3,32 ML 0,17 COMP 5,21 COMP 2,77 FR 11,85

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Orde Geral 12143 12144 12145 12146 12147 12148 12149 12150 12151 12152 12153 12154 12155 12156 12157 12158 12159 12160 12161 12162 12163 12164 12165 12166 12167 12168 12169 12170 12171 12172 12173 12174 12175 12176 12177 12178 12179 12180

CODIGO BENEFICIO 95068112 SOLUCAO FISIOLOGICA - CLORETO DE SODIO 0,9% 95068147 SOLUCAO FISIOLOGICA - CLORETO DE SODIO 0,9% 95068120 SOLUCAO FISIOLOGICA - CLORETO DE SODIO 0,9% 95068104 SOLUCAO FISIOLOGICA - CLORETO DE SODIO 0,9% 95068139 SOLUCAO FISIOLOGICA - CLORETO DE SODIO 0,9% 95068163 SOLUCAO GLICO-FISIOLOGICA 95068155 SOLUCAO GLICO-FISIOLOGICA 95581553 SOLUÇÃO GLICOFISIOLOGICA 95581537 SOLUÇÃO GLICOFISIOLOGICA 95581545 SOLUÇÃO GLICOFISIOLOGICA 95085890 SOLUCAO GLICOFISIOLOGICA - BOLSAS SISTEM 95085904 SOLUCAO GLICOFISIOLOGICA - BOLSAS SISTEM 95085912 SOLUCAO GLICOFISIOLOGICA - BOLSAS SISTEM 95581170 SOLUCAO SALINA BALANCEADA (BSS) 95581189 SOLUCAO SALINA BALANCEADA (BSS) 95044787 SOLU-CORTEF 95068180 SOLU-CORTEF 95210490 SOLU-MEDROL 95210512 SOLU-MEDROL 95210504 SOLU-MEDROL 95210520 SOLU-MEDROL 95210547 SOLU-PRED 95210539 SOLU-PRED 95451137 SOLUPREN 95451145 SOLUPREN 95382631 SOLUSTREP 95042458 SOMAFLEX 95334203 SOMALGIN 95334211 SOMALGIN 95334173 SOMALGIN 95334181 SOMALGIN 95334190 SOMALGIN 95005420 SOMALGIN CARDIO 95005439 SOMALGIN CARDIO 95005447 SOMALGIN CARDIO 95005455 SOMALGIN CARDIO 95897445 SOMALGIN CARDIO 95073892 SOMALIUM

APRESENTAÇÃO Sol, Inj, Uma bolsa plast, Viaflex x 100 ml Sol, Inj, Uma bolsa plast, Viaflex x 1000 ml Sol, Inj, Uma bolsa plast, Viaflex x 250 ml Sol, Inj, Uma bolsa plast, Viaflex x 50 ml Sol, Inj, Uma bolsa plast, Viaflex x 500 ml Sol, Inj, Uma bolsa plast, Viaflex x 1000 ml Sol, Inj, Uma bolsa plast, Viaflex x 500 ml Fr com 1000 ml Fr com 250 ml Fr com 500 ml 1000 ml - cx, c/12 250 ml - cx, c/40 500 ml - cx, c/20 Bolsa 250 ml, Bolsa 500 ml, 100 mg, po liof, inj, ct, 50 FA vd, inc,+ dil, x 2 ml 500 mg, po liof, inj, ct, 50 FA vd, inc,+ dil, x 4 ml Fr, 1 g+ amp, dil, Fr, 125 mg,+ amp, dil, Fr, 40 mg,+ amp, dil, Fr, 500 mg,+ amp, dil, 1 g cx, FA+ dil, 500 mg cx, FA+ dil, 125 mg cx, 25 FA+ dil, 500 mg cx, 25 FA+ dil, 1,500,000 UI liof, cx, 1 FA 25 mg/ml sol, inj, 5 amps, x 3 ml 100 mg, cx, 32 cprs, 325 mg, cx, 32 cprs, 500 mg, cx, 20 cprs, Cardio 100 mg, cx, 32 cprs, Cardio 325 mg, cx, 32 cprs, 100 mg, cx, 32 cprs, 162 mg, 4 blist, x 8 cprs, rev, 200 mg, 4 blist, x 8 cprs, rev, 325 mg, cx, 32 cprs, 81 mg, 32 cprs, rev, 3 mg, bl, 30 cprs,

Laboratorio BAXTER BAXTER BAXTER BAXTER BAXTER BAXTER BAXTER BEKER BEKER BEKER SANOBIOL SANOBIOL SANOBIOL HALEX ISTAR HALEX ISTAR UNIAO QUIMICA UNIAO QUIMICA PFIZER PFIZER PFIZER PFIZER CELLOFARM CELLOFARM BERGAMO BERGAMO BERGAMO SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ACHE

UNIDADE Pco Unt Base A UNID 3,86 UNID 5,45 UNID 3,34 UNID 4,22 UNID 4,01 UNID 6,98 UNID 4,58 FR 3,06 FR 1,41 FR 1,94 BOLSA 6,70 BOLSA 2,94 BOLSA 4,21 UND 47,42 UND 64,92 FA 1,64 FA 7,81 FA 70,20 FA 11,87 FA 6,30 FA 33,66 FA 64,67 FA 42,34 FA 17,39 FA 53,67 FA 702,53 AMP 1,05 CPR 0,32 CPR 0,41 CPR 0,70 CPR 0,38 CPR 0,52 COMP 0,38 COMP 0,41 COMP 0,43 COMP 0,52 COMP 0,22 COMP 0,45

318

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12181 12182 12183 12184 12185 12186 12187 12188 12189 12190 12191 12192 12193 12194 12195 12196 12197 12198 12199 12200 12201 12202 12203 12204 12205 12206 12207 12208 12209 12210 12211 12212 12213 12214 12215 12216 12217 12218

CODIGO BENEFICIO 95271597 SOMALIUM 95073906 SOMALIUM 95271600 SOMALIUM 95979654 SOMALIUM 95989196 SOMAPLUS 95470433 SOMATROP 95068201 SOMAVERT 95068210 SOMAVERT 95068228 SOMAVERT 95280740 SOMAZINA 95059792 SONEBON 95979662 SONIN 95979670 SONRIDOR 95979697 SONRIDOR 95582126 SORBITOL + MANITOL 95582134 SORBITOL + MANITOL 95630384 SORCAL 95750681 SORINE 95750673 SORINE 95023909 SORINE 95073914 SORINE ADULTO 95023917 SORINE SSC 95979700 SOROLIV 95059806 SOROLIV ADULTO 95059814 SOROLIV NATURAL 95750690 SORONEO 95979719 SORUM 95750703 SORUM 95110496 SOTACOR 95110488 SOTACOR 95005498 SOTAHEXAL 95005501 SOY 50 95979727 SOYFEMME 95664033 SPIDUFEN 95664068 SPIDUFEN 95979735 SPIRIVA 95005510 SPIRIVA 95005528 SPIRIVA

APRESENTAÇÃO 3 mg, cx, 20 cprs, 6 mg, bl, 30 cprs, 6 mg, cx, 20 cprs, Gts, fr, 20 ml 10 mg, inj, cx, 50 amps, x 2 ml 4 UI 1 fr, 10 mg, po liof, inj, ct, 30 FA vd, inc,+ 30 FA dil, 15 mg, po liof, inj, ct, 30 FA vd, inc,+ 30 FA dil, 20 mg, po liof, inj, ct, 30 FA vd, inc,+ 30 FA dil, 500 mg, 15 cprs, rev, 2 bl, x 10 cprs, Xpe, fr, 120 ml 12 x 2 cprs, Fracao 2 cprs, Fr com 1000 ml Fr com 2000 ml Cx, 60 envs, x 30 g, - emb, mult, Ad, fr, 30 cc Inf, fr, 30 cc Sol,nasalneb,fr,45 ml Fr, 30 cc 9,0 mg/ml sol, nasal s/conserv, fr, 50 ml Sol, nasal fr, 30 ml Sol, nasal 0,5 mg/ml+ 0,01 mg/ml+ 9,0 mg/ml 30 ml Sol, nasal 9,0 mg/ml fr, 30 ml Sol, nasal inf, vd, 30 ml Cx, c/50 fr, c/30 ml Fr, 30 ml, 120 mg, fr, 30 cprs, 160 mg, 2 bl, x 10 cprs, 160 mg, cx, 20 cprs, Cx, 30 cprs, 150 mg, 3 bl, x 10 caps, gel, 400 mg, gran, 20 envs, x 3 g, 600 mg, gran, 10 envs, x 3 g, 10caps,+HandiHaler 30 caps, 30 caps,+ HandiHaler

Laboratorio ACHE ACHE ACHE ACHE CAZI BIOSINTETICA PFIZER PFIZER PFIZER SOLVAY FARMA SIGMA PHARMA EVOLABIS - SIF GLAXOSMITHKLINE GLAXOSMITHKLINE B, BRAUN B, BRAUN WYETH ACHE ACHE ACHE ACHE ACHE TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, NEO QUIMICA OSORIO DE MORAES OSORIO DE MORAES B-MS B-MS HEXAL GROSS ACHE ZAMBON ZAMBON BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM

UNIDADE Pco Unt Base A CPR 0,43 COMP 0,72 CPR 0,68 GOTAS 0,02 AMP 1,10 FA 142,17 FA 189,06 X FA 283,58 X FA 378,11 X CPR 12,36 COMP 0,51 ML 0,05 CPR 1,16 CPR 1,16 FR 10,61 FR 14,11 ENV 15,79 GOTAS 0,02 GOTAS 0,01 GOTA 0,01 GOTA 0,02 ML 0,24 GOTAS 0,01 GOTA 0,01 GOTA 0,01 GOTAS 0,01 GOTAS 0,01 GOTAS 0,01 CPR 1,81 CPR 2,33 COMP 1,47 COMP 1,47 CPR 1,67 ENV 1,42 ENV 2,26 CPR 9,54 CAPS 8,86 CAPS 9,00

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Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12219 12220 12221 12222 12223 12224 12225 12226 12227 12228 12229 12230 12231 12232 12233 12234 12235 12236 12237 12238 12239 12240 12241 12242 12243 12244 12245 12246 12247 12248 12249 12250 12251 12252 12253 12254 12255 12256

CODIGO BENEFICIO 95083324 SPIRIVA RESPIMAT 95005536 SPIROCTAN 95005544 SPIROCTAN 95979743 SPIROCTAN 95979751 SPIROCTAN 95135260 SPLENDIL 95135243 SPLENDIL 95135251 SPLENDIL 95391835 SPORANOX 95391860 SPORANOX 95391878 SPOROSTATIN UF 95045724 SPRYCEL 95045732 SPRYCEL 95291393 STABLON 95979760 STABLON 95382658 STAFICILIN 95005552 STALEVO 95005560 STALEVO 95005579 STALEVO 95005587 STALEVO 95005595 STALEVO 95005609 STALEVO 95431446 STARFORM 95431454 STARFORM 95979778 STARFORM 95979786 STARFORM 95431470 STARLIX 95059822 STAVIGILE 95291423 STELAZINE 95291431 STELAZINE 95126074 STILAMIN 95664084 STILL 95664092 STILL 95023941 STILNOX 95023933 STILNOX 95670068 STILUX 95401008 STOCRIN (ICMS 0%) 95400990 STOCRIN (ICMS 0%)

APRESENTAÇÃO Laboratorio 2,5 mcg dose sol, inal, ct, fr, plast, 4 ml (60 doses)+ respimat BOEHRINGER INGELHEIM 100 mg, 100 cprs, BIOLAB SANUS 100 mg, 30 cprs, BIOLAB SANUS 100 mg, bl, 20 cprs, BIOLAB SANUS 25 mg cx, 30 cprs, BIOLAB SANUS 2,5 mg, 20 cprs, ASTRAZENECA Cx, 20 cprs, 10 mg ASTRAZENECA Cx, 20 cprs, 5 mg ASTRAZENECA Bl, 4 caps, JANSSEN - CILAG Pulso - 28 caps, JANSSEN - CILAG 500 mg, est, 20 cprs, MANTECORP 20 mg, cx, 60 cprs, B-MS 50 mg, cx, 60 cprs, B-MS 30 drags, SERVIER 60 drags, SERVIER N 500 mg, 50 FA,c/dil, B-MS 100 mg, 10 ce NOVARTIS 100 mg, 30 ce NOVARTIS 150 mg, 10 ce NOVARTIS 150 mg, 30 ce NOVARTIS 50 mg, 10 ce NOVARTIS 50 mg, 30 ce NOVARTIS 120 mg/500 mg 48+ 48 cp, NOVARTIS 120 mg/500 mg 84+ 84 cp, NOVARTIS 120 mg/850 mg, 48+ 48 ce NOVARTIS 120 mg/850 mg, 84+ 84 ce NOVARTIS 120 mg, 4 x 12 cp NOVARTIS 200 mg, or 30 cprs, simp, LIBBS 2 mg, cx, bl, 20 cprs, GLAXOSMITHKLINE 5 mg, cx, bl, 20 cprs, GLAXOSMITHKLINE 3 mg, cx, 1 amp, po liof, p/inj,+ 1 amp, solv, MERCK Bisn, 3,5 g, ALLERGAN Fr, 5 ml ALLERGAN Cx, 10 cprs, SANOFI-AVENTIS Cx, 20 cprs, SANOFI-AVENTIS Colirio fr, 20 ml, EMS 100 mg, fr, plast, 30 caps, MERCK SHARP & DOHME 200 mg, fr, plast, 90 caps, MERCK SHARP & DOHME

UNIDADE Pco Unt Base A Dose 3,67 COMP 0,82 COMP 0,86 CPR 1,05 CPR 0,58 CPR 1,42 CPR 5,07 CPR 2,75 CPR 12,33 CPR 7,14 CPR 0,52 COMP 84,24 X COMP 168,48 X CPR 1,96 CPR 1,88 FA 7,26 COMP 4,00 COMP 4,86 COMP 4,19 COMP 5,09 COMP 4,62 COMP 4,62 CPR 0,93 CPR 0,93 CPR 0,93 CPR 0,93 CPR 1,86 COMP 4,87 CPR 0,26 CPR 0,38 AP 596,22 G 2,31 GOTAS 0,09 COMP 2,44 COMP 2,25 GOTAS 0,02 CPR 3,19 CPR 6,44

320

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12257 12258 12259 12260 12261 12262 12263 12264 12265 12266 12267 12268 12269 12270 12271 12272 12273 12274 12275 12276 12277 12278 12279 12280 12281 12282 12283 12284 12285 12286 12287 12288 12289 12290 12291 12292 12293 12294

CODIGO BENEFICIO APRESENTAÇÃO Laboratorio 95401016 STOCRIN (ICMS 0%) 50 mg, fr, plast, 30 caps, MERCK SHARP & DOHME 95005617 STOCRIN (ICMS 0%) 600 mg, fr, plast, 30 caps, MERCK SHARP & DOHME 95979824 STONGEL Cx,20 cprs, CAZI 95979832 STONGEL VS Cx, 50 cprs, mast, CAZI 95160590 STREK 750,000 UI po liof, 1 FA LIBRA 95160620 STREPTASE 1,500,000 UI liof, inj, ct, fa, CSL BEHRING 95160604 STREPTASE 250,000 UI liof, inj, ct, fa, CSL BEHRING 95160612 STREPTASE 750,000 UI liof, inj, ct, fa, CSL BEHRING 95321438 STUGERINA 75 mg, cx, 30 cprs, HEXAL 95321446 STUGERON 25 mg, blist, 30 cprs, JANSSEN - CILAG 95321462 STUGERON 75 mg, vd, 30 cprs, JANSSEN - CILAG 95068236 SUCCINATO SODICO DE CLORANFENICOL - GENERICO 1 g po liof, sol, inj, IV cx, 50 FA vd, x 10 ml NOVAFARMA 95068244 SUCCINATO SODICO DE METILPREDNISOLONA - GENERICO 125 mg, po liof, sol, inj, cx, 25 FA vd,+ dil, amp, vd, x 8 ml (hosp,) NOVAFARMA 95068252 SUCCINATO SODICO DE METILPREDNISOLONA - GENERICO 500 mg, po liof, sol, inj, cx, 25 FA vd,+ dil, amp, vd, x 8 ml (hosp,) NOVAFARMA 95041036 SUCCINATO DE SUMATRIPTANA - GENERICO 100 mg, cx, c/2 EUROFARMA 95897453 SUCCINATO DE SUMATRIPTANA - GENERICO 100 mg, cx, c/2 ARROW 95041028 SUCCINATO DE SUMATRIPTANA - GENERICO 50 mg, cx, c/2 EUROFARMA 95897461 SUCCINATO DE SUMATRIPTANA - GENERICO 50 mg, cx, c/2 ARROW 95125507 SUCCINATO SODICO DE METILPREDNISOLONA - GENERICO1 (Restrito g po liof, Hosp,) sol, inj, cx, 25 FA vd, inc, + dil, amp, vd, inc, x 16NOVAFARMA ml (hosp,) 95983180 SUCCINIL COLIN 100 mg, 1 FA UNIAO QUIMICA 95983163 SUCCINIL COLIN 500 mg, 1 FA UNIAO QUIMICA 95901140 SUCCITRAT 100 mg, FA ARISTON 95901159 SUCCITRAT 500 mg, FA ARISTON 95032193 SUCRAFILM 1 g, 30 cprs, SIGMA PHARMA 95032207 SUCRAFILM 2 g, 20 flac, x 10 ml, SIGMA PHARMA 95126520 SUCROFER - FERRO, SACARATO DE HIDROXIDO 20 mg/ml sol, inj, ct, 5 amps, vd, inc, x 5 ml CLARIS 95084304 SUFENTA 50 mcg, 5 amps, 1 ml JANSSEN - CILAG 95081666 SUFENTA 50 mcg, 5 amps, 5 ml JANSSEN - CILAG 95084290 SUFENTA Espinhal 5 mcg, 5 amps, 2 ml JANSSEN - CILAG 95382682 SULBACTAM + AMPICILINA - GENERICO 1,5 g 20 FA EUROFARMA 95382690 SULBACTAM + AMPICILINA - GENERICO 3,0 g 20 FA EUROFARMA 95023968 SULBACTER 1000 mg,+ 500 mg, cx, 30 FA CELLOFARM 95023976 SULBACTER 2000 mg,+ 1000 mg, cx, 30 FA CELLOFARM 95059865 SULBAMOX 1000 mg,+ 500 mg, po inj, FA vd,+ amp, vd, x 5 ml FARMASA 95059881 SULBAMOX 200 mg/ml+ 50 mg/ml po fr, plast, x 15 gr, FARMASA 95059890 SULBAMOX 200 mg/ml+ 50 mg/ml po fr, plast, x 30 gr, FARMASA 95059849 SULBAMOX 250 mg,+ 250 mg, bl, 16 cprs, rev, FARMASA 95059857 SULBAMOX 500 mg,+ 250 mg, po inj, FA vd,+ amp, vd, x 5 ml FARMASA

UNIDADE Pco Unt Base A CPR 1,57 CAPS 22,89 CPR 0,23 CPR 0,29 FA 354,02 FA 778,38 FA 141,76 FA 402,62 CPR 0,32 CPR 0,39 CPR 0,55 FA 2,15 FA 7,00 FA 19,88 CP 15,22 COMP 12,96 CP 5,77 COMP 4,93 FA 42,52 AP 13,77 AP 20,36 FA 12,89 FA 19,25 CPR 1,11 UND 2,55 amp 7,48 AMP 14,40 Amp 64,32 AMP 6,16 FA 16,18 FA 28,38 FA 17,70 FA 31,68 FA 44,75 ML 0,47 ML 0,78 COMP 3,35 FA 23,49

321

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12295 12296 12297 12298 12299 12300 12301 12302 12303 12304 12305 12306 12307 12308 12309 12310 12311 12312 12313 12314 12315 12316 12317 12318 12319 12320 12321 12322 12323 12324 12325 12326 12327 12328 12329 12330 12331 12332

CODIGO BENEFICIO 95059830 SULBAMOX 95059873 SULBAMOX 95201211 SULF, DE TERBUTALINA+ GUAIFENESINA - GEN 95201220 SULFA + TRIMETOPRIMA - GENERICO 95041060 SULFADIAZINA DE PRATA - GENERICO 95041079 SULFADIAZINA DE PRATA - GENERICO 95041087 SULFADIAZINA DE PRATA - GENERICO 95042466 SULFADIAZINA DE PRATA - GENERICO 95023984 SULFADIAZINA DE PRATA - GENERICO 95059903 SULFADIAZINA DE PRATA - GENERICO 95201238 SULFADIAZINA DE PRATA - GENERICO 95201246 SULFADIAZINA DE PRATA - GENERICO 95005650 SULFADIAZINA DE PRATA - GENERICO 95005668 SULFADIAZINA DE PRATA - GENERICO 95897470 SULFAMETOXAZOL + TRIMETOPRIMA - GENE 95024000 SULFAMETOXAZOL + TRIMETOPRIMA - GENE 95023992 SULFAMETOXAZOL + TRIMETOPRIMA - GENE 95024018 SULFAMETOXAZOL + TRIMETOPRIMA - GENE 95042482 SULFAMETOXAZOL + TRIMETOPRIMA - GENE 95042474 SULFAMETOXAZOL + TRIMETOPRIMA - GENE 95059911 SULFAMETOXAZOL + TRIMETOPRIMA - GENERICO 95084312 SULFAMETOXAZOL + TRIMETOPRIMA - GENERICO 95083332 SULFAMETOXAZOL + TRIMETOPRIMA - GENERICO 95201343 SULFAMETOXAZOL + TRIMETOPRIMA - GENERICO 95201335 SULFAMETOXAZOL + TRIMETOPRIMA - GENERICO 95201289 SULFAMETOXAZOL + TRIMETOPRIMA - GENERICO 95042504 SULFATO DE AMICACINA - GENERICO 95042512 SULFATO DE AMICACINA - GENERICO 95042490 SULFATO DE AMICACINA - GENERICO 95897488 SULFATO DE GENTAMICINA - GENERIC 95897496 SULFATO DE GENTAMICINA - GENERIC 95073922 SULFATO DE HIDROXICLOROQUINA - GENERICO 95059920 SULFATO DE NEOMICINA - GENERICO 95059938 SULFATO DE NEOMICINA - GENERICO 95897500 SULFATO DE NEOMICINA + BACITRACI 95897518 SULFATO DE NEOMICINA + BACITRACI 95897526 SULFATO DE NEOMICINA + BACITRACI 95897534 SULFATO DE NEOMICINA + BACITRACI

APRESENTAÇÃO Laboratorio 500 mg,+ 500 mg, bl, 8 cprs, rev, FARMASA 875 mg,+ 125 mg, cprs, bl, al, x 14 FARMASA 0,3 mg/ml+ 13,3 mg/ml xpe, ct, fr, vd, amb x 100 ml+ cp, m MEDLEY 800+ 160 mg 10 cprs, APOTEX 10 mg/g crem, bg, al, x 50 g PRATI DONADUZZI 10 mg/g crem, ct, bg, al, x 30 g PRATI DONADUZZI 10 mg/g crem, cx, pt, x 400 g (emb, hosp,) PRATI DONADUZZI 10 mg/g crem, vag, ct, bg, al, x 30 g+ 6 aplic, PRATI DONADUZZI 10 mg/g creme derm, bins, 120 g PRATI DONADUZZI 10 mg/g creme derm, bisn, x 30 g UNIAO QUIMICA 30 g, PRATI DONADUZZI 400 g PRATI DONADUZZI 50 g PRATI DONADUZZI 50 g c/50 bisn, PRATI DONADUZZI 200/40mg/5mlfr,100ml TEUTO BRAS, 40+ 8 mg/ml susp, 100 ml c/50 TEUTO BRAS, 400/80 mg, cx, 100 cprs, TEUTO BRAS, 400/80 mg, cx, 20 cprs, TEUTO BRAS, Susp, 40+ 8 mg/ml 100 ml+ cp, med, NEO QUIMICA Susp, 40+ 8 mg/ml 60 ml+ cp, med, NEO QUIMICA 40+ 8 mg/ml susp, 50 ml c/50 TEUTO BRAS, 40+ 8 mg/ml susp, oral cx, 50 fr, plast, amb, x 100 ml+ 50 cp, TEUTO med, (hosp,) BRAS, 40+ 8 mg/ml susp, oral fr, plast, amb, x 100 ml+ cp, med, TEUTO BRAS, 400 mg+ 80 mg cx, 2 bl, x 10 cprs, APOTEX 800 mg+ 160 mg cx, 1 bl, x 10 cprs, APOTEX Susp, fr, 100 ml EMS 125 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml NOVAFARMA 250 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml NOVAFARMA 50 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml NOVAFARMA Inj, 20 mg/ml cx, 50 amps, 1 ml DUCTO Inj, 40 mg/ml cx, 50 amps, 2 ml DUCTO 400 mg, bl, 30 cprs, rev, SANOFI-AVENTIS 3,5 mg/g pom, derm, ct, bg, al, x 20 g PRATI DONADUZZI 3,5 mg/g pom, derm, cx, 100 bg, al, x 10 g (hosp,) PRATI DONADUZZI 5 mg/g+ 250 UI/g pom, derm, 200 bisn, 15 g (Hosp,) PRATI DONADUZZI 5 mg/g+ 250 UI/g pom, derm, bisn, 15 g PRATI DONADUZZI 5 mg/g+ 250 UI/g pom, derm, bisn, 50 g PRATI DONADUZZI 5 mg/g+ 250 UI/g pom, derm, cx, 200 bisn, 10 g (hosp,) PRATI DONADUZZI

UNIDADE Pco Unt Base A COMP 6,71 COMP 4,38 ML 0,07 CPR 0,66 G 0,32 G 0,38 G 0,05 GRAMA 0,48 GRAMA 0,22 G 0,34 G 0,30 G 0,05 G 0,22 G 0,16 ML 0,07 ML 0,06 COMP 0,29 COMP 0,38 ML 0,07 ML 0,08 ML 0,06 ML 0,06 ML 0,07 CPR 0,34 CPR 0,66 ML 0,07 AMP 7,34 AMP 10,34 AMP 4,46 AMP 0,40 AMP 1,68 COMP 1,35 G 0,33 G 0,17 GRAMA 2,77 GRAMA 5,63 GRAMA 11,58 GRAMA 1,74

322

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12333 12334 12335 12336 12337 12338 12339 12340 12341 12342 12343 12344 12345 12346 12347 12348 12349 12350 12351 12352 12353 12354 12355 12356 12357 12358 12359 12360 12361 12362 12363 12364 12365 12366 12367 12368 12369 12370

CODIGO BENEFICIO 95005676 SULFATO DE POLIMIXINA B - GENERICO 95897550 SULFATO DE SALBUTAMOL - GENERICO 95073930 SULFATO DE SALBUTAMOL - GENERICO 95041095 SULFATO DE SALBUTAMOL - GENERICO 95041109 SULFATO DE SALBUTAMOL - GENERICO 95897569 SULFATO DE SALBUTAMOL - GENERICO 95979867 SULFATO DE SALBUTAMOL - GENERICO 95059946 SULFATO DE SALBUTAMOL - GENERICO 95897577 SULFATO DE SALBUTAMOL - GENERICO 95897585 SULFATO DE SALBUTAMOL - GENERICO 95897593 SULFATO DE SALBUTAMOL - GENERICO 95041117 SULFATO DE SALBUTAMOL + GUAIFENE 95005684 SULFATO DE TERBUTALINA - GENERICO 95059954 SULFATO DE TERBUTALINA - GENERICO 95044248 SULFATO DE TERBUTALINA - GENERICO 95041125 SULFATO DE TERBUTALINA - GENERICO 95979875 SULFATO DE TERBUTALINA - GENERICO 95979883 SULFATO DE TERBUTALINA - GENERICO 95979891 SULFATO DE TERBUTALINA + GUAIFENES 95005692 SULFATO DE TERBUTALINA + GUAIFENES 95201440 SULFATO DE AMICACINA - GENERICO 95201459 SULFATO DE AMICACINA - GENERICO 95201432 SULFATO DE AMICACINA - GENERICO 95086188 SULFATO DE AMICACINA - GENERICO (Restrito Hosp,) 95086196 SULFATO DE AMICACINA - GENERICO (Restrito Hosp,) 95086170 SULFATO DE AMICACINA - GENERICO (Restrito Hosp,) 95201556 SULFATO DE GENTAMICINA - GENERICO 95581227 SULFATO DE MAGNESIO 95841717 SULFATO DE NEOM + BACITRACINA - GENERICO 95201610 SULFATO DE SALBUTAMOL - GENERICO 95201637 SULFATO DE SALBUTAMOL - GENERICO 95201602 SULFATO DE SALBUTAMOL - GENERICO 95201629 SULFATO DE SALBUTAMOL - GENERICO 95201491 SULFATO DE TERBUTALINA - GENERICO 95125515 SULFATO DE TERBUTALINA - GENERICO (Restrito Hosp,) 95125523 SULFATO DE VINCRISTINA - GENERICO (Restrito Hosp,) 95083340 SULFATO GENTA + FOSF, DIS, BETA - GENERICO 95024026 SULFAZINE

APRESENTAÇÃO Laboratorio Ct, 5 FA vd, EUROFARMA 0,4 mg/ml xpe, cx, 50 fr, vd, x 120 ml (hosp,) PRATI DONADUZZI 0,4 mg/ml xpe, cx, 50 frs, vd, amb, x 120 ml+ 50 cp, med, (hosp,) HIPOLABOR 0,4 mg/ml xpe, fr, vd, x 120 ml DUCTO 0,4 mg/ml, xpe, ct, fr, vd, amb, x 120 ml, PRATI DONADUZZI Fr, 100 ml BUNKER Fr, 120 ml CRISTALIA Sol, 120 ml c/50 TEUTO BRAS, Xpe, cx, 50 fr, 120 ml PRATI DONADUZZI Xpe, cx, 50 fr, plast, 100 ml PRATI DONADUZZI Xpe, fr, plast, 120 ml PRATI DONADUZZI Sol, oral fr, 120 ml EMS 0,3 mg/ml xpe, 100 ml+ cp, med, MERCK 0,3 mg/ml xpe, 100 ml+ cp-med, MEDLEY 0,3 mg/ml xpe, fr, x 100 ml EMS 0,3 mg/ml, xpe, ct, fr, vd, amb, x 100 ml, c/cp, med, PRATI DONADUZZI Xpe, 100 ml PRATI DONADUZZI Xpe, 100 ml c/50 fr, PRATI DONADUZZI 0,3 mg/ml+ 13,3 mg/ml xpe, ct, fr, vd,ambx100 ml+c MEDLEY 0,3+ 13,3 mg/ml xpe, 100 ml PRATI DONADUZZI Sol, inj, 125 mg/ml cx, 1 amp, 2 ml TEUTO BRAS, Sol, inj, 250 mg/ml cx, 50 amp, 2 ml TEUTO BRAS, Sol, inj, 50 mg/ml cx, 50 amp, 2 ml TEUTO BRAS, 125 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml NOVAFARMA 250 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml NOVAFARMA 50 mg/ml sol, inj, cx, 50 amps, vd, x 2 ml NOVAFARMA Inj, 80 mg/2 ml cx, 1 amp, 2 ml NEO QUIMICA 50% inj, cx, 100 x 10 ml, HYPOFARMA Pom, bisn, 15 g EMS 0,4 mg/ml sol, oral fr, 120 ml, EMS 0,4 mg/ml xpe, 120 ml+ cp, med, MEDLEY 2 mg/5 ml fr, 100 ml UNIAO QUIMICA Sol, oral fr, 120 ml, TEUTO BRAS, 0,3 mg/ml xpe, 100 ml+ cp-med, MEDLEY 0,5 mg/ml sol, inj, 50 amps, vd, x 1 ml UNIAO QUIMICA 1 mg/ml sol, inj, FA vd, x 2 ml ACCORD Sol, ocular fr, 10 ml EMS Creme bisn, 20 g MEDIC

UNIDADE Pco Unt Base A F,A, 64,92 ML 1,74 ML 0,03 ML 0,03 ML 0,02 ML 0,03 ML 0,03 ML 0,02 ML 0,01 ML 0,01 ML 0,03 ML 0,05 ML 0,06 ML 0,06 ML 0,06 ML 0,06 ML 0,05 ML 0,02 ML 0,07 ML 0,08 AP 5,93 AP 1,97 AP 0,61 AP 7,34 AP 10,34 AP 4,46 AP 2,75 AP 1,01 G 0,34 ML 0,03 ML 0,03 ML 0,03 ML 0,02 ML 0,06 AMP 1,98 FA 28,12 UNID 4,17 GRAMA 0,48

323

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12371 12372 12373 12374 12375 12376 12377 12378 12379 12380 12381 12382 12383 12384 12385 12386 12387 12388 12389 12390 12391 12392 12393 12394 12395 12396 12397 12398 12399 12400 12401 12402 12403 12404 12405 12406 12407 12408

CODIGO BENEFICIO 95024034 SULFAZINE 95979930 SULFERGAN 95571833 SULFERROL 95571817 SULFERROL 95571825 SULFERROL 95360123 SULFITRAT 95680063 SULNIL 95680071 SULNIL 95024042 SULPAN 95334238 SUMAX 95024069 SUPERAN 95024050 SUPERAN 95024077 SUPERAN 95024085 SUPIROCIN 95979948 SUPLAN 95042628 SUPLASYN SUPLEMENTO ORAL ESPECIAL PARA PACIENTE EM 95590927 PROCESSO CICATRICIAL 95590803 SUPLEMENTO ORAL HIPERCALORICO 95590935 SUPLEMENTO SUPLEMENTO ORAL ORAL PARA PARA DIABETICO PACIENTES COM 95590943 INSUFICIENCIA RENAL 95590951 SUPLEMENTO ORAL PEDIATRICO 95005722 SUPLEVIT 95613005 SUPLEVIT 95613013 SUPLEVIT 95613021 SUPLEVIT 95571728 SUPOSITORIO DE GLICERINA 95571736 SUPOSITORIO DE GLICERINA 95670076 SUPRAHYAL 95005730 SUPREFACT 95897607 SUPRELLE 95113347 SUPRELLE 95251901 SURFACTIL 95251910 SURFACTIL 95251928 SURFACTIL 95024115 SURVANTA 95024107 SURVANTA 95982914 SURVANTA 95321500 SURVECTOR

APRESENTAÇÃO Creme bisn, 50 g Composto fr, 50 cprs, Fr, 50 drags, Gts, fr, 30 ml, Liq, fr, 120 ml, Sol, 25 mg/100 ml c/100 ml Bisn, 3,5 g, Fr, 5 ml 20 cprs, 6 MG - CX C/ 1 SERINGA x 0,5 ML 50 mg, 20 cprs, Gts, ped, fr, 30 ml, Inj, 6 amps, x 2 ml, 20 mg/g pom, derm, ct, bg, al, x 15 g Cx, 30 cprs, 20 mg/ml sol. inj. 1 amp. x 2 ml

Laboratorio MEDIC LEGRAND BUNKER BUNKER BUNKER TEUTO BRAS, ALLERGAN ALLERGAN SANOFI-AVENTIS LIBBS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS GLENMARK HEBRON SIGMA PHARMA

1 x 100 drags, 1 x 20 drags, Sol, 1 x 120 ml, Sol, 1 x 240 ml, Ad, cx, c/24 Inf, cx, c/24 10 mg/ml sol. inj. 1 ser. x 2,5 ml. Depot 3,3 mg/microbast, impl, ct, ser, aplic, x 2 microbast, 1 mg/0,5 mg, 28 cprs, rev, 1,0 mg/0,5 mg, 3 bl, x 28 cprs, rev, Exp, ad, fr, 100 ml, Exp, ped, fr, 100 ml, Sol, fr, 50 ml, FA 4 ml FA 8 ml FR C/ 8 ML Cx, 20 cprs,

EMS EMS EMS EMS PFIZER PFIZER ZODIAC SANOFI-AVENTIS BIOLAB SANUS BIOLAB SANUS FARMION FARMION FARMION ABBOTT ABBOTT ATIVUS SERVIER

UNIDADE Pco Unt Base A GRAMA 0,22 CPR 0,19 CPR 0,18 GOTAS 0,01 ML 0,08 ML 0,20 G 1,45 GOTAS 0,05 COMP 0,88 UNID 35,82 COMP 1,22 GOTA 0,02 AMP 4,95 GRAMA 1,67 CPR 0,94 AMP 164,66 x ML 0,23 ML 0,05 ML 0,07 ML 0,08 ML 0,07 DRAG 0,39 CPR 0,77 ML 0,10 ML 0,07 CPR 0,59 CPR 0,57 AP 219,38 x UNID 1285,65 COMP 0,90 comp 0,59 ML 0,15 ML 0,11 ML 0,18 FR 798,02 FR 1596,12 ML 187,28 CPR 1,12

324

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12409 12410 12411 12412 12413 12414 12415 12416 12417 12418 12419 12420 12421 12422 12423 12424 12425 12426 12427 12428 12429 12430 12431 12432 12433 12434 12435 12436 12437 12438 12439 12440 12441 12442 12443 12444 12445 12446

CODIGO BENEFICIO 95321519 SURVECTOR 95150781 SUSTRATE 95301119 SYGEN 95301097 SYGEN 95024174 SYLADOR 95024166 SYLADOR 95024182 SYLADOR 95024190 SYLADOR 95024158 SYLADOR 95979956 SYMBICORT TURBO 95201688 SYMBICORT TURBO 95201696 SYMBICORT TURBO 95048340 SYNAGIS 95073949 SYNAREL 95490434 SYNAREL 95440208 SYNTHROID 95440240 SYNTHROID 95440216 SYNTHROID 95044256 SYNTHROID 95440224 SYNTHROID 95440259 SYNTHROID 95440267 SYNTHROID 95440119 SYNTHROID 95440178 SYNTHROID 95440186 SYNTHROID 95440194 SYNTHROID 95440232 SYNTHROID 95440275 SYNTOCINON 95640460 SYNVISC 95138170 SYNVISC ONE 95075984 TABINE 95076000 TABINE 95075992 TABINE 95901167 TACLIPAXOL 95901175 TACLIPAXOL 95068260 TACLIPAXOL 95979964 TAGALIV 95032240 TAGAMET

APRESENTAÇÃO Cx, 30 cprs, 10 mg. bl. 50 cprs. 100 mg, 1 amp, 20 mg, 5 amps, 100 mg, 6 sup, 50 mg, 10 cprs, Inj, 50 mg,cx,6amps, Inj,100mg,cx,6amps, Sol,oral50mg,10ml 12 / 400 mcg 60 doses 6 / 100 mcg 60 doses 6 / 200 mcg 60 doses FA 100 mcg Spray nasal 8 ml Spray nasal 8 ml 100 mcg, fr, 100 cprs, 112 mcg, 3 x 10 cprs, 125 mcg, fr, 100 cprs, 137 mcg 3 x 10 cprs, 150 mcg, fr, 100 cprs, 175 mcg, 3 x 10 cprs, 200 mcg, 3 x 10 cprs, 25 mcg, 3 x 10 cprs, 25 mcg, fr, 100 cprs, 50 mcg, fr, 100 cprs, 75 mcg, fr, 100 cprs, 88 mcg, 3 x 10 cprs, 5 UI 50 amps, 1 ml, 2 ml 1 SE 6 ml SE 100 mg, sol, inj, ct, 1 FA x 1 ml 1000 mg, sol, inj, ct, 1 FA x 10 ml 500 mg, sol, inj, ct, 1 FA x 5 ml 100 mg, FA x 17 ml 30 mg, FA x 5 ml 300 mg, FA x 50 ml 400 mg, cx, 16 cprs, 200 mg, blist, x 10

Laboratorio SERVIER FARMOQUIMICA TRB-PHARMA TRB-PHARMA SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS ASTRAZENECA ASTRAZENECA ASTRAZENECA ABBOTT PFIZER PHARMACIA/PFIZER ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT ABBOTT NOVARTIS NOVARTIS GENZYME BRASIL MEIZLER MEIZLER MEIZLER BIOCHIMICO BIOCHIMICO BIOCHIMICO TEUTO BRAS, GLAXOSMITHKLINE

UNIDADE Pco Unt Base A CPR 1,12 CPRS 0,33 AP 147,89 AP 32,53 UNID 4,59 COMP 2,98 AMP 5,57 AMP 7,22 GOTA 0,18 DOSE 1,55 DOSE 1,18 DOSE 1,39 F,A, 3985,79 X JATO 2,48 DOSE 3,10 CPR 0,56 CPR 0,79 CPR 0,62 CP 0,86 CPR 0,67 CPR 0,98 CPR 1,08 CPR 0,58 CPR 0,43 CPR 0,49 CPR 0,54 CPR 0,74 AP 1,57 AP 276,02 x AMP 893,70 X FA 9,85 FA 98,49 FA 46,43 FA 1358,38 FA 410,22 FA 4088,66 CPR 0,78 CPR 1,12

325

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12447 12448 12449 12450 12451 12452 12453 12454 12455 12456 12457 12458 12459 12460 12461 12462 12463 12464 12465 12466 12467 12468 12469 12470 12471 12472 12473 12474 12475 12476 12477 12478 12479 12480 12481 12482 12483 12484

CODIGO BENEFICIO 95032266 TAGAMET 95033971 TALERC 95231609 TALERC 95033980 TALERC 95231641 TALERC 95033998 TALERC 95231617 TALERC 95034005 TALERC D 95005757 TALOFILINA 95005765 TALOFILINA 95005773 TALOFILINA 95382712 TALSUTIN 95050582 TAMARIL 95050590 TAMARIL 95076140 TAMIFLU 95090649 TAMIFLU 95090630 TAMIFLU 95076158 TAMIFLU 95979980 TAMIRAM 95560351 TAMOFEN 95542744 TAMOOEX 95542760 TAMOPLEX 95542779 TAMOPLEX 95542787 TAMOXIN 95542795 TAMOXIN 95005781 TAMSULON 95005790 TAMSULON 95005811 TANAKAN 95041133 TANAKAN 95005820 TANAKAN 95068295 TANOHALO 95068287 TANOHALO 95041141 TANTIN 95113355 TANTIN 95897615 TAPAZOL 95897623 TAPAZOL 95034021 TARCEVA 95034030 TARCEVA

APRESENTAÇÃO 400 mg, cx, 2 bl, x 8 10 mg, 10 cprs, 10 mg, 30 cprs, 2 mg/ml xpe fr, 50 ml, 2 mg/ml xpe fr, 50 ml, 20 mg, 10 cprs, 20 mg, 10 cprs, 10 mg,+ 120 mg, 2 bl, x 5 cprs, 100 mg, 20 cs, 200 mg, 20 cs, 300 mg, 20 cs, Cr, vag, 45 g+ 10 aplic, Cx, 20 caps, Geleia fr, 100 g 12 mg/ml po susp oral fr, Vd, Amb x 30g 30 mg, 10 caps, 45 mg, 10 caps, 75 mg 10 caps 250 mg, 7 cprs, Tab, 20 mg, 3 bl, x 10 10 mg, cx, 30 cprs, 10 mg cx, 30 cprs, 20 mg cx, 30 cprs, 10 mg, 30 cprs, 20 mg, 30 cprs, Cx, 20 caps, Cx, 30 caps, 40 mg, 2 bl, x 15 cprs, rev, 40 mg, 3 bl, x 10 cprs, rev, 80 mg, 2 bl, x 10 cprs, rev, 1 fr, 250 ml Fr, 100 ml 0,06/0,015 mg, 28 cprs, rev, 0,060 mg, + 0,015 mg, 3 bl, x 28 cprs, rev, 10 mg, bl, 50 cprs, 5 mg, bl, 100 cprs, 100 mg, bl, 30 cprs, rev, 150 mg, bl, 30 cprs, rev,

Laboratorio UNIDADE Pco Unt Base A GLAXOSMITHKLINE CPR 2,12 ACHE CPR 1,74 BOEHRINGER INGELHEIM CPR 1,70 ACHE GOTA 0,02 BOEHRINGER INGELHEIM ML 0,43 ACHE CPR 2,76 BOEHRINGER INGELHEIM CPR 3,96 BOEHRINGER INGELHEIM CPR 2,60 NOVARTIS COMP 0,52 NOVARTIS COMP 0,64 NOVARTIS COMP 0,82 B-MS G 0,68 MARJAN CPR 1,19 RANBAXY G 0,13 ROCHE ML 1,53 ROCHE CAPS 5,73 ROCHE CAPS 8,60 ROCHE CAPS 14,33 EUROFARMA CPR 2,39 SANOFI-AVENTIS CPR 2,56 MEIZLER CPR 1,68 ASTA MEDICA ONCOLOGIA CPR 1,38 ASTA MEDICA ONCOLOGIA CPR 2,62 EUROFARMA CPR 1,46 EUROFARMA CPR 3,18 ZODIAC CAPS 5,14 ZODIAC CAPS 4,52 ABBOTT COMP 1,25 ABBOTT CP 1,04 ABBOTT COMP 2,61 CRISTALIA ML 0,79 CRISTALIA ML 0,73 BIOLAB SANUS CP 0,42 BIOLAB SANUS comp 0,42 BIOLAB SANUS COMP 0,33 BIOLAB SANUS COMP 0,17 ROCHE CPR 170,55 X ROCHE CPR 193,80 X

326

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12485 12486 12487 12488 12489 12490 12491 12492 12493 12494 12495 12496 12497 12498 12499 12500 12501 12502 12503 12504 12505 12506 12507 12508 12509 12510 12511 12512 12513 12514 12515 12516 12517 12518 12519 12520 12521 12522

CODIGO BENEFICIO 95034048 TARCEVA 95979999 TARGIFOR 95073965 TARGIFOR C 95073957 TARGIFOR C 95382780 TARGOCID 95068309 TARGOCID 95034056 TARTARATO DE ZOLPIDEM - GENERICO 95980016 TARTARATO DE ZOLPIDEM - GENERICO 95034064 TARTARATO DE ZOLPIDEM - GENERICO 95980024 TARTARATO DE ZOLPIDEM - GENERICO 95073973 TARTARATO DE BRIMONIDINA - GENERICO 95113363 TARTARATO DE BRIMONIDINA - GENERICO 95135308 TARTARATO DE METOPROLOL - GENERICO 95050639 TARTARO DE BRIMONIDINA - GENERICO 95068325 TARVEXOL 95068317 TARVEXOL 95024212 TASMAR 95073981 TAVAFLOX 95073990 TAVAFLOX 95074007 TAVAGRAN 95074015 TAVAGRAN 95074023 TAVAGRAN 95382836 TAVANIC 95382810 TAVANIC 95382801 TAVANIC 95542817 TAXILAN 95542809 TAXILAN 95125531 TAXILAN (Restrito Hosp,) 95560378 TAXOFEN - TAMOXIFENO 95041176 TAXOFEN - TAMOXIFENO 95041150 TAXOFEN - TAMOXIFENO 95059962 TAXOFEN - TAMOXIFENO 95560360 TAXOFEN - TAMOXIFENO 95041168 TAXOFEN - TAMOXIFENO 95542841 TAXOL 95542825 TAXOL 95983287 TAXOL 95542850 TAXOTERE

APRESENTAÇÃO 25 mg, bl, 30 cprs, rev, 5 strip, x 4 cprs, eferv, Inf, cx, 16 cprs, Tb, 16 cprs, 200 mg, 1 FA 400 mg, 1 FA 10 mg, cx, 10 cprs, 10 mg, cx, 10 cprs, 10 mg, cx, 20 cprs, 10 mg, cx, 20 cprs, 2 mg/ml sol, oft, 5 ml Sol, oft, 2 mg/ml fr, 5 ml 100 mg, 2 bl, x 15 cprs, rev 0,2% 5 ml 6 mg/ml sol, inj, FA vd, x 16,7 ml 6 mg/ml sol, inj, FA vd, x 5 ml 100 mg, 30 cprs, 500 mg, 1 bl, x 10 cprs, rev, 500 mg, 1 bl, x 7 cprs, rev, 500 mg, 1 bl, x 3 cprs, 500 mg, 1 bl, x 7 cprs, 500 mg,1bl,x10cprs, 250 mg, 3 cprs, rev, 250 mg, 7 cprs, rev, 500 mg, 7 cprs, rev, 100 mg sol, inj, cx, 1 FA 16,7 ml, 30 mg sol, inj, cx, 1 FA 5 ml, 300 mg, sol, inj, ct, 1 FA vd, inc, 50 ml 10 mg, bl, 30 cprs, 10 mg, cx, 250 cprs, 10 mg, cx, 30 cprs 20 mg, 25 bl, plast, x 10 cprs, rev, 20 mg, bl, 30 cprs, 20 mg, cx, 30 cprs, 100 mg, cx, 1 FA 30 mg, sol, inj, 1FA 300 mg, sol, inj, c/ 1 FA 20 mg, 1 amp,

Laboratorio ROCHE SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS SANDOZ HEXAL SANDOZ HEXAL BIOSINTETICA NEO QUIMICA BIOSINTETICA ALCON SANDOZ SANDOZ VALEANT SIGMA PHARMA SIGMA PHARMA LEGRAND LEGRAND LEGRAND SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS BERGAMO BERGAMO BERGAMO BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL BLAUSIEGEL B-MS B-MS B-MS SANOFI-AVENTIS

UNIDADE Pco Unt Base A CPR 53,38 X CPR 1,32 COMP 1,24 COMP 1,30 FA 208,77 FA 417,59 CPR 1,32 CPR 1,27 CPR 1,36 CPR 1,27 GOTA 0,29 gotas 0,30 CPR 0,45 GOTAS 0,30 FA 1664,99 FA 503,48 COMP 4,53 COMP 5,14 COMP 5,48 COMP 6,25 COMP 6,29 COMP 6,27 CPR 7,13 CPR 7,13 CPR 14,75 FA 1201,91 FA 412,42 FA 3421,01 CPR 2,70 CP 1,97 CP 1,97 COMP 4,58 CPR 5,41 CP 3,94 FA 1969,07 X FA 590,70 X CPR 5907,34 x AP 729,21 X

327

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12523 12524 12525 12526 12527 12528 12529 12530 12531 12532 12533 12534 12535 12536 12537 12538 12539 12540 12541 12542 12543 12544 12545 12546 12547 12548 12549 12550 12551 12552 12553 12554 12555 12556 12557 12558 12559 12560

CODIGO BENEFICIO 95542868 TAXOTERE 95032282 TAZEPIN 95032290 TAZEPIN 95032304 TAZEPIN 95024220 TAZOCILINA 95024239 TAZOCILINA 95024247 TAZOCILINA 95024255 TAZOCILINA 95024263 TAZOCILINA 95024271 TAZOCILINA 95382852 TAZOCIN 95382844 TAZOCIN 95005862 TAZPEN 95005889 TAZPEN 95980032 TEBONIN - FITOTERAPICO 95151001 TEBONIN - FITOTERAPICO 95151010 TEBONIN - FITOTERAPICO 95410660 TECNID 95410678 TECNID 95410686 TECNID 95005900 TECNOCARB 95542876 TECNOCARB 95542892 TECNOCRIS 95560394 TECNOFLUT 95560408 TECNOFLUT 95901205 TECNOMAX 95901213 TECNOMAX 95980040 TECNOMET 95542906 TECNOMET 95084320 TECNOMICINA 95542914 TECNOPLATIN 95542922 TECNOPLATIN 95470450 TECNOTAX 95151028 TECNOTAX 95005919 TECNOTECAN 95005927 TECNOTECAN 95613153 TECNOVORIN 95613161 TECNOVORIN

APRESENTAÇÃO 80 mg, 1 amp, 150 mg, 20 cprs, 300 mg, 8 cprs, 50 mg, inj, 5 x 2 ml 2,25 g cx, 1 FA 2,25 g cx, 10 FA 2,25 g cx, 50 FA 4,5 g cx, 1 FA 4,5 g cx, 10 FA 4,5 g cx, 50 FA Ct, 1 FA x 2,25 g, Ct, 1 FA x 4,5 g, 2 g+ 250 mg po cx, 1 fa 30 ml 4 g+ 500 mg po cx, 1 fa 50 ml, 120 mg 20 cprs, 120 mg. 30 cprs. 80 mg. 30 cprs. 1 g, 2 cprs, 450 mg, po oral 15 ml 900 mg, po oral 30 ml 150 mg, po liof, inj, cx, 1FA 450 mg, po liof, inj, 1 mg, sol, inj, 250 mg, 20 cprs, 250 mg, 90 cprs, 10 mg, po liof, FA vd, 50 mg, po liof, FA vd, 2,5 mg 20 cprs, 2,5 mg 50 cprs, 15 U po liof, inj, cx, amp, vd, inc,+ amp, dil, x 10 ml 10 mg, sol, inj, 50 mg, sol, inj, 10 mg, cx, 30 cprs, 20 mg. cx. 30 cprs. 100 mg,sol,inj,cx,1FA 40 mg,sol,inj,cx,1FA 15 mg, fr, 10 cprs, 50 mg, fr, po liof,+ dil,

Laboratorio SANOFI-AVENTIS CLIMAX CLIMAX CLIMAX BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO BIOCHIMICO WYETH WYETH CELLOFARM CELLOFARM NYCOMED PHARMA TAKEDA PHARMA TAKEDA PHARMA ATIVUS ATIVUS ATIVUS ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC ZODIAC

UNIDADE Pco Unt Base A AP 2629,48 X CPR 0,61 CPR 1,42 AP 1,12 FA 50,42 FA 50,44 FA 50,44 FA 80,69 FA 80,69 FA 80,69 FA 69,02 FA 110,55 F,A, 70,95 F,A, 112,76 CPR 3,93 CPRS 4,30 CPRS 2,99 CPR 9,64 ML 1,05 ML 0,70 F,A, 177,40 FA 522,63 X AP 21,63 CPR 2,37 CPR 1,94 FA 54,77 FA 233,01 CPR 0,70 CPR 0,73 AMP 113,09 FA 17,46 FA 77,57 CPR 1,60 CPRS 3,19 F,A, 1159,37 X F,A, 463,76 X CPR 4,69 FA 60,96

328

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12561 12562 12563 12564 12565 12566 12567 12568 12569 12570 12571 12572 12573 12574 12575 12576 12577 12578 12579 12580 12581 12582 12583 12584 12585 12586 12587 12588 12589 12590 12591 12592 12593 12594 12595 12596 12597 12598

CODIGO BENEFICIO 95664130 TEFLAN 95664149 TEFLAN 95005935 TEFLAN 95024280 TEFLAN 95983295 TEFLUT - FLUTAMIDA 95113371 TEGAN 95059970 TEGRETARD 95340572 TEGRETARD 95340564 TEGRETARD 95059989 TEGRETARD 95340602 TEGRETOL 95340645 TEGRETOL 95340599 TEGRETOL 95340610 TEGRETOL 95340629 TEGRETOL 95897631 TEGRETOL 95340580 TEGRETOL 95340653 TEGREX (C1) 95059997 TEGREX (C1) 95980059 TEGREZIN 95005943 TEICONIN 95005951 TEICONIN 95068333 TEICOPLANINA - GENERICO 95024301 TEICOPLANINA - GENERICO 95068341 TEICOPLANINA - GENERICO 95024298 TEICOPLANINA - GENERICO 95068350 TEICOSTON 95041184 TEICOSTON 95068368 TEIPLAN 95136614 TEIPLAN (Restrito Hosp,) 95041192 TELZIR 95334343 TEMGESIC 95060383 TEMODAL 95084916 TEMODAL 95084924 TEMODAL 95060375 TEMODAL 95983309 TEMODAL 95060367 TEMODAL

APRESENTAÇÃO 20 mg, cx, 10 cprs, rev, 20 mg, inj, 1 FA+ dil, 20 mg, po liof, cx, c/50 FA 40 mg, po liof, sol, inj, 5 FA+ 5 amps, dil, 250 mg, 2 bl, x 10 cprs, 0,25 mg/ml 100 ml sol, fr, or, 200 mg, 20 bl, 10 cps, 200 mg, 20 cprs, 400 mg, 20 cprs, 400 mg,20bl,10cps, 200 mg, 20 cprs, 200 mg, 60 cprs, 400 mg, 20 cprs, CR 200 mg, 20 cprs, CR 400 mg, 20 cprs, CR 400 mg, 60 ce Susp, fr, 100 ml, 200 mg cx,20 cprs, 200 mg, cx, 50 bl, x 10 cprs, (hosp,) 200 mg, cx, 20 cprs, 200 mg, cx, FA+ dil, 400 mg, cx, FA+ dil, 200 mg, inj, cx, FA+ amp, dil, 200 mg, po liof, sol, inj, 5 FA vd,+ 5 dil, amp, plast, x 3 400 mg, inj, cx, FA+ amp, dil, 400 mg, po liof, sol, inj, 5 FA vd,+ 5 dil, amp, plast, x 3 133,33 mg/ml po liof, inj, FA vd, amb,+ amp, dil, x 3 ml 66,66 mg/ml po liof, inj, FA vd, amb,+ amp, dil, x 3 ml 400 mg, po liof, inj, 1 FA vd,+ dil, 3 ml 200 mg, po inj, FA + dil, 700 mg, 60 cprs, Sublingual 0,2 mg, est, 2 bl, x 24 cprs, 100 mg, fr, vd, 5 caps, gel, dura 140 mg, est, fr, vd, amb, x 5 caps, 180 mg, est, fr, vd, amb, x 5 caps, 20 mg, fr, vd, 5 caps, gel, dura 250 mg, fr, vd, 5 caps, gel, dura 5 mg, fr, vd, 5 caps, gel, dura

Laboratorio UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA BLAUSIEGEL LIBBS CRISTALIA CRISTALIA CRISTALIA CRISTALIA NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NOVARTIS NEO QUIMICA NEO QUIMICA CAZI BIOCHIMICO BIOCHIMICO ABL EUROFARMA ABL EUROFARMA ARISTON ARISTON UNIAO QUIMICA UNIAO QUIMICA GLAXOSMITHKLINE SCHERING PLOUGH SCHERING-PLOUGH SCHERING-PLOUGH SCHERING-PLOUGH SCHERING-PLOUGH SCHERING-PLOUGH SCHERING-PLOUGH

UNIDADE Pco Unt Base A CPR 1,89 FA 6,60 F,A, 5,83 FA 13,66 CPR 3,65 ml 0,67 COMP 0,30 CPR 0,45 CPR 0,75 COMP 0,61 CPR 0,64 CPR 0,60 CPR 1,27 CPR 0,69 CPR 1,46 COMP 87,35 ML 0,14 CPR 0,36 COMP 0,27 CPR 0,35 F,A, 189,86 F,A, 377,42 FA 126,44 FA 145,66 FA 252,92 FA 291,34 FA 383,49 FA 191,56 FA 393,17 FA 195,83 CP 11,49 CPR 0,79 CAPS 524,30 CAPS 730,46 CAPS 939,16 CAPS 104,86 CPR 1115,10 x CAPS 26,21

329

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12599 12600 12601 12602 12603 12604 12605 12606 12607 12608 12609 12610 12611 12612 12613 12614 12615 12616 12617 12618 12619 12620 12621 12622 12623 12624 12625 12626 12627 12628 12629 12630 12631 12632 12633 12634 12635 12636

CODIGO BENEFICIO 95094873 TEMODAL IV 95042636 TENADREN 95006095 TENADREN 95042644 TENADREN 95041206 TENADREN 95042652 TENADREN 95006117 TENADREN 95042660 TENADREN 95060391 TENADREN 95006133 TENAG 95006141 TENOFTAL 95135332 TENORETIC 95135340 TENORETIC 95664173 TENOTEC 95980067 TENOXICAM - GENERICO 95664220 TENOXICAM - GENERICO 95042679 TENOXICAM - GENERICO 95897640 TENOXICAM - GENERICO 95151095 TENOXICAM - GENERICO 95006150 TENOXICAM - GENERICO 95664211 TENOXICAM - GENERICO 95989323 TENOXIL 95135359 TENSALIV 95135367 TENSALIV 95135375 TENSIDIPIN 95135383 TENSIDIPIN 95135421 TENSODIN 95135413 TENSODIN 95613170 TENSULAN 95135430 TENSURIL 95201734 TEODEN 95034480 TEOLONG 95034498 TEOLONG 95034501 TEOLONG 95980075 TEOMUC 95664246 TEOREMIN 95382941 TEQUIN 95201823 TERBUTIL

APRESENTAÇÃO 100 mg, po liof, inj, 40 mg,+ 12,5 mg, 10 bl, x 10 cprs, 40 mg,+ 12,5 mg, 2 bl, x 15 40 mg,+ 25 mg, 10 bl, x 10 cprs, 40 mg,+ 25 mg, 2 bl, x 15 cprs, 80 mg,+ 12,5 mg, 10 bl, x 10 cprs, 80 mg,+ 12,5 mg, 2 bl, x 15 80 mg,+ 25 mg, 10 bl, x 10 cprs, 80 mg,+ 25 mg, 2 bl, x 15 cprs, Cx, 20 cprs, 5 mg/ml sol, oft, 5 ml 100 mg, 28 cprs, 50 mg,28 cprs, 20 mg, bl, 10 cprs, 20 mg, 1 bl, x 10 cprs, rev, 20 mg, 50 FA+ dil, 2 ml 20 mg, 6 bl, x 10 cprs, rev, 20 mg, bl, 10 cprs, 20 mg. cx. 10 cprs. rev. 20mg,cx,10cprs, 40 mg, 50 FA+ dil, 2 ml 20,0 mg, cx, 10 cprs, rev, 10 mg cx, 2 bl, x 10 cprs, 5 mg cx, 1 bl, x20 cprs, 10 mg, cx, 20 cprs, 5 mg, cx, 20 cprs, 10 mg, 20 cprs, 5 mg, 20 cprs, Cx, 30 caps, 300 mg, cx, 1 amp, x 20 ml 100 mcg aeros, 200 doses 100 mg, 3 bl,x10 caps, 200 mg, 3 bl,x10 caps, 300 mg, 3 bl,x10 caps, 25 mg/5 mlxpe, ped, 140 mg, cx, 18 caps, 400 mg cx, 1 cpr, 0,5 mg inj, cx, 50 amps,

Laboratorio SCHERING-PLOUG SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA MARJAN TEUTO BRAS, ASTRAZENECA ASTRAZENECA ACHE GERMED EUROFARMA EMS RANBAXY NEO QUIMICA EMS EUROFARMA MEDQUIMICA NEO QUIMICA NEO QUIMICA LEGRAND LEGRAND ATIVUS ATIVUS MARJAN CRISTALIA BIOSINTETICA ABBOTT ABBOTT ABBOTT BIOLAB SANUS ACHE B-MS UNIAO QUIMICA

UNIDADE Pco Unt Base A FR 455,15 COMP 0,14 COMP 0,21 COMP 0,09 CP 0,22 COMP 0,24 COMP 0,37 COMP 0,17 COMP 0,39 COMP 1,95 GOTA 0,07 CPR 1,82 CPR 1,12 CPR 2,18 CPR 1,65 FA 4,19 COMP 1,96 COMP 1,63 CPRS 2,12 COMP 1,89 FA 7,77 COMP 1,24 CPR 1,55 CPR 0,63 CPR 1,28 CPR 0,74 CPR 1,30 CPR 0,81 CAPS 1,10 AP 45,35 DOSE 0,10 CPR 0,37 CPR 0,59 CPR 0,71 ML 0,11 CPR 1,26 CPR 13,07 AP 3,20

330

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12637 12638 12639 12640 12641 12642 12643 12644 12645 12646 12647 12648 12649 12650 12651 12652 12653 12654 12655 12656 12657 12658 12659 12660 12661 12662 12663 12664 12665 12666 12667 12668 12669 12670 12671 12672 12673 12674

CODIGO BENEFICIO 95201815 TERBUTIL 95382976 TERICIN AT 95382984 TERICIN AT 95980083 TERMOGRIPE C/ VIT,C, 95334360 TERMOL 95334351 TERMOL 95334432 TERMOPIRONA 95334416 TERMOPIRONA 95897658 TERMOPIRONA 95334394 TERMOPIRONA 95980105 TERMOPRIN 95980113 TERMOPRIN 95980091 TERMOPRIN 95980121 TERMOSIL 95024310 TEROST 95790969 TERRA-CORTRIL 95382992 TERRAMICINA 95980130 TERRAMICINA (*) 95383000 TERRAMICINA (*) 95383026 TERRAMICINA C/ POLIMIXINA 95383034 TERRAMICINA C/ POLIMIXINA 95980156 TETRABEN 95024328 TETRACAPS 95383050 TETRACICLINA + ANFOTERICINA B - GENERICO 95383069 TETRACINA 95041214 TETRACINA 95383085 TETRACLIN 95421386 TETRAHELMIN 95421394 TETRAHELMIN 95041222 TETRALUP 95383123 TETRALYSAL 95383115 TETRALYSAL 95060405 TETRALYSAL 95383131 TETRAMAX 95383158 TETRAMICIN 95383174 TETREX 95060413 TEUTOFORMIN 95980172 TEUTOMICINA

APRESENTAÇÃO 0,5 mg inj, cx, 6 amps, Bisn, 40 g+ 10 aplic, Bisn, 60 g,+ 1 aplic, 50 x 4 drags, 200 mg/ml gts, fr, 15 ml 750 mg cx, 200 cprs, 500 mg cx, 25 bl, x 4 cprs, Gts, 500 mg/ml fr, pl, 10 ml Gts,500mg/mlfr,20ml Inj, 500 mg/ml cx, 50 amps,2 ml 500 mg, cx, 200 cprs, 500 mg, gts, fr, 10 ml 50mg/mlxpe,fr,100ml Cx, 100 amps, 2 ml 70 mg, 4 cprs, Pom, top, 15 g, IM 5 amps, 100 mg, 500 mg, x 100 caps, Xpe, fr, 120 ml, Pom, oftal, tb, 3,5 g, Pom, topica 15 g 20 mg, pom, bisn, 20 g 100 caps, (hosp,) Cr, vag, bisn, 45 g+ 10 aplic, 500 mg, cx, 25 str, x 4 caps, Fracao de venda 500 mg, env, 100 caps, Cx, 6 cprs, Liq, 30 ml, 500 mg, 100 caps, 16 caps, 150 mg, 16 caps, 300 mg 28 caps, 300 mg, 500 mg, 25 str x 4 caps, 500 mg, 25 envs, x 4 caps, 500 mg, cx, 25 envs, x 4 caps, (emb, mult,) 850 mg, 30 bl, x 5 cprs, (hosp,) Pom, derm, bisn, 10 g

Laboratorio UNIAO QUIMICA ATIVUS ATIVUS LUPER UNIAO QUIMICA UNIAO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA NEO QUIMICA CAZI CAZI CAZI ISOFARMA ATIVUS PFIZER PFIZER PFIZER PFIZER PFIZER PFIZER CAZI BRASTERAPICA MEDLEY BUNKER BUNKER TEUTO BRAS, LUPER LUPER LUPER GALDERMA GALDERMA GALDERMA LUPER EMS B-MS TEUTO BRAS, TEUTO BRAS,

UNIDADE Pco Unt Base A AP 3,41 G 0,52 G 0,32 CPR 0,35 GOTAS 0,03 CPR 0,77 CPR 0,49 GOTAS 0,02 GOTA 0,01 AP 1,50 CPR 0,38 GOTAS 0,02 ML 0,08 AP 0,62 COMP 7,36 G 0,81 AP 4,43 CPR 0,69 ML 0,08 G 1,56 G 0,62 G 0,34 COMP 0,46 G 0,47 CPR 1,00 CP 0,84 CAPS 0,70 CPR 0,81 ML 0,20 CP 0,71 CPR 2,88 CPR 5,77 CAPS 4,85 CPR 0,69 CPR 0,70 CPR 0,78 COMP 0,42 G 0,80

331

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12675 12676 12677 12678 12679 12680 12681 12682 12683 12684 12685 12686 12687 12688 12689 12690 12691 12692 12693 12694 12695 12696 12697 12698 12699 12700 12701 12702 12703 12704 12705 12706 12707 12708 12709 12710 12711 12712

CODIGO BENEFICIO 95980180 TEUTONICO 95383190 TEUTRIN 95383212 TEUTRIN 95060421 TEUTRIN 95068376 TEVABLEO 95068384 TEVACARBO 95068392 TEVACARBO 95068406 TEVACARBO 95068414 TEVAETOPO 95068430 TEVAFOLIN 95068422 TEVAFOLIN 95068449 TEVAMESNA 95068473 TEVAMETHO 95068481 TEVAMETHO 95068457 TEVAMETHO 95068465 TEVAMETHO 95068490 TEVAOXALI 95068511 TEVAPACLI 95068503 TEVAPACLI 95041230 TEVAVINOR 95041249 TEVAVINOR 95791027 THERACORT 95980210 THERAPSOR 95421424 THIABEN 95421432 THIABEN 95421440 THIABENA 95980237 THIANAX 95980229 THIANAX 95063820 THIOCTACID 95897666 THIOMUCASE 95982957 THIONEMBUTAL 95271775 THIOPENTAX 95271783 THIOPENTAX 95980253 THYLOM 95334475 THYLOM 95334459 THYLOM 95989340 THYROGEN 95024336 TIABENDAZOL - GENERICO

APRESENTAÇÃO Sol, oral fr, 400 ml abacaxi Cx, 20 cprs, Susp, 60 ml, Susp, cx, 50 fr, x 60 ml 15 U po liof, inj, ct, FA vd, 150 mg, sol, inj, FA vd, x 15 ml (hosp,) 450 mg, sol, inj, FA vd, x 45 ml (hosp,) 50 mg, sol, inj, FA vd, x 5 ml 100 mg, sol, inj, 10 FA vd, inc, x 5 ml 300 mg, sol, inj, FA x 30 ml 50 mg, sol, inj, FA x 5 ml 400 mg, sol, inj, 5 amps, x 4 ml 1 g sol, inj,FAx10ml 5 g sol, inj, FA x 50 ml 50 mg, sol, inj, FA vd, x 2 ml 500 mg, sol, inj, FA vd, x 20 ml 100 mg, po liof, inj, FA vd, 100 mg/16,7 ml sol, inj, 1 FA vd, 30 mg/5 ml sol, inj, 1 FA vd, 10 mg/ml sol, inj, FA vd, x 1 ml 10 mg/ml sol, inj, FA vd, x 5 ml Inj, FA 2 ml, Pom, bisn, 15 g Cx, 6 cprs, Susp, oral 40 ml Pom, tb, 15 g, 500 mg, cx, 6 cprs, 50mg,pom,bisn,45g 600 mg, fr, vd, amb, x 30 cprs, rev, 25 TRU+ 1350 UCEIP+ 3000 UH bl, 60 cprs, rev, 500 MG - CX C/ 25 FA 0,5 g - 25 fr, c/0,5 g, 1,0 g - 25 fr, c/1 g, 200 mg/ml cx, c/50 fr, c/15 ml 200 mg/ml fr, 15 ml, 750 mg 2 bl, x 10 cprs, Kit diag, 2 frs, tirotrofina alfa (TSH recombinante) 50 mg/g pom, bisn, 45 g

Laboratorio TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA TEVA THERASKIN THERASKIN UCI-FARMA UCI-FARMA UCI-FARMA CAZI CAZI MERCK FARMASA EVERSIL CRISTALIA CRISTALIA OSORIO DE MORAES OSORIO DE MORAES OSORIO DE MORAES GENZYME DO BRASIL EMS

UNIDADE Pco Unt Base A ML 0,02 CPR 0,45 ML 0,09 ML 1,32 FA 144,27 FA 312,80 FA 850,05 FA 111,70 FA 41,92 FA 332,57 FA 35,72 AMP 10,99 FA 149,33 FA 746,63 FA 12,88 FA 80,15 FA 2488,19 FA 1305,57 FA 390,88 FA 134,16 FA 629,91 FA 22,48 G 0,48 CPR 1,92 ML 0,27 G 0,67 CPR 1,67 G 0,37 COMP 3,57 COMP 0,34 ML 1,17 FR 15,36 FR 20,18 GOTAS 0,01 GOTAS 0,02 CPR 0,40 F,A, 1590,64 X GRAMA 0,24

332

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12713 12714 12715 12716 12717 12718 12719 12720 12721 12722 12723 12724 12725 12726 12727 12728 12729 12730 12731 12732 12733 12734 12735 12736 12737 12738 12739 12740 12741 12742 12743 12744 12745 12746 12747 12748 12749 12750

CODIGO BENEFICIO 95024344 TIABENDAZOL - GENERICO 95024352 TIABENDAZOL - GENERICO 95897674 TIABENDAZOL - GENERICO 95897682 TIABENDAZOL - GENERICO 95897690 TIABENDAZOL - GENERICO 95006192 TIABENZOL 95083367 TIAMIN 95084401 TIAMIN 95083359 TIAMIN 95024360 TIAPRIDAL 95980261 TIBIAL 95024387 TICLID 95160663 TICLOBAL 95068554 TIEPEM 95068546 TIEPEM 95068538 TIEPEM 95201831 TILADE 95664319 TILATIL 95664254 TILATIL 95664300 TILATIL 95024395 TILONAX 95060430 TILONAX 95664327 TILOXICAN 95113380 TILOXICAN 95334521 TIMASEN 95334513 TIMASEN 95334483 TIMASEN 95334505 TIMASEN 95334491 TIMASEN 95138056 TIMENTIN 95060448 TIMONEO 95720316 TIMOPTOL 95720308 TIMOPTOL 95720324 TIMOPTOL 95720332 TIMOPTOL 95750231 TIMPANOL 95044264 TINIDAZOL - GENERICO 95044280 TINIDAZOL - GENERICO

APRESENTAÇÃO 50 mg/g pom, bisn, 45 g 50 mg/g pom, bisn, 45 g 500 mg, 1 bl, x 6 cprs, 500 mg, 1 bl, x 6 cprs, 500 mg, 6 cprs, Susp, oral 250 mg/5 ml fr, 60 ml Gts, vd, 30 ml Sol, inj, cx, 50 amps, 2 ml Sol, oral fr, 100 ml Cx, 20 cprs, 2,5 mg, cx, bl, 28 cprs, Cx, 20 drags, 250 mg cx, 30 cprs, 120 ml FA 20 ml FA 20 ml FA - monovial Aerossol 15,53 g c/112 doses 20 mg, 1 FA+ 1 amp, dil, x 2 ml, 20 mg, 10 cprs, 40 mg, 1 FA+ amp, dil, x 2 ml 20 mg, 10 cprs, 20 mg, bl, 10 cprs, 20 mg, cx, 10 cprs, 25 mg, bl, 10 cprs, rev, 100 mg, 6 amps, 2 ml 100 mg, gts, fr, 10 ml 50 mg, bl, 10 caps, SR 100 mg, bl, 10 caps, SR 50 mg, bl, 10 caps, 3,1 g inj. cx. 10 amps. s/dil. 5 mg/ml sol, oft, fr, 5 ml 0,25% fr, 5 ml, 0,5% fr, 5 ml, XE - sol, oft, 0,25% XE - sol, oft, 0,5%, 5ML Sol, fr, 10 ml, 500 mg, 1 bl, x 4 cprs, rev, 500 mg, 1 bl, x 4 cprs, rev,

Laboratorio GERMED GEN - LEGRAND GERMED GEN - LEGRAND EMS TEUTO BRAS, NEO QUIMICA NEO QUIMICA NEO QUIMICA SANOFI-AVENTIS NEO QUIMICA SANOFI-AVENTIS BALDACCI BIOCHIMICO BIOCHIMICO BIOCHIMICO AVENTIS PHARMA ROCHE ROCHE ROCHE CIFARMA CIFARMA HEXAL HEXAL ACHE ACHE ACHE ACHE ACHE GLAXOSMITHKLINE NEO QUIMICA MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME HEXAL EMS GERMED

UNIDADE Pco Unt Base A GRAMA 0,20 GRAMA 0,20 COMP 0,97 COMP 0,98 COMP 1,03 ML 0,19 GOTA 0,01 AMP 4,69 ML 0,07 COMP 0,69 CPR 1,75 DRAG 2,12 CPR 1,29 FA 97,25 FA 97,25 FA 97,25 DOSE 0,47 FA 6,11 CPR 3,83 FA 10,76 COMP 1,46 COMP 1,73 CPR 1,58 comp 1,97 AP 6,52 GOTAS 0,22 CPR 2,70 CPR 5,28 CPR 3,17 FA 39,42 GOTA 0,07 GOTAS 0,07 GOTAS 0,10 GOTAS 0,21 GOTAS 0,33 GOTAS 0,03 CP 1,42 CP 1,42

333

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12751 12752 12753 12754 12755 12756 12757 12758 12759 12760 12761 12762 12763 12764 12765 12766 12767 12768 12769 12770 12771 12772 12773 12774 12775 12776 12777 12778 12779 12780 12781 12782 12783 12784 12785 12786 12787 12788

CODIGO BENEFICIO 95044272 TINIDAZOL - GENERICO 95044299 TINIDAZOL - GENERICO 95897704 TINIDAZOL - GENERICO 95897712 TINIDAZOL - GENERICO 95897720 TINIDAZOL - GENERICO 95897739 TINIDAZOL - GENERICO 95044302 TINIDAZOL + NITRATO DE MICONAZOL - GENER 95041265 TINIDAZOL + NITRATO DE MICONAZOL - GENER 95897747 TINIDAZOL + NITRATO DE MICONAZOL - GENER 95897755 TINIDAZOL + NITRATO DE MICONAZOL - GENER 95897763 TINIDAZOL + NITRATO DE MICONAZOL - GENER 95391894 TINIDAZOL+NITR, DE MICONAZOL - GENERICO 95391908 TINIDAZOL+NITR, DE MICONAZOL - GENERICO 95024409 TINORAL 95041273 TIOCONAZOL - GENERICO 95980270 TIOCONAZOL - GENERICO 95897771 TIOCONAZOL - GENERICO 95391916 TIOCONAZOL - GENERICO 95391924 TIOCONAZOL - GENERICO 95980300 TIOCONAZOL - GENERICO 95980318 TIOCONAZOL - GENERICO 95897780 TIOCONAZOL - GENERICO 95980334 TIOCONAZOL + TINIDAZOL - GENERICO 95391932 TIOCONAZOL + TINIDAZOL - GENERICO 95024425 TIOCONAZOL + TINIDAZOL - GENERICO 95024417 TIOCONAZOL + TINIDAZOL - GENERICO 95060456 TIOCONAZOL + TINIDAZOL - GENERICO 95980326 TIOCONAZOL + TINIDAZOL - GENERICO 95980342 TIOCONAZOL + TINIDAZOL - GENERICO 95041281 TIOCONAZOL + TINIDAZOL - GENERICO 95060464 TIOCONAZOL + TINIDAZOL - GENERICO 95897798 TIOCONAZOL + TINIDAZOL - GENERICO 95980350 TIONAZEN 95980369 TIONAZEN 95980377 TIONAZEN 95897801 TIORFAN 95113398 TIORFAN SACHE 95024433 TIORFAN SACHE

APRESENTAÇÃO 500 mg, 2 bl, x 4 cprs, rev, 500 mg, 2 bl, x 4 cprs, rev, 500 mg, 4 cprs, 500 mg, 8 cprs, 500 mg, bl, 4 cprs, rev, 500 mg, bl, 8 cprs, rev, 1 bisn, 40 g 30 mg/g+ 20 mg/g crem, vag, ct, bg, al, x 45g+ aplic, 30 mg/g+ 20 mg/g creme vag, bisn, 40 g+ 7 aplic, 30 mg/g+ 20 mg/g creme vag, bisn, 80 g+ 14 aplic, Creme vag, cx, 50 bisn, 45 g 30 mg/g+ 20 mg/g cr, vag, bisn, 40 g+ 7 aplic, Bisn, 40 g+ 7 aplic, Bl, 14 cprs, rev, 10 mg/g crem, derm, ct, bg, al, x 30 g 10 mg/g creme 30 g 10 mg/g locao top, 30 g 30 mg, creme derm, bisn, 30 g 30 mg, locao bisn, 30 g Creme 1% bisn, 30 g Locao fr, 30 g Pom, vag, 65 mg/g 1 aplic, gin, 4,62 g 20 mg,+ 30 mg, bisn, 35 g,+ aplic, 20 mg/g+ 30 mg/g cr, vag, bisn, 35 g+ 7 aplic, 20 mg/g+ 30 mg/g creme vag, 100 bisn, 35 g+ 7 aplic, 20 mg/g+ 30 mg/g creme vag, bisn, 35 g+ 7 aplic, 20 mg/g+ 30 mg/g creme vag, bisn, 35 g+ 7 aplic, 20+ 30 mg/g creme vag, 35 g Creme bisn, 35 g+ 7 aplic, Creme vag, 35 g+ 7 aplic, Creme vag, bisn, 35 g+ 7 aplic, Creme vag, bisn, 35 g+ 7 aplic, 10 mg/g creme derm, bisn, 30 g 10 mg/ml locao emuls, fr, x 30 g 280mg/mlsol,fr,12ml 100 mg 9 caps, 10 mg, po oral ct, 18 saches x 1 g 30 mg, po oral ct, 18 saches x 3 g

Laboratorio EMS GERMED MEDLEY MEDLEY FARMASA FARMASA CRISTALIA PRATI DONADUZZI FARMASA FARMASA PRATI DONADUZZI MEDLEY CRISTALIA UNIAO QUIMICA PRATI DONADUZZI PRATI DONADUZZI PRATI DONADUZZI MEDLEY MEDLEY EMS EMS BLAUSIEGEL EMS MEDLEY PRATI DONADUZZI PRATI DONADUZZI NEO QUIMICA PRATI DONADUZZI ATIVUS GERMED MEPHA-RATIOPHARM GEN - LEGRAND CAZI CAZI CAZI BAGO BAGO BAGO

UNIDADE Pco Unt Base A CP 1,18 CP 1,18 COMP 1,41 COMP 1,18 COMP 1,13 COMP 0,94 G 0,27 G 0,28 GRAMA 16,61 GRAMA 16,52 G 7,50 G 0,38 G 0,38 COMP 0,52 G 0,38 G 0,36 GRAMA 0,38 G 0,61 G 0,61 G 0,53 G 0,45 UND 15,17 G 0,76 G 0,76 GRAMA 33,06 GRAMA 0,69 G 0,76 G 0,53 G 0,62 G 0,70 G 0,75 G 0,75 G 0,91 G 0,77 GOTAS 0,41 CAPS 2,71 ENV 1,48 ENV 1,57

334

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12789 12790 12791 12792 12793 12794 12795 12796 12797 12798 12799 12800 12801 12802 12803 12804 12805 12806 12807 12808 12809 12810 12811 12812 12813 12814 12815 12816 12817 12818 12819 12820 12821 12822 12823 12824 12825 12826

CODIGO BENEFICIO 95113401 TIORFAN SACHE 95980385 TIOTRAX 95068562 TIOXIN 95042806 TIRA REAGENTE P GLICEMIA - GLICOSIMETRO 95074040 TIRATOSSE 95260706 TIRATOSSE 95074031 TIRATOSSE 95260692 TIRATOSSE 95980393 TIROIDIN 95068570 TISSUCOL 95068589 TISSUCOL 95068597 TISSUCOL 95980407 TOBRACIN 95980415 TOBRACIN 95980423 TOBRACIN-D 95980431 TOBRACIN-D 95700200 TOBRACORT 95700218 TOBRACORT 95383280 TOBRADEX 95383298 TOBRADEX 95700226 TOBRAGAN 95113410 TOBRALOX 95383301 TOBRAMICINA - GENERICO 95383310 TOBRAMICINA - GENERICO 95081682 TOBRAMICINA - GENERICO 95081674 TOBRAMICINA - GENERICO 95897810 TOBRAMICINA + DEXAMETASONA - GENERICO 95383328 TOBRAMICINA + DEXAMETASONA - GENERICO 95383336 TOBRAMICINA 0,3%+DEXAMETASONA 0,1%-GEN, 95006265 TOBRAMINA 95383360 TOBRANOM 95383379 TOBRANOM 95383395 TOBREX 95383387 TOBREX 95291440 TOFRANIL 95291458 TOFRANIL 95060480 TOFRANIL 95291474 TOFRANIL

APRESENTAÇÃO 30 mg, po oral ct, 2 saches x 3 g Creme bisn, 35 g+ 7 aplic, 3,0 g+ 0,1 g po sol, inj, IV FA vd, inc, (emb, hosp,) Und - uso capilar Ad, fr, 120 ml, Ad, fr, 120 ml, Ped, fr, 120 ml, Ped, fr, 120 ml, 100 mcg, cx, 2 bl, x 15 cprs, 1,0 ml+ dil,+ aplic, 2,0 ml+ dil,+ aplic, 5,0 ml+ dil,+ aplic, Bisn, 3,5 g Fr, 5 ml Bisn, 3,5 g Fr, 5 ml Colirio 5 ml Pom, 3,5 g Pom, oft, bisn, 3,5 g Susp, fr, 5 ml 5 ml, Sol, oft, fr, 5 ml 0,3% fr, 5 ml 0,3% sol, oft, cx, 1 fr, 5 ml, 3 mg, sol, oft, fr, 5 ml 3 mg/ml sol, oft, fr, 5 ml 0,3%+ 0,1% susp, oft, fr, plast, 5 ml Susp, 5 mlALCON 5 mlALLERGAN 75 mg, cx, 2 amps, 1,5 ml, Colirio 5 ml Pom, 3,5 g Pom, 3,5 g, Sol, ocular 5 ml, 10 mg, 20 drags, 25 mg, 20 drags, Pamoato 150 mg, 30 cs, Pamoato 150 mg, bl, 20 caps,

Laboratorio BAGO EMS NOVAFARMA COSMED COSMED COSMED COSMED NEO QUIMICA BAXTER BAXTER BAXTER LATINOFARMA LATINOFARMA LATINOFARMA LATINOFARMA UNIAO QUIMICA UNIAO QUIMICA ALCON ALCON ALLERGAN EMS ALCON CRISTALIA GEN - LEGRAND GERMED BIOSINTETICA ALCON ALLERGAN ABL UNIAO QUIMICA UNIAO QUIMICA ALCON ALCON NOVARTIS NOVARTIS NOVARTIS NOVARTIS

UNIDADE Pco Unt Base A ENV 1,57 G 0,84 FA 29,87 Und 1,19 ML 0,11 ML 0,08 ML 0,10 ML 0,08 CPR 0,77 UNID 430,67 X UNID 818,24 X UNID 1963,86 X G 6,30 GOTAS 0,17 G 6,85 GOTAS 0,22 GOTAS 0,17 G 5,31 G 6,39 GOTAS 0,21 GOTAS 0,17 Gotas 0,09 GOTAS 0,10 GOTAS 0,11 UNID 10,28 UNID 10,28 GOTA 11,98 ML 0,13 GOTAS 0,14 AMP 25,73 GOTAS 0,12 G 4,24 G 6,18 GOTAS 0,17 CPR 0,34 CPR 0,41 COMP 2,16 CPR 1,71

335

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12827 12828 12829 12830 12831 12832 12833 12834 12836 12837 12838 12839 12840 12841 12842 12843 12844 12845 12846 12847 12848 12849 12850 12851 12852 12853 12854 12855 12856 12857 12858 12859 12860 12861 12862 12863 12864 12865

CODIGO BENEFICIO 95060472 TOFRANIL 95291466 TOFRANIL 95074058 TOLREST 95897828 TOLREST 95291490 TOLREST 95897836 TOLREST 95291520 TOLREST 95480706 TOMUDEX 95340688 TOPAMAX 95340670 TOPAMAX 95340696 TOPAMAX SPRINKLE 95340700 TOPAMAX SPRINKLE 95024468 TOPIRAMATO - GENERICO 95024492 TOPIRAMATO - GENERICO 95024522 TOPIRAMATO - GENERICO 95042709 TOPIRAMATO - GENERICO 95024450 TOPIRAMATO - GENERICO 95024484 TOPIRAMATO - GENERICO 95024514 TOPIRAMATO - GENERICO 95042687 TOPIRAMATO - GENERICO 95024441 TOPIRAMATO - GENERICO 95024476 TOPIRAMATO - GENERICO 95024506 TOPIRAMATO - GENERICO 95094679 TOPIRAMATO - GENERICO 95042695 TOPIRAMATO - GENERICO 95113428 TOPISON 95980547 TOPISON 95980555 TOPISON 95068600 TOPLANINA 95260714 TOPLEXIL 95260722 TOPLEXIL 95260730 TOPLEXIL 95260749 TOPLEXIL 95076018 TOPORAN 95841784 TOPPYC 95060499 TOPTIL 95060502 TOPTIL 95060570 TOPTIL

APRESENTAÇÃO Pamoato 75 mg, 30 cs, Pamoato 75 mg, bl, 20 caps, 100 mg, bl, 20 cprs, 100mg,bl,14cprs, rev, 25 mg, cx, 7 cprs, 50 mg, bl, 21 cprs, rev, 75 mg, 2 bl, x 15 cprs, rev, 2 mg 1 FA 100 mg, 60 cprs, 50 mg, 60 cprs, 15 mg cart, 1 fr, 60 caps, 25 mg cart, 1 fr, 60 caps, 100 mg, 4 bl, x 15 cprs, rev, 100 mg, 4 bl, x 15 cprs, rev, 100 mg, 4 bl, x 15 cprs, rev, 100 mg, bl, 60 cprs, rev, 25 mg, 3 bl, x 20 cprs, rev, 25 mg, 3 bl, x 20 cprs, rev, 25 mg, 3 bl, x 20 cprs, rev, 25mg,bl,60 cprs, rev, 50 mg, 4 bl, x 15 cprs, rev, 50 mg, 4 bl, x 15 cprs, rev, 50 mg, 4 bl, x 15 cprs, rev, 50 mg, x 60 cprs, rev, 50mg,bl,60 cprs, rev, Creme 10 g Creme1mg/g20g, Pom,1mg/g20g, 400 mg, po liof, inj, IV/IM Fr, 120 ml, Ped, fr, 120 ml, Xpe ad, fr, vd, 100 ml, Xpe ped, fr, vd, 100 ml 4 mg, po liof, inj, ct, FA vd, inc, Fr, 60 ml 100 mg, bl, 30 cprs, rev, 100 mg, bl, 60 cprs, rev, 100mg,bl,10cprs,rev,

Laboratorio NOVARTIS NOVARTIS BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA ASTRAZENECA JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG EMS GERMED GEN - LEGRAND EUROFARMA EMS GERMED GEN - LEGRAND EUROFARMA EMS GERMED GEN - LEGRAND BIOSINTETICA EUROFARMA LIBBS LIBBS LIBBS MEIZLER AVENTIS PHARMA AVENTIS PHARMA SANOFI-AVENTIS SANOFI-AVENTIS MEIZLER JOHNSON & JOHNSON SANDOZ SANDOZ SANDOZ

UNIDADE Pco Unt Base A COMP 1,23 CPR 0,98 COMP 2,25 COMP 4,75 CPR 1,76 COMP 1,13 CPR 1,82 FA 665,99 CPR 6,07 CPR 2,98 CPR 1,09 CPR 1,82 COMP 3,79 COMP 2,82 COMP 2,90 COMP 3,72 COMP 0,96 COMP 0,83 COMP 0,90 COMP 0,88 COMP 1,91 COMP 1,51 COMP 1,73 CPR 1,47 COMP 1,87 GRAMA 1,42 G 1,59 G 1,59 FA 364,11 ML 0,05 ML 0,04 ML 0,13 ML 0,10 FA 834,03 X ML 0,18 COMP 1,81 COMP 1,81 COMP 1,81

336

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12866 12867 12868 12869 12870 12871 12872 12873 12874 12875 12876 12877 12878 12879 12880 12881 12882 12883 12884 12885 12886 12887 12888 12889 12890 12891 12892 12893 12894 12895 12896 12897 12898 12899 12900 12901 12902 12903

CODIGO BENEFICIO 95060553 TOPTIL 95060510 TOPTIL 95060537 TOPTIL 95060561 TOPTIL 95060529 TOPTIL 95060545 TOPTIL 95006281 TORADOL 95897844 TORAGESIC 95006303 TORAGESIC 95006311 TORAGESIC 95980563 TORAGESIC SL 95084932 TORLOS 95980571 TORLOS 95980580 TORLOS 95980598 TORLOS 95980601 TORLOS H 95980610 TORLOS H 95006320 TORVAL CR 95006338 TORVAL CR 95260757 TOSSILERG 95006354 TOTELLE 95006346 TOTELLE CICLO 95074066 TOTELMIN 95980628 TOXOIDE TETANICO 95334602 TRABILIN 95334599 TRABILIN 95334580 TRABILIN 95600450 TRACITRANS-PLUS 95897852 TRACLEER 95897860 TRACLEER 95410716 TRACONAL 95980636 TRACONAX 95910450 TRACRIUM 95910441 TRACRIUM 95006362 TRACTOCILE 95006370 TRACTOCILE 95910468 TRACUR 95910476 TRACUR

APRESENTAÇÃO 25 mg, bl, 10 cprs, rev, 25mg, bl,30cprs,rev, 25mg,bl,60cprs,rev, 50 mg, bl, 10 cprs, rev, 50mg, bl,30cprs,rev, 50mg, bl,60cprs,rev, Inj, 30 mg, 10 amps, 20 mg/ml gts, fr, 10 ml Inj, 30 mg/ml 3 amps, 1 ml Inj, 60 mg/2 ml 3 amps, 2 ml 10 mg cx, 10 caps, 100 mg, cx, 10 cprs, 25 mg cx, 28 cprs, 50 mg cx, 14 cprs, 50 mg cx, 28 cprs, 50/12,5 mg cx, 14 cprs, 50/12,5 mg cx, 28 cprs, 300 mg, cx, 30 cprs, 500 mg, cx, 30 cprs, Xpe fr, 100 ml, Ct, 1 bl, x 28 drags, Ct, 1 bl, x 14+ 14 drags, Susp, 10 ml Cart,1 ser, 1 dose 100 mg, 5 amps, 50 mg, 10 caps, Gts, 100 mg, fr, 10 ml 10 x 10 ml 125 mg, fr, plast, 60 cprs, rev, 62,5 mg, fr, plast, 60 cprs, rev, 100 mg, caps, gel, bl, x 15 100 mg, 4 caps, 25 mg, 5 amps, 2,5 ml, 50 mg, 5 amps, 5 ml, 7,5 mg/ml 1 amp, 0,9 ml 7,5 mg/ml 1 amp, 5,0 ml 10 mg/ml - 5 amp, 2,5 ml, 10 mg/ml - 5 amp, 5 ml,

Laboratorio SANDOZ SANDOZ SANDOZ SANDOZ SANDOZ SANDOZ ROCHE SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA TORRENT TORRENT TORRENT TORRENT TORRENT TORRENT TORRENT TORRENT BUNKER WYETH WYETH DOVALLE AVENTIS PASTEUR MEPHA MEPHA MEPHA FRESENIUS KABI ACTELION ACTELION ACHE LUPER GLAXOSMITHKLINE GLAXOSMITHKLINE FERRING FERRING CRISTALIA CRISTALIA

UNIDADE Pco Unt Base A COMP 0,45 COMP 0,45 COMP 0,40 COMP 0,89 COMP 0,80 COMP 0,80 AMP 5,41 GOTA 30,32 AMP 6,07 AMP 12,15 CPR 2,10 COMP 1,09 CPR 0,46 CPR 0,72 CPR 0,72 CPR 0,63 CPR 0,63 COMP 0,67 COMP 1,11 ML 0,10 DRAG 1,80 DRAG 1,80 ML 0,60 UND 7,84 AP 5,58 CPR 2,05 GOTAS 0,19 AP 17,08 COMP 189,48 COMP 189,38 CPR 5,43 CPR 7,16 AP 15,09 AP 28,85 AMP 165,79 AMP 515,51 AP 16,02 AP 30,41

337

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12904 12905 12906 12907 12908 12909 12910 12911 12912 12913 12914 12915 12916 12917 12918 12919 12920 12921 12922 12923 12924 12925 12926 12927 12928 12929 12930 12931 12932 12933 12934 12935 12936 12937 12938 12939 12940 12941

CODIGO BENEFICIO 95068619 TRACUR 95068627 TRACUR 95084428 TRACUR 95084410 TRACUR 95084436 TRAMADEN 95024530 TRAMADEN 95334688 TRAMADON 95334629 TRAMADON 95334653 TRAMADON 95334610 TRAMADON 95391959 TRAMADON 95334661 TRAMADON 95334670 TRAMADON 95334734 TRAMAL 95334718 TRAMAL 95334742 TRAMAL 95334696 TRAMAL 95334700 TRAMAL 95068635 TRAMALIV 95042717 TRAMALIV 95068643 TRAMALIV 95980644 TRANDOR 95986448 TRANQUINAL 95980652 TRANQUINAL 95271813 TRANQUINAL 95271821 TRANQUINAL 95160701 TRANSAMIN 95160710 TRANSAMIN 95024590 TRANXILENE 95024573 TRANXILENE 95024581 TRANXILENE 95980709 TRATZOL 95980717 TRAVAD ENEMA 95670084 TRAVATAN 95160728 TRAVISCO 95510982 TRAVOGYN 95510990 TRAVOGYN 95042733 TRENTAFILINA

APRESENTAÇÃO 10 mg/ml - 5 amps, 2,5 ml 10 mg/ml - 5 amps, 5 ml 10 mg/ml sol, inj, 25 amps, 5 ml 10 mg/ml sol, inj, 25 amps, x 2,5 ml 50 mg, cx, 10 bl, x 10 caps, (hosp,) 50 mg, cx, 10 caps, 100 mg, cx, 10 cprs, rev, 100 mg, fr, 10 ml gts, 50 mg, 10 bl, c/10 50 mg, cx, 10 caps, 50 mg, cx, 6 amps, 1 ml 50 mg, inj, cx, 100 amps, 1 ml 50 mg, inj, cx, 100 amps, 2 ml Caps, 10 x 50 mg, Gts, 100 mg/10 ml Inj, 6 x 100 mg, Inj, 6 x 50 mg, Retard 100 mg, cx, 10 cprs, 100 mg, sol, inj, c/6 50 mg, (A2) 10 caps, 50 mg, sol, inj, c/6 200 mg, cx, 10 caps, 0,25 mg, com est cart, bl al pvc x 20 0,5 mg, com est cart, bl al pvc x 20 1 mg 20 cprs, 2 mg 20 cprs, Cx, 12 cprs, Cx, 5 amps, 5 ml, 10 mg, fr, 20 caps, 15 mg, fr, 20 caps, 5 mg, fr, 20 caps, 100 mg, cx, 4 caps, Bolsa plast, X 133 ml, - 16G/100 ml+ 6G/100 ml 0,004% fr, 2,5 ml, 200 mg, cx, 30 cprs, 7 aplic, vag,pre-envasados desc, Bisn, 35 g,+ 7 aplic, 400 mg, 3 bl, x 10 cprs, rev,

Laboratorio CRISTALIA CRISTALIA CRISTALIA CRISTALIA NEO QUIMICA NEO QUIMICA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA CRISTALIA PFIZER PFIZER PFIZER PFIZER PFIZER TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, BIOLAB SANUS BAGO BAGO BAGO BAGO NIKKHO NIKKHO SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS CAZI BAXTER ALCON CHIESI ATIVUS ATIVUS SIGMA PHARMA

UNIDADE Pco Unt Base A AMP 16,90 AMP 32,07 AMP 32,22 AMP 16,98 CAPS 14,66 CAPS 1,69 CPR 3,86 GOTAS 0,19 CPR 2,43 CPR 2,06 AP 5,23 AP 5,13 AP 7,41 CAPS 3,51 GOTAS 0,32 AP 7,59 AP 5,31 CPR 6,36 AMP 6,35 COMP 2,01 AMP 4,11 CPR 1,35 COMP 0,35 CPR 0,69 CPR 1,22 CPR 2,08 CPR 2,95 AP 5,86 CAPS 0,31 CAPS 0,42 CAPS 0,22 CPR 9,58 UND 12,05 GOTAS 1,51 CPR 1,76 UND 7,44 G 0,65 COMP 0,66

338

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12942 12943 12944 12945 12946 12947 12948 12949 12950 12951 12952 12953 12954 12955 12956 12957 12958 12959 12960 12961 12962 12963 12964 12965 12966 12967 12968 12969 12970 12971 12972 12973 12974 12975 12976 12977 12978 12979

CODIGO BENEFICIO 95897879 TRENTAFILINA 95042725 TRENTAFILINA 95040285 TRENTAL 95040293 TRENTAL VERT 95006460 TRENTOFIL 95041290 TRESSLIV 95125540 TREZEVIT AB (Restrito Hosp,) 95125558 TREZEVIT AB (Restrito Hosp,) 95640487 TRIANCIL 95125787 TRIANCINOLONA 40MG/ML - USO OFTALMOLOGICO 95041338 TRIANCINOLONA ACETONIDA + SULF, DE NEOM, 95041346 TRIANCINOLONA ACETONIDA + SULF, DE NEOM, 95041303 TRIANCINOLONA ACETONIDA + SULF, DE NEOM, 95041311 TRIANCINOLONA ACETONIDA + SULF, DE NEOM, 95041320 TRIANCINOLONA ACETONIDA + SULF, DE NEOM, 95135448 TRIATEC 95135456 TRIATEC 95135464 TRIATEC 95074074 TRIATEC D 95980725 TRIATEC PREVENT 95980733 TRIATEC PREVENT 95151770 TRIAXIN 95125566 TRIAXIN 95151788 TRIAXIN 95024603 TRIAXON 95068678 TRIAXON 95084479 TRIAXON 95084460 TRIAXON 95068660 TRIAXON 95068651 TRIAXON 95042741 TRIAXON 95901272 TRIAXTON 95392025 TRIAZOL 95392033 TRIAZOL 95392009 TRIAZOL 95511016 TRICANGINE A 95511040 TRICOCILIN B 95511059 TRICOLPEX

APRESENTAÇÃO Laboratorio 400mg,2 bl,x10 cprs, SIGMA PHARMA 600 mg, 2 bl, x 10 cprs, rev, SIGMA PHARMA Cx, 5 amps, 5 ml, SANOFI-AVENTIS 600 mg 2 bl, x 10 cprs, rev, SANOFI-AVENTIS 400 mg, cx, 20 cprs, UCI-FARMA Cx, 30 cprs, CIFARMA Sol, inj, A + sol, inj, B - cx, 25 amps, A x 5 ml + 25 amps, B xINPHARMA 5 ml adulto Sol, inj, A + sol, inj, B - cx, 25 amps, A x 5 ml + 25 amps, B xINPHARMA 5 ml pediatrico 20 mg/ml susp, inj, FA 5 ml APSEN 40 mg/ml 1 mg/g+ 1,68 mg/g+ 0,25 mg/g+ 100,000 UI/g cr derm, ct, bPRATI DONADUZZI 1 mg/g+ 2,5 mg/g+ 0,25 mg/g+ 100,000 UI/g pom, derm, ct,PRATI DONADUZZI Creme bisn, 30 g EMS Creme bisn, 30 g GEN - LEGRAND Pom, bisn, 30 g GEN - LEGRAND 2,5 mg, 3 str, x 10 cprs, SANOFI-AVENTIS 5,0 mg, 3 str, x 10 cprs, SANOFI-AVENTIS D 5 mg,+ 25 mg, bl, 30 cprs, AVENTIS PHARMA 5 mg,+ 25 mg, bl, 30 cprs, SANOFI-AVENTIS 10 mg fr, vd, 15 caps, SANOFI-AVENTIS 10 mg fr, vd, 30 caps, SANOFI-AVENTIS 1 g po sol. inj. IM FA vd. inc. + amp. dil. plast. inc. x 3,5 ml MOMENTA 250 inj,FA fr, vd. vd, inc. inc, + + amp. amp, dil. dil, plast. plast, inc. inc, xx 22 ml EUROFARMA 500 mg, mg. po po liof, sol. sol, inj. IM ml MOMENTA 1 g IV po inj, 50 FA vd, (hosp,) TEUTO BRAS, 1 g IV po inj, FA+ dil, cx, c/1 TEUTO BRAS, 250 mg, IM po sol, inj, FA+ dil, x 2 ml TEUTO BRAS, 500 mg, IM po inj, FA vd,+ dil 2 ml TEUTO BRAS, 500 mg, IV po inj, 50 FA vd, (emb, hosp,) TEUTO BRAS, 500 mg, IV po inj, FA+ dil cx/ c/1 TEUTO BRAS, IM 1 g cx, FA+ amp, dil, x 3,5 ml TEUTO BRAS, 1,0 g po inj, cx, 20 FA+ 20 amps, dil, plast, x 10 ml ARISTON 100 mg, cx, 8 caps BIOLAB SANUS 150 mg, cx, 1 caps BIOLAB SANUS 150 mg, cx, 2 caps, BIOLAB SANUS Creme bisn, 85 g,+ 15 aplic, ACHE Creme vag, 10 aplic, bisn, 45 g, EMS Creme vag, tb, 40 g, BUNKER

UNIDADE Pco Unt Base A COMP 0,99 COMP 0,99 AP 1,77 CPR 2,46 COMP 1,36 CP 1,21 AMP 8,10 AMP 8,10 FA 56,87 Amp 15,53 TB 15,77 TB 14,59 G 0,47 G 0,52 G 0,47 CPR 2,46 CPR 4,64 CPR 3,62 COMP 4,01 CPR 5,18 CPR 5,18 FA 18,32 FR 4,19 FA 11,25 FA 23,86 FA 24,30 FA 5,53 FA 11,06 FA 15,61 FA 15,61 FA 16,84 FA 33,60 CPR 12,11 CPR 12,30 CPR 10,06 G 0,43 G 0,73 G 0,54

339

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 12980 12981 12982 12983 12984 12985 12986 12987 12988 12989 12990 12991 12992 12993 12994 12995 12996 12997 12998 12999 13000 13001 13002 13003 13004 13005 13006 13007 13008 13009 13010 13011 13012 13013 13014 13015 13016 13017

CODIGO BENEFICIO 95980741 TRICOMAX 95140883 TRIDIL 95140891 TRIDIL 95125574 TRIDIL (Restrito Hosp,) 95125582 TRIDIL (Restrito Hosp,) 95060618 TRIEXIDYL 95980750 TRIFAMOX IBL 95980768 TRIFAMOX IBL 95980776 TRIFAMOX IBL 95980784 TRIFAMOX IBL 95113436 TRIFAMOX IBL 95980792 TRIFAMOX IBL 95090827 TRIFAMOX IBL 95006478 TRIFAMOX IBL BD 95006486 TRIFAMOX IBL BD 95006494 TRIFAMOX IBL BD 95240160 TRIFEDRIN 95041354 TRILAX 95340742 TRILEPTAL 95340718 TRILEPTAL 95340769 TRILEPTAL 95024611 TRILEPTAL 95340777 TRILEPTAL 95340750 TRILEPTAL 95340726 TRILEPTAL 95980822 TRI-LUMA 95024670 TRIMEXAZOL 95024638 TRIMEXAZOL 95024662 TRIMEXAZOL 95024646 TRIMEXAZOL 95024654 TRIMEXAZOL 95461469 TRINESTRIL-AP 95511075 TRINIZOL 95006516 TRIOXINA 95383662 TRIOXINA 95980830 TRIPSOL 95980849 TRISCON 95980857 TRISCON

APRESENTAÇÃO Laboratorio Creme vag, bisn, 50 g CAZI 25 mg 1 amp, 5 ml, CRISTALIA 50 mg, 1 amp, 10 ml, CRISTALIA 25 mg, 10 amps, 5 ml CRISTALIA 50 mg, 10 amps, 10 ml CRISTALIA 5 mg, 20 bl, 10 cps, CRISTALIA 25 mg/ml+ 25 mg/ml po prep, ext, ct cart, fr, plas, x 30 g BAGO 250 mg,+ 250 mg, com rev, ct cart, 2 bl al pvc x 8 BAGO 250 mg,+ 250 mg, com rev, ct cart, bl al pvc x 8 BAGO 50 mg/ml+ 50 mg/ml po prep, ext, ct cart, fr, plas, opc x 3 BAGO 500 mg, + 250 po inj, ct cart, FA vd inc + dil, amp, vc inc, x 5BAGO ml 500 mg,+ 500 mg, com rev, ct cart, bl al pvc x 8 BAGO 1000 mg,+ 500 mg, po inj, ct cart, FA vd inc,+ dil, amp, inc, xBAGO 5 ml 200 mg/ml+ 50 mg/ml (apos reconst,) po p/prep, ext, fr, pla BAGO 200 mg/ml+ 50 mg/ml (apos reconst,) po p/prep, ext, fr, pla BAGO 875 mg,+ 125 mg, 2 bl, x 7 cprs, rev, BAGO Inf, fr, 100 ml, FARMOQUIMICA 300 mg,+ 125 mg,+ 30 mg,+ 50 mg, bl, 30 cprs, HEXAL 300 mg, 10 cp, NOVARTIS 300 mg, 20 cp, NOVARTIS 300 mg, 60 cp, NOVARTIS 6% 100 ml susp, ind, ped, NOVARTIS 600 mg 60 cp, NOVARTIS 600 mg, 10 cp, NOVARTIS 600 mg, 20 cp, NOVARTIS Creme bisn, 15 g GALDERMA 400 cx, 25 x 4 cprs, SANOFI-AVENTIS 400 mg, 20 cprs, SANOFI-AVENTIS 800 cx, 10 cprs, SANOFI-AVENTIS Ped, vd, 100 cc SANOFI-AVENTIS Ped, vd, 50 cc SANOFI-AVENTIS Cx, 1 amp, SANOFI-AVENTIS M Creme vag, 80 g, aplic, UCI-FARMA 1 g I,V, po inj, ct, 50 FA vd, inc, UNIAO QUIMICA 1 g IM 1 FA+ dil, 3,5 ml UNIAO QUIMICA 25 mg, cx, 20 cprs, CAZI 3 bl, x 4 cprs, EMS 50 bl, x 4 cprs, EMS

UNIDADE Pco Unt Base A G 0,57 AP 19,49 AP 20,79 AMP 19,50 AMP 20,79 COMP 0,35 G 0,96 CPR 3,99 CPR 4,33 CPR 17,14 FA 28,04 CPR 7,99 FA 46,27 ML 0,19 ML 0,32 COMP 4,47 ML 0,08 CP 0,71 CPR 1,59 CPR 1,56 CPR 1,56 ML 0,35 CPR 2,66 CPR 3,05 CPR 2,99 G 3,73 COMP 0,45 COMP 0,47 COMP 0,97 ML 0,07 ML 0,08 AP 4,97 G 0,24 F,A, 18,30 FA 34,12 CPR 0,53 CPR 1,04 CPR 0,63

340

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13018 13019 13020 13021 13022 13023 13024 13025 13026 13027 13028 13029 13030 13031 13032 13033 13034 13035 13036 13037 13038 13039 13040 13041 13042 13043 13044 13045 13046 13047 13048 13049 13050 13051 13052 13053 13054 13055

CODIGO BENEFICIO 95980865 TRISCON 95980873 TRISCON 95125590 TRISENOX (Restrito Hosp,) 95060626 TRISOMATOL 95060634 TRISOMATOL 95125604 TRISOMATOL (Restrito Hosp,) 95125612 TRISOMATOL (Restrito Hosp,) 95980890 TRISORB 95511091 TRIVAGEL-N 95613277 TRI-VI-FLUOR 95613285 TRI-VI-SOL 95068708 TRIXOTENE 95068716 TRIXOTENE 95870245 TROFODERMIN 95870261 TROFODERMIN 95980903 TROK 95980911 TROK 95980920 TROK-N 95980938 TROK-N 95901280 TROMETAMINA CETOROLACO - GENERICO 95901299 TROMETAMINA CETOROLACO - GENERICO 95041362 TROMETAMOL CETOROLACO - GENERICO 95024760 TROMETAMOL CETOROLACO - GENERICO 95024735 TROMETAMOL CETOROLACO - GENERICO 95024727 TROMETAMOL CETOROLACO - GENERICO 95024743 TROMETAMOL CETOROLACO - GENERICO 95024751 TROMETAMOL CETOROLACO - GENERICO 95113444 TROMETAMOL CETOROLACO - GENERICO 95041389 TROMIX 95041370 TROMIX 95897887 TROMIX 95334769 TROPINAL 95334777 TROPINAL 95710035 TROPINOM 95041397 TROZOLET 95720340 TRUSOPT 95291563 TRYPTANOL 95291571 TRYPTANOL

APRESENTAÇÃO Gts, fr, 15 ml Sol, oral fr, 60 ml 1 mg/ml sol, inj, IV 10 amps, vd, x 10 ml 25 mg, cprs, bl, 20 75 mg, cprs, bl, 20 25 mg, bl, 200 cprs, (hosp,) 75 mg, bl, 200 cprs, (hosp,) Sol, 15 ml Cr, bisn, 60 g Sol, oral ct, c/fr, plast x 30 ml Sol, oral ct, c/fr, conta-gts x 30 ml 20 mg, sol, inj, FA vd, x 0,5 ml+ sol, dil, x 1,5 ml 80 mg, sol, inj, FA vd, x 2,0 ml+ sol, dil, x 6,0 ml Bisn, 30 g, cr, derm, Creme ginec, 45 g 8 aplic, Creme 1 bisn, 10 g Pom, 1 bisn, 10 g Creme 1 bisn, 10 g Pom, 1 bisn, 10 g 30mg/ml 3amps,x1 ml 60 mg/ml 3 amps, x 2 ml Sol,oft,5mg/mlfr,5 ml 10 mg, fr, 10 cprs, 10 mg,S, L,fr , 10 cprs, 10mg,S, L,fr, 10 cprs, 30 mg/ml inj, 3 amps, x 1 ml 30 mg/ml inj, 3 amps, x 2 ml 5 mg/ml sol, oft, gts, fr, plast, 5 ml 500 mg, 12 bl, x 3 cprs, rev, 500 mg, bl, x 3 cprs, rev, 500 mg, cx, 36 cprs, Cx, 20 cprs, Sol, fr, 15 ml, Colirio 5 ml 1 mg, 2 bl, x 14 cprs, rev, Sol, oft, 2% cx, fr, 5 ml 25 mg, 20 cprs, 75 mg, 20 cprs,

Laboratorio EMS EMS ZODIAC UCI-FARMA UCI-FARMA UCI-FARMA UCI-FARMA ALCON MARJAN B-MS B-MS SANDOZ SANDOZ PHARMACIA/PFIZER PHARMACIA/PFIZER EUROFARMA EUROFARMA EUROFARMA EUROFARMA GERMED GERMED EMS GEN - LEGRAND GERMED EMS GEN - LEGRAND GEN - LEGRAND BIOSINTETICA ARISTON ARISTON ARISTON SIGMA PHARMA SIGMA PHARMA UNIAO QUIMICA ZODIAC MERCK SHARP & DOHME MERCK SHARP & DOHME MERCK SHARP & DOHME

UNIDADE Pco Unt Base A GOTAS 0,02 ML 0,10 AMP 548,83 COMP 0,44 COMP 1,29 comp 0,36 comp 1,06 GOTAS 0,04 G 0,62 GOTAS 0,02 GOTAS 0,02 FA 778,35 FA 2806,80 G 0,54 G 0,71 G 0,85 G 0,82 G 0,88 G 0,83 AMP 3,68 AMP 7,35 GOTA 0,22 COMP 1,07 COMP 1,05 COMP 1,07 AMP 3,56 AMP 7,12 GOTA 0,20 CP 7,41 CP 7,41 COMP 7,19 CPR 0,59 GOTAS 0,04 GOTAS 0,09 CP 13,99 GOTAS 0,51 CPR 0,75 CPR 2,17

341

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13056 13057 13058 13059 13060 13061 13062 13063 13064 13065 13066 13067 13068 13069 13070 13071 13072 13073 13074 13075 13076 13077 13078 13079 13080 13081 13082 13083 13084 13085 13086 13087 13088 13089 13090 13091 13092 13093

CODIGO BENEFICIO 95074082 TUSSODINA 95074090 TUSSODINA 95024778 TYFLEN 95060642 TYFLEN 95334785 TYFLEN 95024786 TYGACIL 95046569 TYKERB 95989374 TYLAFLEX 95041419 TYLAFLEX 95041400 TYLAFLEX 95024794 TYLECETAMOL 95041427 TYLECETAMOL 95060669 TYLENOL 95060693 TYLENOL 95060715 TYLENOL 95060677 TYLENOL 95060707 TYLENOL 95060723 TYLENOL 95060685 TYLENOL 95060731 TYLENOL 95980946 TYLENOL DC 95980954 TYLENOL DC 95980962 TYLENOL DC 95335005 TYLEX 95986502 TYLEX 95335021 TYLIDOL 95980970 TYLIDOL 95335030 TYLIDOL 95044310 TYNEO 95044329 TYNEO 95543058 UFT 95074104 UFT 95074112 UFT 95024808 ULCEDINE 95024824 ULCEDINE 95024816 ULCEDINE 95989382 ULCENAX 95989390 ULCENAX

APRESENTAÇÃO Ad, 120 ml Ped, 120 ml 750 mg, cx, 200 cprs, Cx, 20 cprs, Gts, 15 ml 50 mg, po liof, 10 FA vd, 250 mg, 70 cprs, 500 mg, cx, 500 cprs, 750 mg, cx, 12 cprs, 750 mg, cx, 200 cprs, 750 mg, 200 cprs, Fracao de venda 200 mg, gts, fr, 15 ml 32 mg, sus, fr, 60 ml 500 mg, bl, emb, mult, 50 x 4 - 200 cprs, 750 mg, bl, 20 cprs, 750 mg, bl, emb, mult, 50 bl, x 4 - 200 cprs, Bebe 100 mg, gts, fr, 15 ml Fracao de venda 500 mg, 4 cprs, Fracao de venda 750 mg, bl, 4 cprs, 1 bl, x 20 cprs, 25 bl, 4 cprs, Bl, 4 cprs, 30,0 mg, blist, 12 cprs, 7,5 mg, blist, 12 cprs, 500 mg, cx, 20 cprs, 750 mg, cx, 200 cprs, Gts, fr, 15 ml 200 mg/ml sol, oral fr, plast, got, x 15 ml 750 mg, bl, 100 cprs, 100 mg 28 caps, 100 mg/224 mg, fr, plast, 120 caps, gel, dura 100 mg/224 mg, fr, plast, 28 caps, gel, dura 200 mg, cx, 40 cprs, 400 cx, 16 cprs, Inj, cart, 6 x 2 ml, 200 mg, cx, 40 cprs, 400 mg, cx, 20 cprs,

Laboratorio DOVALLE DOVALLE BRASTERAPICA BRASTERAPICA BRASTERAPICA WYETH GLAXOSMITHKLINE MEDQUIMICA MEDQUIMICA MEDQUIMICA HEXAL HEXAL JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG/J&J JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG JANSSEN - CILAG TEUTO BRAS, TEUTO BRAS, TEUTO BRAS, NEO QUIMICA NEO QUIMICA B-MS MERCK MERCK SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS MEDQUIMICA MEDQUIMICA

UNIDADE Pco Unt Base A ML 0,09 ML 0,09 COMP 0,37 COMP 0,39 GOTAS 0,01 FA 136,65 COMP 42,05 X COMP 0,28 CP 0,53 CP 0,31 COMP 0,50 CP 0,48 GOTA 0,05 ML 0,20 COMP 0,48 COMP 0,91 COMP 1,01 GOTA 0,05 COMP 0,48 COMP 0,88 CPR 0,70 CPR 0,73 CPR 0,74 CPR 1,57 COMP 1,14 CPR 0,39 CPR 0,43 GOTAS 0,02 GOTA 0,02 CP 0,59 CPR 16,89 CAPS 17,89 CAPS 17,89 COMP 0,05 COMP 0,97 AMP 1,62 COMP 0,25 COMP 0,59

342

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13094 13095 13096 13097 13098 13099 13100 13101 13102 13103 13104 13105 13106 13107 13108 13109 13110 13111 13112 13113 13114 13115 13116 13117 13118 13119 13120 13121 13122 13123 13124 13125 13126 13127 13128 13129 13130 13131

CODIGO BENEFICIO 95032410 ULCERACID 95032479 ULCINAX 95032487 ULCINAX 95032495 ULCINAX 95032509 ULCITRAT 95032517 ULCITRAT 95032525 ULCOREN 95910484 ULTIVA 95910492 ULTIVA 95910506 ULTIVA 95980989 ULTRACET 95074139 ULTRAFER 95074120 ULTRAFER 95897895 ULTRAFER 95383689 ULTRAMOX 95383697 ULTRAMOX 95024832 ULTRAMOX 95060758 ULTRAPROCT 95897909 UMCKAN 95046054 UMCKAN 95383751 UNASYN 95383778 UNASYN 95440348 UNASYN 95006575 UNASYN 95383832 UNI AMOX 95383824 UNI AMOX 95383816 UNI AMOX 95383794 UNI AMOX 95383808 UNI AMOX 95383883 UNI AMPICILIN 95383840 UNI AMPICILIN 95383875 UNI AMPICILIN 95271864 UNI BROMAZEPAX 95271872 UNI BROMAZEPAX 95006583 UNI CARBAMAZ 95024840 UNI CARBAMAZ 95383905 UNI CEFALEXIN 95383891 UNI CEFALEXIN

APRESENTAÇÃO 200 mg, 20 cprs, 200 mg cx, 2 bl, x 10 cprs, 400 mg cx, 2 bl, x 8 cprs, Inj, 300 mg/2 ml cx, 6 amps, 2 ml 200 mg, cx, 20 cprs, 400 mg, cx, 16 cprs, 150 mg, cx, 20 cprs, 1 mg, inj, cx, 5 amps, 2 mg, inj, cx, 5 amps, 5 mg, inj, cx, 5 amps, 325 mg, bl, 10 cprs, 10mg/mlxpe, fr, 100ml 50 mg/ml sol, oral fr, plast, amb, got, x 30 ml 50 mg/ml sol, oral, fr, plast, amb, got, x 20 ml 125 mg, cx, 1 fr, 60 ml, 250 mg, cx, 1 fr, 60 ml, 500 mg, cx, 10 caps, Pomada 10 g, c/aplic, Sol, 800 mg, 50 ml Sol, 825 mg, 20 ml 1000/2000 mg, po inj, 30 fr, 250 mg, po susp, oral fr, 60 ml 375 mg, x 10 cprs, 500/1000 mg, po inj, cx, 30 fr, 250 mg/5 ml fr, 150 ml, 250 mg/5ml, fr, 60 ml, 500 mg, cx, 15 caps, 500 mg, cx, 21 caps, 500 mg/5 ml, fr, 150 ml 1000 mg, cx, 50 FA 500 mg, cx, 50FA Susp, oral 60 ml, 3 mg, 20 cprs, 6 mg, 20 cprs, 200 mg, x 200 cprs, Fr, 100 ml 2% 250 mg, susp, oral 100 ml, 500 mg, 10 caps,

Laboratorio LUPER NEO QUIMICA NEO QUIMICA NEO QUIMICA BUNKER BUNKER MEDLEY GLAXOSMITHKLINE GLAXOSMITHKLINE GLAXOSMITHKLINE JANSSEN - CILAG FARMOQUIMICA FARMOQUIMICA FARMOQUIMICA ROYTON ROYTON ROYTON INTENDIS DO BRASIL FARMOQUIMICA FARMOQUIMICA PFIZER PFIZER PFIZER PFIZER UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA

UNIDADE Pco Unt Base A CPR 0,64 CPR 0,66 CPR 1,11 AP 1,67 CPR 0,54 CPR 0,86 CPR 0,69 AP 28,55 AP 42,98 AP 98,05 CPR 2,78 ML 0,13 GOTA 0,04 GOTA 13,75 ML 0,20 ML 0,25 CAPS 1,59 G 0,98 ML 1,06 ML 1,70 FA 47,87 ML 1,09 CPR 8,87 F,A, 27,17 ML 0,20 ML 0,26 CPR 1,55 CPR 1,43 ML 0,28 FA 4,43 FA 1,61 ML 0,27 CPR 0,49 CPR 0,82 COMP 0,20 ML 0,11 ML 0,33 CPR 3,11

343

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13132 13133 13134 13135 13136 13137 13138 13139 13140 13141 13142 13143 13144 13145 13146 13147 13148 13149 13150 13151 13152 13153 13154 13155 13156 13157 13158 13159 13160 13161 13162 13163 13164 13165 13166 13167 13168 13169

CODIGO BENEFICIO 95271899 UNI CLONAZEPAX 95271902 UNI CLONAZEPAX 95271880 UNI CLONAZEPAX 95897917 UNI DEXA 95451161 UNI DEXAMETASON (*) 95451170 UNI DEXAMETASON (*) 95024859 UNI DIAZEPAX 95024867 UNI DIAZEPAX 95271937 UNI DIAZEPAX 95271929 UNI DIAZEPAX 95271910 UNI DIAZEPAX 95680080 UNI FENICOL 95431500 UNI GLIBEN 95006591 UNI GLIBEN 95280820 UNI HALOPER 95280812 UNI HALOPER 95383743 UNI HALOPER 95138048 UNI HALOPER (Restito Hosp.) 95006605 UNI IMIPRAX 95291580 UNI IMIPRAX 95006613 UNI IMIPRAX 95291598 UNI IMIPRAX 95201840 UNI NORFLOXACIN 95090410 UNI PROPALOL 95401032 UNI VIR 95983228 UNI VIR (*) 95024875 UNIFEDRINE 95024891 UNIFENITOIN 95340807 UNIFENOBARB 95006621 UNIFENOBARB 95340815 UNIFENOBARB 95068732 UNIFENTAL 95068724 UNIFENTAL 95897925 UNIFENTAL 95981004 UNIGYN 95981012 UNIGYN 95650253 UNIHIOSCIN 95650245 UNIHIOSCIN

APRESENTAÇÃO 0,5 mg 20 cprs, 2,0 mg 20 cprs, 2,5 mg, fr, 20 ml, Creme 0,1% bisn, 10 g, 2 mg/ml cx, 2 amps, 2 ml, 4 mg/ml cx, 50 FA 2,5 ml, 10 mg,10 bl,x20 cprs, 5 mg, 10 bl, x 20 cprs, 50 amps, 10 mg, 2 ml, Cx, 20 cprs, 10 mg, Cx, 20 cprs, 5 mg, Colirio fr, 10 ml 5 mg, cx, 20 cprs, Com ct, str, x 500 2 mg, fr, 20 ml 5 mg, cx, 200 cprs, 5 mg, cx, 50 amps, 1 ml 5 mg. cx. 200 cprs. (hosp.) 10 mg, com rev, ct, 10 bl, x 20 10 mg, cx, 20 cprs, rev, 25 mg, com rev, ct, 10 bl, x 20 25 mg, cx, 20 cprs, rev 400 mg, cx, 14 cprs, 40 mg, cx, 40 cprs, 50 mg, bisn, 10 g 250 mg, cx, 5 FA+ dil, Sol,inj,25amps,x1 ml 100 mg, bl, 100 cprs, 100 mg, cx, 200 cprs, 200 mg, sol, inj, ct, 5 amp, vd, inc, x 1 ml 4% gts, fr, 20 ml 50 mcg 25 amps, x 2 ml 50 mcg 50 amps, x 2 ml 50 mcg/ml sol, inj, 25 FA vd, 1 g bl, 4 cprs, 1 g cx, 2 cprs, 10 mg, 20 cprs, rev, 20 mg, cx, 50 amps,

Laboratorio UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA SIGMA PHARMA SIGMA PHARMA UNIAO QUIMICA UNIAO QUIMICA

UNIDADE Pco Unt Base A CPR 0,24 CPR 0,43 GOTAS 0,03 GRAMA 1,05 AP 5,07 FA 3,96 COMP 0,28 COMP 0,24 AP 0,86 CPR 0,64 CPR 0,28 GOTAS 0,02 CPR 0,26 COMP 0,21 GOTAS 0,01 CPR 0,13 AP 2,31 COMP 0,13 COMP 0,18 CPR 0,18 COMP 0,23 CPR 0,20 CPR 1,88 CPR 0,15 G 1,82 CPR 21,33 AMP 5,41 COMP 0,18 CPR 0,15 AMP 1,15 GOTAS 0,01 AMP 2,10 AMP 0,84 ML 0,42 CPR 4,38 CPR 4,98 CPR 0,46 AP 0,96

344

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13170 13171 13172 13173 13174 13175 13176 13177 13178 13179 13180 13181 13182 13183 13184 13185 13186 13187 13188 13189 13190 13191 13192 13193 13194 13195 13196 13197 13198 13199 13200 13201 13202 13203 13204 13205 13206 13207

CODIGO BENEFICIO 95024905 UNIMEDROL 95024913 UNIMEDROL 95032614 UNIPRAZOL 95032606 UNIPRAZOL 95006630 UNIPRAZOL 95664378 UNIPROFEN 95897941 UNITIDAZIN 95897933 UNITIDAZIN 95897950 UNITIDAZIN 95897968 UNITIDAZIN 95981020 UNITIFEN 95543082 UNITREXATE 95024921 UNNAFLEX BOTA UNNA 95530983 UNOPROST 95531009 UNOPROST 95024948 UNOPROST 95530991 UNOPROST 95986529 URBANIL 95986537 URBANIL 95981055 UREADIN 95981063 UREADIN 95044337 URICEMIL 95044345 URICEMIL 95383948 URITRAT 95383930 URITRAT 95383956 UROCTRIN 95986545 UROFLOX 95986553 UROFLOX 95041435 UROPAC 95042750 UROSEPTAL 95060766 URO-VAXOM 95384057 UROXAZOL-N 95006648 UROXINA 95080627 URSACOL 95080635 URSACOL 95201866 URSACOL 95897976 UTROGESTAN 95068759 UXALUN

APRESENTAÇÃO 125 mg, po p/sol, inj, ct, FA vd, amb,+ amp, dil, x 2 ml 500 mg, po p/sol, inj, ct, FA vd, amb,+ amp, dil, x 8 ml 10 mg, cx, 14 caps 20 mg, cx, 14 caps, 20 mg, fr, 28 caps, gel, dura 600 mg, cx, 20 drags, 100 mg, 2 bl, x 10 drags, 10mg,2bl,x10drags, 25mg,2bl,x10drags, 50mg,2bl,x10drags, 1 mg,cx, 20 cprs, 2,5 mg, 100 cprs, 10,2 cm x 9,14 m - cx, c/24 (IPI incluso) 1 mg, 20 cprs, 2 mg, 30 cprs, 4 mg, 2 bl, x 15 cprs, 4 mg, 20 cprs, Cx, 20 cprs, 10 mg, Cx, 20 cprs, 20 mg, 10%100mg/ml locao fr,plast,150ml 20%200mg/gcreme derm, bisn, plast,50g 100 mg, 50 bl, 10 cps, 300 mg, 50 bl, 10 cps, 400 mg, cx, 14 cprs, 400 mg, cx, 6 cprs, 20 cprs 400 mg, fr, 14 cprs, rev, 400 mg, fr, 6 cprs, rev, 125+ 50+ 50 mg,25 bl, x 4 cprs, rev, 400 mg,comrev,est,cart,bl,al,pvcx20 6 mg, cx, 30 caps, 400 mg, cx, 14 cprs, 400 mg, cx, 20 caps, 150 mg, comp, 5 st, x 4 300 mg, comp, 5 st, x 4 50 mg, comp, 5 st, x 4 100 mg, cx, 30 caps, 100 mg, po liof, FA vd, x 1000 mg,

Laboratorio UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA UNIAO QUIMICA MEIZLER HELIANTO APSEN APSEN APSEN APSEN SANOFI-AVENTIS SANOFI-AVENTIS MEDLEY MEDLEY CRISTALIA CRISTALIA LIBBS LIBBS LEGRAND FARMION FARMION EMS BAGO APSEN BUNKER CHIESI ZAMBON ZAMBON ZAMBON FARMOQUIMICA SANDOZ

UNIDADE Pco Unt Base A FA 21,27 FA 58,65 CPR 1,09 CPR 2,03 CAPS 0,75 CPR 0,96 DRAG 0,97 DRAG 0,25 DRAG 0,44 DRAG 0,53 CPR 0,58 CPR 0,87 UND 2,04 CPR 1,41 CPR 1,73 COMP 1,34 CPR 2,31 CPR 0,38 CPR 0,68 ML 0,20 G 0,70 CP 0,09 CP 0,23 CPR 2,64 CPR 2,80 CPR 1,07 COMP 2,25 COMP 2,45 CP 1,04 COMP 2,16 CAPS 2,65 CPR 1,62 CAPS 0,92 CPR 2,36 CPR 4,66 CPR 0,95 CAPS 1,16 FA 2310,47

345

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13208 13209 13210 13211 13212 13213 13214 13215 13216 13217 13218 13219 13220 13221 13222 13223 13224 13225 13226 13227 13228 13229 13230 13231 13232 13233 13234 13235 13236 13237 13238 13239 13240 13241 13242 13243 13244 13245

CODIGO BENEFICIO 95068740 UXALUN 95384073 VAGI-SULFA 95511105 VAGITRENE 95511113 VAGITRIN-N 95074147 VAGIVIT 95006680 VALCYTE 95083375 VALDOXAN 95083383 VALDOXAN 95897984 VALERATO DE BETAMETASONA - GENERICO 95897992 VALERATO DE BETAMETASONA - GENERICO 95981110 VALERATO DE BETAMETASONA - GENERICO 95981101 VALERATO DE BETAMETASONA - GENERICO 95898000 VALERATO DE BETAMETASONA - GENERICO 95981128 VALERATO DE BETAMETASONA - GENERICO 95981136 VALERATO DE BETA + SULFA,NEO - GENERICO 95898018 VALERATO DE BETA + SULFA,NEO - GENERICO 95898026 VALERATO DE BETA + SULFA,NEO - GENERICO 95898034 VALERATO DE BETA + SULFA,NEO - GENERICO 95898042 VALERATO DE BETA + SULFA,NEO - GENERICO 95060790 VALERATO DE BETAMETASONA - GENERICO 95041443 VALERATO DE BETAMETASONA - GENERICO 95060804 VALERATO DE BETAMETASONA - GENERICO 95791078 VALERATO DE BETAMETASONA - GENERICO 95791108 VALERATO DE BETAMETASONA - GENERICO 95791094 VALERATO DE BETAMETASONA - GENERICO 95791086 VALERATO DE BETAMETASONA - GENERICO 95983333 VALERATO DE BETAMETASONA - GENERICO 95791140 VALERATO DE BETAMETASONA - GENERICO 95041486 VALERATO DE BETAMETASONA + SULF, GENT, + 95024964 VALERATO DE BETAMETASONA + SULF, GENT, + 95041478 VALERATO DE BETAMETASONA + SULF, GENT, + 95024972 VALERATO DE BETAMETASONA + SULF, GENT, + 95041451 VALERATO DE BETAMETASONA + SULF, GENT, + 95024956 VALERATO DE BETAMETASONA + SULF, GENT, + 95041460 VALERATO DE BETAMETASONA + SULF, GENT, + 95898050 VALERATO DE BETAMETASONA + SULF, GENTAMI 95898069 VALERATO DE BETAMETASONA + SULF, GENTAMI 95898077 VALERATO DE BETAMETASONA + SULF, GENTAMI

APRESENTAÇÃO Laboratorio 50 mg, po liof, FA vd, x 500 mg, SANDOZ Creme bisn, 80 g JANSSEN - CILAG Bisn, 40 g, c/10 aplic, EUROFARMA Creme tb, 30 g, BUNKER 250 mg, bl, 6 cprs, vag,+ 6 aplic, EUROFARMA 450 mg, fr, 60 cprs, ROCHE 25 mg, 14 cprs, rev, SERVIER 25 mg, 28 cprs, rev, SERVIER 1mg/gpom,bisn,30 g NEO QUIMICA Creme bisn, 30 g GEN - LEGRAND Creme bisn, 30 g MEDLEY Creme1mg/gbisn,30g, NEO QUIMICA Pom, bisn, 30 g GEN - LEGRAND Pom, bisn, 30 g EMS Creme bisn 30 g, EMS Creme bisn, 30 g GERMED Creme bisn, 30 g GEN - LEGRAND Creme derm, cx, 100 bisn, x 30 g PRATI DONADUZZI Pom, bisn, 30 g GERMED 1 mg/g locao derm, fr, 50 g EMS 1,0 mg/g crem, derm, ct, bg, al, x 30 g PRATI DONADUZZI Sol, cap, fr, 50 ml NEO QUIMICA Cr, ct bisn, al 30 g EUROFARMA Creme bisn, 15 g MEDLEY Creme bisn, 30 g MEDLEY Pom, ct bisn al 30 g EUROFARMA Pom, derm, bisn, 15 g MEDLEY Pom, derm, bisn, 30 g MEDLEY 0,5 mg/g+ 1 mg/g+ 10 mg/g+ 10 mg/g cr derm, ct, bg, al, x PRATI DONADUZZI 0,5 mg/g+ 1 mg/g+ 10 mg/g+ 10 mg/g pom, derm, bisn, 20 gPRATI DONADUZZI 0,5 mg/g+ 1mg/g+ 10 mg/g+ 10 mg/g pom, derm, ct, bg, al, PRATI DONADUZZI Creme bisn, 20 g GERMED Creme derm, bisn, 20 g MEDLEY Pom, bisn, 20 g NEO QUIMICA Pom, derm, bisn, 20 g MEDLEY 0,5 mg/g+ 1 mg/g+ 10 mg/g+ 10 mg/g creme derm, bisn, 20FARMASA g 0,5 mg/g+ 1 mg/g+ 10 mg/g+ 10 mg/g creme derm, bisn, 20PRATI g DONADUZZI 0,5 mg/g+ 1 mg/g+ 10 mg/g+ 10 mg/g pom, derm, bisn, 20 gFARMASA

UNIDADE Pco Unt Base A FA 1155,21 G 0,37 G 0,64 G 0,36 UNID 4,58 COMP 147,96 x COMP 7,52 COMP 7,52 GRAMA 11,81 GRAMA 0,36 G 0,40 G 0,37 G 0,33 G 0,42 G 0,33 GRAMA 0,32 GRAMA 0,33 G 5,77 G 0,34 G 0,41 G 0,43 ML 0,38 G 0,32 G 0,40 G 0,40 G 0,32 G 0,43 G 0,42 G 0,68 GRAMA 0,49 G 0,72 GRAMA 0,63 G 0,71 GRAMA 0,70 G 0,71 GRAMA 10,69 GRAMA 9,74 GRAMA 10,75

346

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13246 13247 13248 13249 13250 13251 13252 13253 13254 13255 13256 13257 13258 13259 13260 13261 13262 13263 13264 13265 13266 13267 13268 13269 13270 13271 13272 13273 13274 13275 13276 13277 13278 13279 13280 13281 13282 13283

CODIGO BENEFICIO APRESENTAÇÃO 95898085 VALERATO DE BETAMETASONA + SULF, GENTAMI Bisn, 20 g 95981152 VALERATO DE BETAMETASONA + SULF, GENTAMI Creme bisn, 20 g 95981179 VALERATO DE BETAMETASONA + SULF, GENTAMI Pom, bisn, 20 g 95041508 VALERATO DE BETAMETASONA + SULF, NEOM, 1 mg/g+ 5 mg/g crem, derm, ct, bg, al, x 30 g 95041494 VALERATO DE BETAMETASONA + SULF, NEOM, Pom, bisn,30 g 95083391 VALERATO DE BETAMETASONA+SULF, GENT,+TOLNAFTATO+CLIOQUINOL-GENERICO Creme derm, bisn, 20 g 95083405 VALERATO DE BETAMETASONA+SULF, GENT,+TOLNAFTATO+CLIOQUINOL-GENERICO Pom, derm, bisn, 20 g 95470549 VALERIX 50 mg, 30 cprs, rev, 95006826 VALEZEN 50 mg cx, 30 drags, 95272046 VALIUM 10 mg, 3 bl, x 10 cprs, 95272011 VALIUM 10 mg, cx, 20 cprs, 95272038 VALIUM 5 mg, 3 bl, x 10 cprs, 95024980 VALPAKINE Cx, 200 mg, 40 cprs, 95025006 VALPAKINE Cx, 500 mg, 40 cprs, 95024999 VALPAKINE Gts, cx, 40 ml, 95986570 VALPRENE Xpe, 250mg/mlfr,100ml, 95898107 VALPROATO DE SODIO - GENERICO 250mg/5mlxpe,100 ml 95006834 VALPROATO DE SODIO - GENERICO 50 mg/ml fr, 100 ml 95006842 VALPROATO DE SODIO - GENERICO 95006850 VALPROATO DE SODIO - GENERICO 95340866 VALPROATO DE SODIO - GENERICO 95074155 VALPROATO DE SODIO - GENERICO 95060812 VALPROATO DE SODIO - GENERICO 95401067 VALTREX 95401075 VALTREX 95006869 VALTRIAN 95006877 VALTRIAN 95006885 VALTRIAN 95543112 VANCEL 95543120 VANCEL 95084495 VANCOCID 95068775 VANCOCID 95384138 VANCOCINA CP 95006907 VANCOCINA CP 95384022 VANCOCINA CP 95068783 VANCOCINA CP 95068813 VANCOSON 95384197 VANCOTRAT

Laboratorio EUROGENUS - LEGRAND BRAINFARMA BRAINFARMA PRATI DONADUZZI GEN - LEGRAND TEUTO BRAS, TEUTO BRAS, ATIVUS TEUTO BRAS, ROCHE ROCHE ROCHE SANOFI-AVENTIS SANOFI-AVENTIS SANOFI-AVENTIS TEUTO BRAS, TEUTO BRAS, EMS

50 mg/ml fr, 100 ml GERMED 50 mg/ml fr, 100 ml GEN - LEGRAND 50 mg/ml xpe, 100 ml, UNIAO QUIMICA 50 mg/ml xpe, cx, 50 frs, vd, amb, x 100 ml+ 50 cp, med, (hosp,) HIPOLABOR 50 mg/ml xpe, cx, 50 frs, vd, x 100 ml+ 50 cp, med, (hosp,) TEUTO BRAS, 500 mg, 10 cprs, GLAXOSMITHKLINE 500 mg, 42 cprs, GLAXOSMITHKLINE 100 mg, 2 bl, x 15 cprs, rev, MEDLEY 25 mg, 2 bl, x 15 cprs, rev, MEDLEY 50 mg, 2 bl, x 15 cprs, rev, MEDLEY Sol, inj, 150 mg cx, 1 FA DARROW Sol, inj, 450 mg cx, 1 FA DARROW 500 mg, cx, 1 fr, BIOCHIMICO 500 mg, po liof, cx, 50 FA BIOCHIMICO 1 g, FA ABL 500 mg, cx, 25 FA ABL 500 mg, FA, ABL 500 mg, po inj, FA+ bolsa flexivel ABL 500 mg, po liof, inj, cx, 20 FA vd, ARISTON 500 mg, 1 FA UNIAO QUIMICA

UNIDADE Pco Unt Base A GRAMA 9,65 G 0,70 G 0,72 G 0,31 G 0,29 G 0,72 G 0,72 CPR 0,88 DRAG 0,79 CPR 0,45 CPR 0,45 CPR 0,34 COMP 0,24 COMP 0,58 GOTA 0,01 ML 0,07 ML 0,05 ML 0,06 ML ML ML ML ML CPR CPR COMP COMP COMP FA FA UNID FA FA F,A, FA FA FA FA

0,05 0,05 0,05 0,04 0,05 10,24 9,19 1,67 0,65 0,27 405,54 X 1130,79 X 9,28 9,28 43,83 25,25 24,33 25,24 24,99 25,41

347

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13284 13285 13286 13287 13288 13289 13290 13291 13292 13293 13294 13295 13296 13297 13298 13299 13300 13301 13302 13303 13304 13305 13306 13307 13308 13309 13310 13311 13312 13313 13314 13315 13316 13317 13318 13319 13320 13321

CODIGO BENEFICIO 95025014 VARFARINA SODICA - GENERICO 95060820 VARFARINA SODICA - GENERICO 95060839 VARFARINA SODICA - GENERICO 95041524 VARICOSS 95041516 VARICOSS 95074171 VASATIV 95074180 VASATIV 95074163 VASATIV 95074198 VASATIV 95981187 VASCASE 95981195 VASCASE 95981209 VASCASE 95981217 VASCASE 95981225 VASCASE 95981233 VASCASE 95025022 VASCER 95160752 VASCER 95981241 VASCLIN 95135561 VASCLIN 95770216 VASELINA 95181008 VASLIP 95086242 VASLIP 95181016 VASLIP 95046100 VASLIP 95180990 VASLIP 95321527 VASODIPINA 95981250 VASOGARD 95981268 VASOGARD 95981276 VASOGARD 95981284 VASOGARD 95135570 VASOJET 95135588 VASOJET 95135596 VASOPRIL 95135618 VASOPRIL 95135600 VASOPRIL 95135626 VASOPRIL PLUS 95135634 VASOPRIL PLUS 95076131 VASOTON

APRESENTAÇÃO 5 mg, 30 cprs, 5 mg, bl, 30 cprs, 5 mg, bl, 50 cprs, (hosp,) 15 mg,+ 90 mg, 2 bl, x 10 drags, 15 mg,+ 90 mg, 3 bl, x 20 drags, 100 mg, bl, 30 cprs, 100 mg, bl, 60 cprs, 50 mg, bl, 30 cprs, 50 mg, bl, 60 cprs, 1,0 mg, 28 cprs, 2,5 mg, 14 cprs, 2,5 mg, 28 cprs, 5,0 mg, 14 cprs, 5,0 mg, 28 cprs, Plus 5,0/12,5mg, 28 cprs, 20 mg/ml sol, inj, 50 amps, x 5 ml 400 mg, cx, 20 cprs, rev, 40/100 mg, 30 caps, 60/100 mg, 30 caps, Tb, 20 g, 10 mg cx, 30 cprs, rev, 20 mg, bl, 60 cprs, rev, 20 mg, cx, 30 cprs, rev, 40 mg, cx, 30 cprs, rev, 5 mg cx, 30 cprs, rev, 30 mg cx, 3 bl, x 10 cprs, 100mg,2bl,x15cprs, 100mg,4bl,x15cprs, 50 mg, 2 bl, x 15 cprs, 50 mg, 4 bl, x 15 cprs, 10 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 10 mg, cx, 30 cprs, 20 mg, cx, 30 cprs, 5 mg, cx, 30 cprs, 10/25 mg cx, 30 cprs, 20/12,5 mg cx, 30 cprs, 2,5 mg/ml sol, Inj, Cx 5 amps vd,inc, x ml

Laboratorio UNIAO QUIMICA TEUTO BRAS, TEUTO BRAS, CIFARMA CIFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA ROCHE ROCHE ROCHE ROCHE ROCHE ROCHE UNIAO QUIMICA UNIAO QUIMICA LIBBS LIBBS ABBOTT BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS NEO QUIMICA BIOSINTETICA BIOSINTETICA BIOSINTETICA BIOSINTETICA UNIAO QUIMICA UNIAO QUIMICA BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS BIOLAB SANUS ARISTON

UNIDADE Pco Unt Base A COMP 0,26 COMP 0,30 COMP 0,26 CP 0,98 CP 0,81 COMP 0,98 COMP 0,60 COMP 0,50 COMP 0,30 CPR 1,45 CPR 3,17 CPR 2,96 CPR 5,44 CPR 5,01 CPR 3,85 AMP 1,38 CPR 1,57 CPR 1,35 CPR 1,93 G 0,25 CPR 0,30 CPR 0,48 CPR 0,59 COMP 1,59 CPR 0,68 CPR 1,09 CPR 1,29 CPR 0,51 CPR 0,43 CPR 0,26 CPR 0,98 CPR 0,63 CPR 0,82 CPR 1,23 CPR 0,55 CPR 0,90 CPR 1,43 AMP 0,84

348

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13322 13323 13324 13325 13326 13327 13328 13329 13330 13331 13332 13333 13334 13335 13336 13337 13338 13339 13340 13341 13342 13343 13344 13345 13346 13347 13348 13349 13350 13351 13352 13353 13354 13355 13356 13357 13358 13359

CODIGO BENEFICIO 95140905 VASTAREL 95025030 VASTAREL 95060855 VASTAREL MR 95060863 VASTAREL MR 95025049 VASTATIL 95025057 VASTATIL 95025065 VASTATIL 95025073 VASTATIL 95034188 VAZY 95034196 VAZY 95981292 VECASTEN 95201890 VECTARION 95981306 VECTAVIR 95664394 VECURON 95664386 VECURON 95060871 VEDICA 95384200 VELAMOX 95384219 VELAMOX 95981314 VELAMOX 95981322 VELAMOX 95384243 VELAMOX 95981330 VELAMOX 95901426 VELBAN 95068821 VELCADE 95125620 VELCADE (Restrito Hosp,) 95981349 VENAFLON 95006923 VENAFORT 95060235 VENALOT 95074201 VENALOT 95060243 VENALOT 95898131 VENALOT (*) 95898140 VENALOT (*) 95664408 VENDREX 95898158 VENLAFAXINA - GENERICO 95898166 VENLAFAXINA - GENERICO 95025111 VENLAXIN 95025103 VENLAXIN 95981357 VENLIFT OD

APRESENTAÇÃO 30 cprs, rev, 60 cprs, rev, 30 cprs, rev, 60 cprs, rev, 10 mg, 30 cprs, 20 mg, 30 cprs, 40 mg, 10 cprs, 80 mg, 10 cprs, 10mg,3 bl, x 10 caps, 15mg,3 bl, x 10 caps, Cx, 20cprs, 30 cprs, reves, 5 g cr 10 mg po liof, 10 FA 4 mg 10 FA+ dil, amp, 1 ml 350 mg, cx, 60 cprs, rev, 1 g, bl, x 12 cprs, 500 mg, bl, x 18 cprs, BD 875 mg, 2 bl, x 7 cprs, BD susp, 400 mg/5 ml fr, 100 ml Susp, 500 mg/5 ml fr, 150 ml Susp, oral 250 mg/5 ml fr, 150 ml 10 mg, inj, FA 1 fr,amp,3,5mg,inj, 1 fr, amp, 1,0 mg, inj, 450+ 50 mg, cx, 30 cprs, rev, 100 mg cx, 30 caps, gel, mole 20 drags, 30 drags, 60 drags, H creme 40 ml, H creme derm, fr, plast, 80 ml Cx, 1 bl, x 20 cprs, 150 mg, 14 caps, 75 mg, 14 caps, 150 mg, bl, 14 caps, gel dura 75 mg, bl, 14 caps, gel dura 150 mg, cx, 14 caps,

Laboratorio SERVIER SERVIER SERVIER SERVIER CIFARMA CIFARMA CIFARMA CIFARMA SIGMA PHARMA SIGMA PHARMA MARJAN SERVIER NOVARTIS CRISTALIA CRISTALIA APSEN SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA SIGMA PHARMA ABL JANSSEN - CILAG JANSSEN - CILAG TEUTO BRAS, TEUTO BRAS, NYCOMED PHARMA NYCOMED PHARMA NYCOMED PHARMA ALTANA PHARMA NYCOMED PHARMA IQB EUROFARMA EUROFARMA EUROFARMA EUROFARMA TORRENT

UNIDADE Pco Unt Base A CPR 0,81 COMP 0,77 COMP 1,44 COMP 1,44 COMP 0,60 COMP 0,68 COMP 1,38 COMP 2,65 CPR 0,82 CPR 0,97 CPR 2,13 CPR 2,91 G 2,96 FA 54,99 FA 32,42 COMP 1,07 CPR 2,29 CPR 0,64 CPR 1,83 ML 0,19 ML 0,13 ML 0,06 FA 55,75 FA 2520,48 X FA 869,36 X CPR 1,38 CAPS 0,45 CPR 1,06 DRAG 1,00 CPR 0,90 ML 0,12 ML 0,15 CPR 0,75 CAPS 4,29 CAPS 2,99 CAPS 4,29 CAPS 3,02 CPR 2,15

349

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13360 13361 13362 13363 13364 13365 13366 13367 13368 13369 13370 13371 13372 13373 13374 13375 13376 13377 13378 13379 13380 13381 13382 13383 13384 13385 13386 13387 13388 13389 13390 13391 13392 13393 13394 13395 13396 13397

CODIGO BENEFICIO 95981365 VENLIFT OD 95060260 VENOCUR 95060278 VENOCUR 95135642 VENOPRIL 95135650 VENOPRIL 95135669 VENOPRIL 95060286 VENORUTON 95060308 VENORUTON 95060294 VENORUTON 95074210 VENOTAC 95543147 VEPESID 95543155 VEPESID 95543163 VEPESID 95060880 VERAMIL 95025162 VERMIBEN 95025170 VERMIBEN 95025200 VERMICLASE 95025189 VERMICLASE 95025197 VERMICLASE 95421467 VERMITAL 95421475 VERMITAL 95068830 VERONIO 95901434 VERONIO 95291610 VEROTINA 95981373 VEROTINA S 95981381 VEROVERME 95084509 VERSA 95084517 VERSA 95084525 VERSA 95084533 VERSA 95084541 VERSA 95084550 VERSA 95981390 VERTIGIUM 95321535 VERTIX 95981403 VERTIX 95321543 VERTIZINE D 95170448 VERZUM 95006966 VEXELL

APRESENTAÇÃO 75 mg, cx, 14 caps, Triplex 2 bl, x 10 drags Triplex 6 bl, x 10 drags, 12,5 mg, 15 cprs, 25,0 mg, 16 cprs, 50,0 mg, 16 cprs, 300 mg, 20 caps, 500 mg, 20 cprs, Gel 20 g, 30 caps, gel, dura 100 mg, caps, ct, c/fr c/10, 100 mg, sol, inj, cx, c/10 FA 50 mg, fr, 20 caps, 80 mg, cx, 3 bl, x 10 cprs, 100 mg, 6 cprs, 2% susp, oral 30 ml 200 mg, 2 cprs, 400 mg, 1 cpr, 40mg/mlsusp, oral10 ml Cx, 2 cprs, Fr, 10 ml 10mg,poliof, 10 FA vd, 4 mg/ml po liof,+ dil, 10 amps, vd, x 1 ml Fr, 20 ml, 90 mg, or, 4 caps, Xpe, fr, 60 ml Sol, inj, 20 mg, 0,2 ml 10 ser, Sol, inj, 20 mg, 0,2 ml 2 ser, Sol, inj, 40 mg, 0,4 ml 10 ser, Sol, inj, 40 mg, 0,4 ml 2 ser, Sol, inj, 60 mg, 0,6 ml 2 ser, Sol, inj, 80 mg, 0,8 ml 2 ser, 10 mg cx, 2 bl, x 25 cprs, Cx, 50 cprs Gts, fr, 30 ml 20 cprs, Cx, 30 cprs, 20 mg, cx, 2 bl, x 10 caps,

Laboratorio TORRENT KNOLL KNOLL LUPER LUPER LUPER NOVARTIS NOVARTIS NOVARTIS ATIVUS B-MS B-MS B-MS DUCTO CIFARMA CIFARMA CIFARMA CIFARMA CIFARMA ELOFAR ELOFAR BIOCHIMICO BIOCHIMICO LIBBS LIBBS MEDIC EUROFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA EUROFARMA NEO QUIMICA ACHE ACHE ACHE ELOFAR GROSS

UNIDADE Pco Unt Base A CPR 1,51 CPR 3,11 CPR 1,38 CPR 0,56 CPR 0,69 CPR 1,23 CPR 1,18 CPR 2,01 G 0,35 DRAG 0,76 CPR 65,73 FA 51,44 CPR 37,13 COMP 0,45 COMP 0,47 ML 0,12 COMP 1,54 COMP 3,05 ML 0,44 CPR 2,93 GOTAS 0,03 FA 45,80 AMP 27,00 GOTAS 0,09 CPR 12,14 ML 0,13 UNID 18,14 UNID 17,67 UNID 35,25 UNID 34,33 UNID 53,71 UNID 71,66 CPR 0,14 CPR 0,37 GOTAS 0,01 CPR 2,08 CPR 0,42 CAPS 0,50

350

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13398 13399 13400 13401 13402 13403 13404 13405 13406 13407 13408 13409 13410 13411 13412 13413 13414 13415 13416 13417 13418 13419 13420 13421 13422 13423 13424 13425 13426 13427 13428 13429 13430 13431 13432 13433 13434 13435

CODIGO BENEFICIO 95006974 VEXELL 95006982 VEXELL 95006990 VEXELL 95007008 VEXELL 95007016 VEXELL 95007024 VFEND 95007032 VFEND 95007040 VFEND 95034200 VIAGRA 95060898 VIBRADOXIN 95260790 VIBRAL 95260803 VIBRAL 95260811 VIBRAL 95384286 VIBRAMICINA 95384278 VIBRAMICINA 95384294 VIBRAMICINA 95981446 VICK VAPORUB 95074228 VICODIL 95981454 VICOG 95983376 VICTRIX 95060901 VICTRIX 95007059 VICTRIX 95125710 VIDAZA (Restrito Hosp,) 95090665 VIDEX EC (ICMS 0%) 95090657 VIDEX EC (ICMS 0%) 95571884 VI-FERRIN 95571892 VI-FERRIN 95981470 VI-FERRIN 95007067 VIGAMOX 95068848 VIKATRON 95007075 VILNE 95007083 VILNE 95068856 VINATIN 95543180 VINCIZINA (VINCRISTINA) 95068864 VINCIZINA CS (VINCRISTINA) 95007091 VINCRISAN 95791159 VIOFORMIO-HIDROCORTISONA 95401121 VIRAMID

APRESENTAÇÃO 20 mg, cx, 3 bl, X 10 caps, 40 mg, cx, 2 bl, x 10 caps, 40 mg, cx, 3 bl, x 10 caps, 60 mg, cx, 2 bl, x 10 caps, 60 mg, cx, 3 bl, X 10 caps, 200 mg x 1 amp, 200 mg x 14 cprs, 50 mg x 14 cprs, 50 mg, x 8 cprs, rev, 100 mg, bl, 15 cprs, sol, Gts, fr, 10 ml, Xpe, ad, 120 ml, Xpe, ped, 120 ml, 100 mg, 1 bl, x 20 cprs, Cx, 15 drags, 100 mg, Cx, 3 drags, 100 mg, 30 gr 30 mg, 12 cprs, Cx, 30 cprs 10 mg, fr, 14 caps, 20 mg, fr, 14 caps, 40mg,fr,amp,x10 ml Po liof, p/inj, 100 mg, cx, 1 FA 250 mg, cx, fr, 30 cprs, 400 mg, cx, fr, 30 cprs, Elixir fr, 150 ml Fr, 60 cprs, rev Gts, fr, 20 ml Sol, fr, 5 ml 10 mg, inj, cx, 100 amps, x 1 ml 10 mg/ml sol, inj, ct, FA vd, inc, x 1 ml 10 mg/ml sol, inj, ct, FA vd, inc, x 5 ml 1 mg/ml sol, inj, IV FA vd, x 10 ml 1 mg, sol, inj, 5 FA plast, 1 mg, sol, inj, 5 FA plast, 1 mg/ml sol, inj, cx, 5 amps, Bisn, 20 g, 6 g po liof, FA 100 ml

Laboratorio GROSS GROSS GROSS GROSS GROSS PFIZER PFIZER PFIZER PFIZER HEXAL SOLVAY FARMA SOLVAY FARMA SOLVAY FARMA PFIZER PFIZER PFIZER PROCTER & GAMBLE ARROW MARJAN FARMASA FARMASA FARMASA UNITED MEDICAL B-MS B-MS ELOFAR ELOFAR ELOFAR ALCON ARISTON CHEMICALTECH CHEMICALTECH MEIZLER PHARMACIA/PFIZER PFIZER QUIRAL NOVARTIS VALEANT

UNIDADE Pco Unt Base A CAPS 0,43 CAPS 0,99 CAPS 0,87 CAPS 1,49 CAPS 1,30 AMP 894,25 COMP 263,02 COMP 65,76 CPR 15,41 COMP 1,37 GOTAS 0,04 ML 0,10 ML 0,07 CPR 2,62 CPR 2,54 CPR 1,81 G 0,30 COMP 1,27 CPR 0,48 CPR 1,15 CAPS 2,84 F,A, 24,20 FA 1208,96 X COMP 9,48 COMP 15,17 ML 0,08 CPR 0,39 GOTAS 0,02 Gotas 0,23 AMP 1,71 F,A, 121,15 F,A, 569,26 FA 53,67 FA 19,57 FA 19,57 AMP 24,94 G 0,63 FA 975,14

351

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral 13436 13437 13438 13439 13440 13441 13442 13443 13444 13445 13446 13447 13448 13449 13450

CODIGO BENEFICIO 95401130 VIRAMUNE 95401148 VIRAMUNE 95080643 VIRAZOLE 95025219 VIROTIN 95025227 VIROTIN 95680098 VISALMIN (COLIRIO CLORAFENICOL) 95982973 VISCOAT 95982981 VISCOAT 95670092 VISCOTEARS 95690182 VISIONOM 95680101 VISIPLEX 95135685 VISKALDIX 95135693 VISKEN 95135707 VISKEN 95690190 VISLIN

APRESENTAÇÃO 200 mg, 60 cprs Susp, oral fr, 240 ml,+ ser, dos,+ adaptador 250 mg 60 caps, 200mg,5 bl,x5 cprs, 400 mg, 14 bl, x 5 cprs, Fr, 10 ml, SERINGA - CX C/ 1 UNID x 0,50 ML SERINGA - CX C/ 1 UNID x 0,75 ML 10 g, Colirio 10 ml Colirio fr, 15 ml, Cx, 20 cprs, 10 mg, cx, 2 bl, x 10 5 mg, cx, 2 bl, x 10 Sol, ocular fr, 15 ml,

Laboratorio BOEHRINGER INGELHEIM BOEHRINGER INGELHEIM UCI-FARMA CELLOFARM CELLOFARM BUNKER ALCON ALCON NOVARTIS UNIAO QUIMICA BUNKER NOVARTIS NOVARTIS NOVARTIS ALCON

UNIDADE Pco Unt Base A CPR 1,62 ML 0,17 CPR 1,34 COMP 2,35 COMP 3,32 GOTAS 0,03 UNID 203,11 UNID 214,71 G 2,69 GOTAS 0,05 GOTAS 0,02 CPR 1,87 CPR 1,80 CPR 1,01 GOTAS 0,02

13451 95690204 VISODIN

Fr, 24 cc

FARMASA

GOTAS

13452 95730036 VISONEST

Sol, fr, 5 ml,

ALLERGAN

GOTAS

0,06

13453 95152792 VISTAGEL 2%

Seringa de vidro com 2,5 ml + cânula (23G) especial para viscoelástico VISTATEK

UNIDADE

30,00

13454 95048685 VISUDYNE

15 mg, po sol,+ kit,

NOVARTIS

F,A,

13455 95007105 VITA K

10 mg/ml sol, inj, 50 amps, x 1 ml

UNIAO QUIMICA

AMP

2,26

13456 95981489 VITAFER

Fr, 50 cprs, rev,

EMS

CPR

0,20

13457 95981497 VITAFER

Gts, fr, 30 ml

EMS

GOTAS

0,01

13458 95981500 VITAFER 13459 95126317 VITAMINA A

Xpe, fr, 150 ml 25,000 UI 2 ML

EMS

0,05

AMP

2,61

13460 95083413 VITAMINA B1

300 mg, cx, 30 cprs, rev,

NEO QUIMICA

COMP

0,44

13461 95007156 VITAMINA C

500 mg, cx, 20 cprs,

MEDQUIMICA

COMP

0,55

13462 95090673 VITAMINA C

500 mg/5 ml - cx, 100 amps, vd,

FARMACE

AMP

0,60

13463 95007164 VITAMINA C

Gts, vd, 20 ml

MEDQUIMICA

GOTA

0,02

13465 95981527 VITA-PED

Fr, 30 ml

STIEFEL

GOTAS

0,02

13466 95044825 VITARISTON C

100 mg/ml sol, inj, cx, 50 amps, vd, x 5 ml

ARISTON

AMP

0,62

13467 95044833 VITARISTON C

200 mg/ml sol, inj, cx, 50 amps, vd, x 5 ml

ARISTON

AMP

0,70

13468 95025316 VITERGYL C

20 ml gts,

CIFARMA

GOTA

0,02

13469 95025308 VITERGYL C

500 mg, 20 cprs,

CIFARMA

COMP

0,56

13470 95025375 VIVACOR

10 mg, cx, 10 cprs,

ASTRAZENECA

COMP

2,76

13471 95041540 VIVACOR

10 mg, cx, 10 cprs,

BIOLAB SANUS

4,00

13472 95025367 VIVACOR

10 mg, cx, 30 cprs,

ASTRAZENECA

COMP

3,31

13473 95041532 VIVACOR

10 mg, cx, 30 cprs,

BIOLAB SANUS

3,72

0,01

4723,77 X

352

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral

APRESENTAÇÃO

Laboratorio

13474 95025391 VIVACOR

CODIGO BENEFICIO

20 mg, cx, 10 cprs,

ASTRAZENECA

13475 95041567 VIVACOR

20 mg, cx, 10 cprs,

13476 95025383 VIVACOR

20 mg, cx, 30 cprs,

13477 95041559 VIVACOR

UNIDADE Pco Unt Base A COMP

4,51

BIOLAB SANUS

4,67

ASTRAZENECA

COMP

5,81

20 mg, cx, 30 cprs,

BIOLAB SANUS

6,52

13478 95898190 VIVANZA

10 mg, bl, 2 cprs, rev,

MEDLEY

COMP

28,98

13479 95898182 VIVANZA

10mg,bl,4cprs,rev,

MEDLEY

COMP

26,29

13480 95898204 VIVANZA

20mg,bl,4cprs,rev,

MEDLEY

COMP

40,38

13481 95898212 VIVANZA

5 mg, bl, 2 cprs, rev,

MEDLEY

COMP

23,38

13482 95280847 VIVERDAL

1 mg cx, 6 cprs,

UNIAO QUIMICA

CPR

1,45

13483 95280855 VIVERDAL

2 mg cx, 20 cprs,

UNIAO QUIMICA

CPR

1,69

13484 95384308 VIXMICINA

1 g, cx, 50 FA+ dil,

UNIAO QUIMICA

3,83

13485 95074236 VOLFENACO

50 mg, cx, 20 cprs,

MILIAN

COMP

0,32

13486 95898220 VOLTAFLAN

10 mg/g gel bisn, 60 g

BUNKER

GRAMA

0,27

13487 95664530 VOLTAFLAN

100 mg, cx, 10 cprs

BUNKER

CPR

1,07

13488 95664513 VOLTAFLAN

25 mg/ml cx, 5 amps, 3 ml

BUNKER

1,40

13489 95664548 VOLTAFLAN

50 mg, cx, 20 cprs,

BUNKER

CPR

0,60

13490 95664521 VOLTAFLAN

75 mg, cx, 20 cprs,

BUNKER

CPR

0,85

13491 95664572 VOLTAFLEX (*)

1 x 10 cprs,

EMS

CPR

0,98

13492 95664564 VOLTAFLEX (*)

1 x 20 cprs

EMS

CPR

0,65

13493 95664599 VOLTAFLEX (*)

AP 1 x 10 cprs

EMS

CPR

1,27

13494 95664580 VOLTAFLEX (*)

Gts, 1 x 10 ml

EMS

GOTAS

0,03

13495 95898239 VOLTAREN

Emulgel 30 g

NOVARTIS

GRAMA

0,23

13496 95664610 VOLTAREN (*)

50 mg, 20 cprs,

NOVARTIS

COMP

0,70

13497 95664629 VOLTAREN (*)

50 mg, 5 suposits,

NOVARTIS

UND

1,32

13498 95664653 VOLTAREN (*)

75 mg, 5 amps,

NOVARTIS

2,09

13499 95986626 VOLTAREN (*)

Colirio 5 ml,

NOVARTIS

GOTAS

0,30

13500 95981578 VOLTASIL

75 mg/3ml cx, 100 amps,

ISOFARMA

0,64

13501 95664734 VOLTRIX

50 mg, cx, 10 drags,

BUNKER

CPR

0,60

13502 95664718 VOLTRIX

75 mg, inj, cx, 10 amps,3 ml,

BUNKER

2,37

13503 95664726 VOLTRIX

AP 100 mg, cx, 10 drags,

BUNKER

CPR

0,80

13504 95664700 VOLTRIX

Gel tb, 30 g,

BUNKER

0,38

13505 95664696 VOLTRIX

Gts, fr, 10 ml,

BUNKER

GOTAS

0,03

13506 95007237 VOLUVEN

130/0,46% (bolsa) 1 x 500 ml

FRESENIUS KABI

88,82

13507 95007245 VOMISTOP METOCLOP,

Cx, 20 cprs,

MEDQUIMICA

COMP

0,17

13508 95007253 VOMISTOP METOCLOP,

Gts,vd, 10 ml

MEDQUIMICA

GOTA

0,01

13509 95321551 VONAU

4 mg, cx, 1 amp, 2 ml

BIOLAB SANUS

9,99

353

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral

APRESENTAÇÃO

Laboratorio

13510 95321560 VONAU

CODIGO BENEFICIO

8 mg, cx, 1 amp, 4 ml

BIOLAB SANUS

UNIDADE Pco Unt Base A

13511 95401164 VUDIRAX-LAMIVUDINA

150 mg, fr, 60 cprs,

BLAUSIEGEL

13512 95981594 VULGIX

Locao top, fr, 60 ml

CAZI

0,14

13513 95543228 VUMON

50 mg, inj, cx, c/10 amp, x 5 ml (emb mult),

B-MS

73,54

13514 95613609 VYTINAL

60 drags,

LEGRAND

CPR

0,59

13515 95007261 VYTORIN

10 mg/10 mg, cx, bl, 14 cprs,

MERCK SHARP & DOHME

COMP

2,73

13516 95007270 VYTORIN

10 mg/10 mg, cx, bl, 28 cprs,

MERCK SHARP & DOHME

COMP

2,93

13517 95007288 VYTORIN

10 mg/20 mg, cx, bl, 14 cprs,

MERCK SHARP & DOHME

COMP

2,93

13518 95007296 VYTORIN

10 mg/20 mg, cx, bl, 28 cprs,

MERCK SHARP & DOHME

COMP

2,93

13519 95007300 VYTORIN

10 mg/40 mg, cx, bl, 14 cprs,

MERCK SHARP & DOHME

COMP

5,13

13520 95007318 VYTORIN

10 mg/40 mg, cx, bl, 28 cprs,

MERCK SHARP & DOHME

COMP

5,13

13521 95060910 VYTORIN

10 mg/80 mg, cx, bl, 28 cprs,

MERCK SHARP & DOHME

COMP

5,23

13522 95291644 WELLBUTRIN

150 mg, 30 cprs,

GLAXOSMITHKLINE

CPR

3,23

13523 95041575 WELLPROCT

Bisn, 45 g

IQB

13524 95041583 WINTER AP

6 mg,+ 120 mg, cx, 8 caps,

DIFFUCAP - CHEMOBRAS

13525 95025421 WINTOMYLON

Cx, 14 x 4 cprs,

13526 95025413 WINTOMYLON

11,24

CPR

6,23

0,90

2,09

SANOFI-AVENTIS

COMP

1,09

Susp, vd, 60 ml

SANOFI-AVENTIS

0,16

13527 95060928 WONILIN

300,000 UI+ 100,000 UI po inj, cx, 50 FA vd,

NOVAFARMA

4,81

13528 95898255 WYCILLIN

Cx,100FA+dil,2ml

EUROFARMA

4,73

13529 95720359 XALACOM

Sol, oft, esteril fr, 2,5 ml,

PFIZER

GOTAS

2,18

13530 95720367 XALATAN

Sol, oft, fr, 2,5 ml

PFIZER

GOTAS

2,00

13532 95613676 XANTINON B12

Complex 12 x 10 ml

ALTANA PHARMA

1,29

13533 95613668 XANTINON B12

Cx, 10 bl, x 10 drags,

NYCOMED PHARMA

CPR

0,17

13534 95613617 XANTINON B12

Cx, 20 drags,

NYCOMED PHARMA

CPR

0,19

13535 95613633 XANTINON B12

Vd, 100 ml,

ALTANA PHARMA

0,06

13536 95126449 XARELTO

10 mg, 10 cprs, rev,

BAYER

COMP

6,58

13537 95126457 XARELTO

10 mg, 30 cprs, rev,

BAYER

COMP

6,58

13538 95126465 XARELTO

15 mg, x 14 com, rev, ct, bl, al, pp

BAYER

COMP

6,58

13539 95126473 XARELTO

15 mg, x 28 com, rev, ct, bl, al, pp

BAYER

COMP

6,58

13540 95126481 XARELTO

20 mg, x 14 com, rev, ct, bl, al, pp

BAYER

COMP

6,58

13541 95126490 XARELTO

20 mg, x 28 com, rev, ct, bl, al, pp

BAYER

COMP

6,58

13542 95981616 XAROPE VICK MEL

120 ml,

PROCTER & GAMBLE

0,10

13543 95981624 XAROPE VICK MEL

240 ml,

PROCTER & GAMBLE

0,08

13544 95025430 XATRAL

2,5 mg, cx, 30 cprs,

SANOFI-AVENTIS

COMP

1,08

13545 95025448 XATRAL

LP 5 mg, cx, 20 cprs,

SANOFI-AVENTIS

COMP

1,71

13546 95025456 XATRAL

OD 10 mg, 10 cprs,

SANOFI-AVENTIS

COMP

5,92

354

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral

APRESENTAÇÃO

Laboratorio

13547 95025464 XATRAL

CODIGO BENEFICIO

OD 30 cprs,

SANOFI-AVENTIS

UNIDADE Pco Unt Base A

13548 95543236 XELODA

150 mg, 60 cprs,

ROCHE

CPR

5,39

13549 95543244 XELODA

500 mg, 120 cprs,

ROCHE

CPR

14,92

13550 95901442 XIGRIS

Fr, 20 mg

ELI LILLY

GOTAS

12,94 X

13551 95901450 XIGRIS

Fr, 5 mg

ELI LILLY

1294,38 X

13552 95060332 XILODASE

Bisn, 30 g, c/ aplic,

APSEN

1,01

13553 95060340 XILODASE

Pom, bisn, 15 g, c/ aplic,

APSEN

1,32

13554 95901469 XOLAIR

150 mg, 1+ 1

NOVARTIS

13555 95068872 XYLESTESIN

1% S/V 10 etj, 20 ml (SP)

CRISTALIA

0,40

13556 95068880 XYLESTESIN

1% S/V 10 fr, 20 ml

CRISTALIA

0,37

13557 95920293 XYLESTESIN

10% spray cx, 1 fr, 50 ml

CRISTALIA

1,53

13558 95068902 XYLESTESIN

2% gel,10ser,10ml

CRISTALIA

UNID

12,54

13559 95920285 XYLESTESIN

2% geleia cx, 10 bisn, x 30 g

CRISTALIA

0,33

13560 95068929 XYLESTESIN

2% S/V 10 etj, 20 ml (SP)

CRISTALIA

0,45

13561 95068937 XYLESTESIN

2% S/V 10 fr, 20 ml

CRISTALIA

0,35

13562 95068910 XYLESTESIN

2% S/V 50 carps, 1,8 ml

CRISTALIA

AMP

0,45

13563 95068899 XYLESTESIN

2% S/V50amps,5ml

CRISTALIA

AMP

2,17

13564 95068945 XYLESTESIN + EPINEFRINA

1% C/V 10 etj, 20 ml (OF)

CRISTALIA

0,48

13565 95068953 XYLESTESIN + EPINEFRINA

2% C/V 10 etj, 20 ml (OF)

CRISTALIA

0,46

13566 95068961 XYLESTESIN + EPINEFRINA

2% C/V 10 fr, 20 ml

CRISTALIA

0,43

13567 95068970 XYLESTESIN + NOREPINEFRINA

2% C/V50carp,1,8ml

CRISTALIA

AMP

0,46

13568 95920307 XYLESTESIN 1% C/V

10 etj, 20 ml, (OF)

CRISTALIA

0,40

13569 95920315 XYLESTESIN 1% S/V

10 etj, 20 ml, (SP)

CRISTALIA

0,34

13570 95920323 XYLESTESIN 1% S/V

10 fr, 20 ml,

CRISTALIA

0,31

13571 95920331 XYLESTESIN 2% C/V

10 etj, 20 ml, (OF)

CRISTALIA

0,39

13572 95920340 XYLESTESIN 2% C/V

10 fr, 20 ml,

CRISTALIA

0,36

13573 95920358 XYLESTESIN 2% GEL,

10 seringas 10 ml,

CRISTALIA

10,53

13574 95920366 XYLESTESIN 2% S/V

10 etj, 20 ml, (SP)

CRISTALIA

0,37

13575 95920374 XYLESTESIN 2% S/V

10 fr, 20 ml,

CRISTALIA

0,30

13576 95920382 XYLESTESIN 2% S/V

50 amp, 5 ml,

CRISTALIA

1,85

13577 95920390 XYLESTESIN 5% PESADA

50 etj, 2 ml, (SP)

CRISTALIA

2,84

13578 95068988 XYLESTESIN PESADA 13579 95983023 XYLOCAINA

5% pesada - 50 etj, 2 ml (SP)

CRISTALIA

AMP

3,38

GELÉIA 2% - CX C/ 1 TB 30 G

ASTRAZENECA

0,73

13580 95007369 XYLOCAINA

Pomada 5% 25 g

ASTRAZENECA

0,51

13581 95007377 XYLOCAINA 13582 95983031 XYLOCAINA

Pomada sabor 5% 25 g

ASTRAZENECA

0,49

SPRAY 10% - CX C/ 1 FR x 50 ML

ASTRAZENECA

0,29

COMP

5,63

1497,23 X

355

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral

APRESENTAÇÃO

Laboratorio

13583 95060359 XYLOPROCT

CODIGO BENEFICIO

Pom, 25 g,

ASTRAZENECA

UNIDADE Pco Unt Base A G

0,67

13584 95083421 XYLOPROCT

Pom, ret, ct, bisn, al, x 25 mg, ct, 10 aplic,

ASTRAZENECA

UNID

1,99

13585 95490442 YOMAX

5,4 mg, 60 cprs,

APSEN

CPR

0,79

13586 95981659 ZAARPRESS

100 mg, 2 bl, x 15 cprs,

SIGMA PHARMA

CPR

1,76

13587 95042784 ZAARPRESS

100 mg, 7 bl, x 10 cprs, rev,

SIGMA PHARMA

COMP

1,23

13588 95981667 ZAARPRESS

100 mg, bl, 15 cprs,

SIGMA PHARMA

CPR

2,08

13589 95981675 ZAARPRESS

25 mg, 2 bl, x 15 cprs,

SIGMA PHARMA

CPR

0,61

13590 95042768 ZAARPRESS

25 mg, 7 bl, x 10 cprs, rev,

SIGMA PHARMA

COMP

0,43

13591 95981683 ZAARPRESS

50 mg, 2 bl, x 15 cprs,

SIGMA PHARMA

CPR

1,06

13592 95042776 ZAARPRESS

50 mg, 7 bl, x 10 cprs, rev,

SIGMA PHARMA

COMP

0,73

13593 95032711 ZADINE

150 mg, cx, 20 cprs,

UCI-FARMA

CPR

0,63

13594 95981705 ZADITEN

Colirio 0,25 mg, 5 ml

NOVARTIS

GOTAS

0,24

13595 95231765 ZADITEN

Fr, 120 ml,

NOVARTIS

0,38

13596 95231781 ZADITEN

Sol, oral 30 ml,

NOVARTIS

1,83

13597 95231790 ZADITEN

SRO 2 mg, bl, 20 cprs

NOVARTIS

CPR

3,74

13598 95231773 ZADITEN

STR 20 cprs,

NOVARTIS

CPR

1,90

13599 95025472 ZAMADOL

100 mg/2 ml sol, inj, 50 amps, vd, x 2 ml

BERGAMO

AMP

5,28

13600 95007407 ZAMADOL

100 mg/ml sol, oral fr, plast, opaco gts, x 10 ml

BERGAMO

GOTA

0,20

13601 95007415 ZAMADOL

50 mg, caps, gel dura - blist, alum, plast, incolor x 10

BERGAMO

CAPS

2,28

13602 95981713 ZANIDIP

10 mg, 3 strip, x 10 cprs, rev,

MEDLEY

CPR

2,44

13603 95135715 ZANIDIP

10 mg, cx, 20 cprs,

MEDLEY

CPR

2,44

13604 95042792 ZANIDIP

20 mg, strip, 20 cprs, rev,

MEDLEY

COMP

4,15

13605 95280898 ZARGUS

1 mg, 20 cprs,

BIOSINTETICA

CPR

1,13

13606 95280871 ZARGUS

2 mg, 20 cprs,

BIOSINTETICA

CPR

1,13

13607 95280880 ZARGUS

3 mg, 20 cprs,

BIOSINTETICA

CPR

1,13

13608 95041591 ZART

50 mg,bl,30cprs,rev,

EUROFARMA

0,69

13609 95060944 ZART H

(100+ 25 mg,) bl, 30 cprs,

EUROFARMA

COMP

1,25

13610 95060952 ZART H

(50+ 12,50 mg,) bl, 30 cprs,

EUROFARMA

COMP

0,70

13611 95007423 ZARV

30 caps,

ATIVUS

CAPS

13612 95272100 ZAVEDOS

10 mg, FA

PFIZER

753,89 X

13613 95272097 ZAVEDOS

5 mg, FA

PFIZER

401,87 X

13614 95113452 ZAX

Cx, 15 caps,

HEBRON

13615 95392114 ZELIX

150 mg, 1 caps,

ATIVUS

13616 95981721 ZELMAC

6 mg, 10 cp,

13617 95007431 ZELMAC

6 mg, 30 cp,

13618 95007440 ZELMAC

6 mg, 60 cp,

1,09

CAPS

1,82

CPR

15,08

NOVARTIS

CPR

3,19

NOVARTIS

COMP

3,92

NOVARTIS

COMP

3,92

356

Tabela de Medicamentos Hospitalar do SiSau - HPM - Vigência 02/05/2014

Orde Geral

APRESENTAÇÃO

Laboratorio

13619 95125752 ZEMPLAR

CODIGO BENEFICIO

5,0 mcg/ml sol, inj, 5 amps, vd, inc, x 1 ml

ABBOTT

UNIDADE Pco Unt Base A FA

38,56

13620 95125760 ZEMPLAR

5,0 mcg/ml sol, inj, 5 amps, vd, inc, x 2 ml

ABBOTT

74,53

13621 95384375 ZENCEF

750 mg, IV / IM cx, 1 FA+ dil, 6 ml

CELLOFARM

23,70

13622 95125639 ZENCEF (Restrito Hosp,)

750 mg, 50 FA IV / IM sol, inj,

ASPEN PHARMA

19,95

13623 95421521 ZENTEL

200 mg, bl, x 2 cprs,

GLAXOSMITHKLINE

CPR

3,71

13624 95421556 ZENTEL

4% susp, vd, 10 ml

GLAXOSMITHKLINE

0,83

13625 95421548 ZENTEL

400 mg, cx, 1 cpr

GLAXOSMITHKLINE

CPR

7,41

13626 95090690 ZERITAVIR (ICMS 0%)(Restrito Hosp,)

30 mg, cx, fr, 60 caps,

B-MS

CAPS

8,50

13627 95090681 ZERITAVIR (ICMS 0%)(Restrito Hosp,)

40 mg, cx, fr, 60 caps,

B-MS

CAPS

8,83

13628 95135723 ZESTORETIC

20 mg, 30 cprs,

ASTRAZENECA

CPR

2,69

13629 95135731 ZESTRIL

10 mg, cx, 30 cprs,

ASTRAZENECA

CPR

2,08

13630 95135758 ZESTRIL

20 mg, cx, 30 cprs,

ASTRAZENECA

CPR

2,97

13631 95135740 ZESTRIL

5 mg, cx, 30 cprs,

ASTRAZENECA

CPR

1,30

13632 95040331 ZETALERG

1 mg/ml fr, 75 ml, sol, oral

UCI-FARMA

[PDF] Tabela de Medicamentos Hospitalar do SiSau - HPM - Free Download PDF (2024)

References