WHO Model List of Essential Medicines for Children
{{Short description|Formulary}}
{{for|the adult list|WHO Model List of Essential Medicines}}
{{Use dmy dates|date=August 2021}}
The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children or EMLc{{cite web | title=WHO Model Lists of Essential Medicines | website=World Health Organization | url=https://www.who.int/groups/expert-committee-on-selection-and-use-of-essential-medicines/essential-medicines-lists | access-date=15 April 2021 | archive-date=7 November 2020 | archive-url=https://web.archive.org/web/20201107104721/https://www.who.int/groups/expert-committee-on-selection-and-use-of-essential-medicines/essential-medicines-lists | url-status=live }}), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.{{cite web|title=Essential medicines|url=https://www.who.int/medicines/services/essmedicines_def/en/|archive-url=https://web.archive.org/web/20081002110638/http://www.who.int/medicines/services/essmedicines_def/en/|url-status=dead|archive-date=2 October 2008|website=World Health Organization|accessdate=20 January 2017}}{{cite book | vauthors = ((World Health Organization)) | year = 2021 | title = The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2021 (including the 22nd WHO model list of essential medicines and the 8th WHO model list of essential medicines for children) | publisher = World Health Organization | location = Geneva | author-link = World Health Organization | hdl = 10665/351172 | id = WHO technical report series;1035. License: CC BY-NC-SA 3.0 IGO | hdl-access=free | isbn=9789240041141 }}
The list is divided into core items and complementary items. The core items are deemed to be the most cost-effective options for key health problems and are usable with little additional health care resources. The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost–benefit ratio.
The first list for children was created in 2007, and the list is in its 9th edition {{as of|2023|lc=yes}}.{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines for children: 7th list 2019 | year = 2019 | hdl = 10665/325772 | author-link = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}{{cite book | vauthors = ((World Health Organization)) | year = 2019 | title = Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines | location = Geneva | author-link = World Health Organization | hdl = 10665/325773 | id = WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines for children: 8th list (2021) | year = 2021 | hdl = 10665/345534 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2021.03 | hdl-access=free }}{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex B: World Health Organization model list of essential medicines for children: 9th list (2023) | year = 2023 | hdl = 10665/371091 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.03 | hdl-access=free }}
Note: An α indicates a medicine is on the complementary list.
Anaesthetics, preoperative medicines and medical gases
=General anaesthetics and oxygen=
==Inhalational medicines==
==Injectable medicines==
=Local anaesthetics=
=Preoperative medication and sedation for short-term procedures=
=Medical gases=
Medicines for pain and palliative care
=Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)=
=Opioid analgesics=
=Medicines for other symptoms common in palliative care=
Antiallergics and medicines used in anaphylaxis
Antidotes and other substances used in poisonings
=Non-specific=
=Specific=
- Acetylcysteine
- Atropine
- Calcium gluconate
- Naloxone
- Deferoxamine{{ref|Alpha|α}}
- Dimercaprol{{ref|Alpha|α}}
- Fomepizole{{ref|Alpha|α}}
- Sodium calcium edetate{{ref|Alpha|α}}
- Succimer{{ref|Alpha|α}}
Anticonvulsants/antiepileptics
- Carbamazepine
- Diazepam
- LamotrigineFor use as adjunctive therapy for treatment-resistant partial or generalized seizures.
- LorazepamAlternatives limited to diazepam and midazolam
- MidazolamFor buccal administration when solution for oromucosal administration is not available.
- Phenobarbital
- PhenytoinThe presence of both 25 mg/5 mL and 30 mg/5 mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
- Valproic acid (sodium valproate)Avoid use in pregnancy and in women and girls of child-bearing potential, unless alternative treatments are ineffective or not tolerated because of the high risk of birth defects and developmental disorders in children exposed to valproate in the womb.
- Ethosuximide{{ref|Alpha|α}}
- Valproic acid (sodium valproate){{ref|Alpha|α}}Avoid use in pregnancy and in women and girls of child-bearing potential, unless alternative treatments are ineffective or not tolerated because of the high risk of birth defects and developmental disorders in children exposed to valproate in the womb.
Anti-infective medicines
=Anthelminthics=
==Intestinal anthelminthics==
==Antifilarials==
==Antischistosomals and other antinematode medicines==
==Cysticidal medicines==
- Albendazole{{ref|Alpha|α}}
- Mebendazole{{ref|Alpha|α}}
- Praziquantel{{ref|Alpha|α}}
=Antibacterials=
==Access group antibiotics==
- Amikacin
- Amoxicillin
- Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)
- Ampicillin
- Benzathine benzylpenicillin
- Benzylpenicillin
- Cefalexin
- Cefazolin> 1 month.
- ChloramphenicolOnly for the presumptive treatment of epidemic meningitis in children older than two years and in adults.
- Clindamycin
- CloxacillinAlternatives limited to 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)cloxacillin, dicloxacillin and flucloxacillin are preferred for oral administration due to better bioavailability.
- DoxycyclineUse in children <8 years only for life-threatening infections when no alternative exists.
- Gentamicin
- Metronidazole
- Nitrofurantoin
- Phenoxymethylpenicillin (penicillin V)
- Procaine benzylpenicillinProcaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
- Sulfamethoxazole/trimethoprim (sulfamethoxazole + trimethoprim)
- Trimethoprim
==Watch group antibiotics==
- Azithromycin
- Cefixime
- CefotaximeThird-generation cephalosporin of choice for use in hospitalized neonates.
- CeftriaxoneDo not administer with calcium and avoid in infants with hyperbilirubinemia.> 41 weeks corrected gestational age.
- Cefuroxime
- Ciprofloxacin
- ClarithromycinErythromycin may be an alternative.
- Piperacillin/tazobactam (piperacillin + tazobactam)
- Vancomycin
- Ceftazidime{{ref|Alpha|α}}
- Meropenem{{ref|Alpha|α}}Imipenem/cilastatin is an alternative for complicated intraabdominal infections and high-risk febrile neutropenia only, except for acute bacterial meningitis in neonates, where meropenem is preferred
- Vancomycin{{ref|Alpha|α}}
==Reserve group antibiotics==
Reserve antibiotics are last-resort antibiotics. The EML antibiotic book was published in 2022.{{Cite web |date=24 November 2021 |title=The WHO Essential Medicines List Antibiotic Book |url=https://www.who.int/news-room/questions-and-answers/item/the-who-essential-medicines-list-antibiotic-book |access-date=2022-10-06 |website=World Health Organization (WHO) |archive-date=11 November 2022 |archive-url=https://web.archive.org/web/20221111171654/https://www.who.int/news-room/questions-and-answers/item/the-who-essential-medicines-list-antibiotic-book |url-status=live }}{{cite book | title=The WHO AWaRe (Access, Watch, Reserve) antibiotic book | location=Geneva | publisher=World Health Organization (WHO) | year=2022 | url=https://www.who.int/publications/i/item/9789240062382 | access-date=29 January 2023 | isbn=978-92-4-006238-2 | archive-date=13 August 2023 | archive-url=https://web.archive.org/web/20230813134739/https://www.who.int/publications/i/item/9789240062382 | url-status=live }}{{cite book | title=The WHO AWaRe (Access, Watch, Reserve) antibiotic book - Infographics | location=Geneva | publisher=World Health Organization (WHO) | year=2022 | url=https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2022.02 | access-date=29 January 2023 | id=WHO/MHP/HPS/EML/2022.02 | archive-date=29 January 2023 | archive-url=https://web.archive.org/web/20230129194901/https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2022.02 | url-status=live }}
- Ceftazidime/avibactam (ceftazidime + avibactam){{ref|Alpha|α}}
- Colistin{{ref|Alpha|α}}
- Fosfomycin{{ref|Alpha|α}}
- Linezolid{{ref|Alpha|α}}
- Polymyxin B{{ref|Alpha|α}}
==Antileprosy medicines==
==Antituberculosis medicines==
File:Ethambutol substance photo.jpg
- Ethambutol
- Isoniazid
- Isoniazid/pyrazinamide/rifampicin (isoniazid + pyrazinamide + rifampicin)
- Isoniazid/rifampicin (isoniazid + rifampicin)
- Isoniazid/rifapentine (isoniazid + rifapentine)
- Pyrazinamide
- Rifampicin
- Rifapentine
- Amikacin{{ref|Alpha|α}}
- Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid){{ref|Alpha|α}}For use only in combination with meropenem.
- Bedaquiline{{ref|Alpha|α}}
- Clofazimine{{ref|Alpha|α}}
- Cycloserine{{ref|Alpha|α}}Terizidone may be an alternative
- Delamanid{{ref|Alpha|α}}
- Ethionamide{{ref|Alpha|α}}Prothionamide may be used as an alternative.
- Levofloxacin{{ref|Alpha|α}}
- Linezolid{{ref|Alpha|α}}
- Meropenem{{ref|Alpha|α}}
- Moxifloxacin{{ref|Alpha|α}}
- P-aminosalicylic acid{{ref|Alpha|α}}
- Streptomycin{{ref|Alpha|α}}
=Antifungal medicines=
- Amphotericin B
- Fluconazole
- Flucytosine
- Griseofulvin
- ItraconazoleFor treatment of chronic pulmonary aspergillosis, acute invasive aspergillosis, histoplasmosis, sporotrichosis, paracoccidiodomycosis, mycoses caused by T. marneffei and chromoblastomycosis; and prophylaxis of histoplasmosis and infections caused by T. marneffei in AIDS patients.
- Nystatin
- VoriconazoleFor treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis.
- Micafungin{{ref|Alpha|α}}Alternatives limited to anidulafungin and caspofungin
- Potassium iodide{{ref|Alpha|α}}
=Antiviral medicines=
==Antiherpes medicines==
==Antiretrovirals==
===Nucleoside/nucleotide reverse transcriptase inhibitors===
===Non-nucleoside reverse transcriptase inhibitors===
===Protease inhibitors===
===Integrase inhibitors===
=== Fixed-dose combinations of antiretroviral medicines ===
==Other antivirals==
==Antihepatitis medicines==
===Medicines for hepatitis B===
====Nucleoside/Nucleotide reverse transcriptase inhibitors====
===Medicines for hepatitis C===
====Pangenotypic direct-acting antiviral combinations====
====Non-pangenotypic direct-acting antiviral combinations====
No listings in this section.
====Other antivirals for hepatitis C====
No listings in this section.
=Antiprotozoal medicines=
==Antiamoebic and antigiardiasis medicines==
==Antileishmaniasis medicines==
==Antimalarial medicines==
===For curative treatment===
- AmodiaquineTo be used in combination with artesunate 50 mg.
- ArtemetherFor use in the management of severe malaria.
- Artemether/lumefantrine (artemether + lumefantrine)Not recommended in the first trimester of pregnancy or in children below 5 kg.
- ArtesunateTo be used in combination with either amodiaquine, mefloquine or sulfadoxine + pyrimethamine.
- Artesunate/amodiaquine (artesunate + amodiaquine)Other combinations that deliver the target doses required such as 153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be alternatives.
- Artesunate/mefloquine (artesunate + mefloquine)
- Artesunate/pyronaridine tetraphosphate (artesunate + pyronaridine tetraphosphate)
- ChloroquineFor use only for the treatment of Plasmodium vivax infection.
- Dihydroartemisinin/piperaquine phosphate (dihydroartemisinin + piperaquine phosphate)
- DoxycyclineFor use only in combination with quinine.
- MefloquineTo be used in combination with artesunate 50 mg.
- PrimaquineOnly for use to achieve radical cure of Plasmodium vivax and Plasmodium ovale infections, given for 14 days.
- QuinineFor use only in the management of severe malaria, and should be used in combination with doxycycline.
- Sulfadoxine/pyrimethamine (sulfadoxine + pyrimethamine)Only in combination with artesunate 50 mg.
===For chemoprevention===
==Antipneumocystosis and antitoxoplasmosis medicines==
==Antitrypanosomal medicines==
===African trypanosomiasis===
====1st stage====
====2nd stage====
===American trypanosomiasis===
=Medicines for ectoparasitic infections=
Antimigraine medicines
=For treatment of acute attack=
=For prophylaxis=
Immunomodulators and Antineoplastics
=Immunomodulators for non-malignant disease=
=Antineoplastic and supportive medicines=
== Cytotoxic medicines ==
- Arsenic trioxide{{ref|Alpha|α}}
- Asparaginase{{ref|Alpha|α}}
- Bleomycin{{ref|Alpha|α}}
- Calcium folinate{{ref|Alpha|α}}
- Carboplatin{{ref|Alpha|α}}
- Cisplatin{{ref|Alpha|α}}
- Cyclophosphamide{{ref|Alpha|α}}
- Cytarabine{{ref|Alpha|α}}
- Dacarbazine{{ref|Alpha|α}}
- Dactinomycin{{ref|Alpha|α}}
- Daunorubicin{{ref|Alpha|α}}
- Doxorubicin{{ref|Alpha|α}}
- Etoposide{{ref|Alpha|α}}
- Fluorouracil{{ref|Alpha|α}}
- Hydroxycarbamide{{ref|Alpha|α}}
- Ifosfamide{{ref|Alpha|α}}
- Irinotecan{{ref|Alpha|α}}
- Mercaptopurine{{ref|Alpha|α}}
- Methotrexate{{ref|Alpha|α}}
- Oxaliplatin{{ref|Alpha|α}}
- Paclitaxel{{ref|Alpha|α}}
- Pegaspargase{{ref|Alpha|α}}including quality-assured biosimilars
- Procarbazine{{ref|Alpha|α}}
- Realgar/Indigo naturalis{{ref|Alpha|α}}
- Tioguanine{{ref|Alpha|α}}
- Vinblastine{{ref|Alpha|α}}
- Vincristine{{ref|Alpha|α}}
- Vinorelbine{{ref|Alpha|α}}
==Targeted therapies==
- All-trans retinoid acid (ATRA){{ref|Alpha|α}}
- Dasatinib{{ref|Alpha|α}}
- Everolimus{{ref|Alpha|α}}
- Imatinib{{ref|Alpha|α}}
- Nilotinib{{ref|Alpha|α}}
- Rituximab{{ref|Alpha|α}}including quality-assured biosimilars
==Immunomodulators==
- Filgrastim{{ref|Alpha|α}}
==Hormones and antihormones==
- Dexamethasone{{ref|Alpha|α}}
- Hydrocortisone{{ref|Alpha|α}}
- Methylprednisolone{{ref|Alpha|α}}
- Prednisolone{{ref|Alpha|α}}Alternatives limited to prednisone
==Supportive medicines==
- Allopurinol{{ref|Alpha|α}}
- Mesna{{ref|Alpha|α}}
- Rasburicase{{ref|Alpha|α}}
Medicines affecting the blood
=Antianaemia medicines=
=Medicines affecting coagulation=
- EnoxaparinAlternatives are limited to nadroparin, dalteparin, and their quality-assured biosimilars.
- Phytomenadione
- Desmopressin{{ref|Alpha|α}}
- Heparin sodium{{ref|Alpha|α}}
- Protamine sulfate{{ref|Alpha|α}}
- Warfarin{{ref|Alpha|α}}
=Other medicines for haemoglobinopathies=
Blood products of human origin and plasma substitutes
=Blood and blood components=
=Plasma-derived medicines=
==Human immunoglobulins==
==Blood coagulation factors==
- Coagulation factor VIII{{ref|Alpha|α}}
- Coagulation factor IX{{ref|Alpha|α}}
=Plasma substitutes=
Cardiovascular medicines
=Antianginal medicines=
No listings in this section.
=Antiarrhythmic medicines=
No listings in this section.
=Antihypertensive medicines=
=Medicines used in heart failure=
- Digoxin
- Furosemide
- Dopamine{{ref|Alpha|α}}
=Antithrombotic medicines=
No listings in this section.
=Lipid-lowering agents=
No listings in this section.
Dermatological medicines (topical)
=Antifungal medicines=
=Anti-infective medicines=
=Anti-inflammatory and antipruritic medicines=
=Medicines affecting skin differentiation and proliferation=
=Scabicides and pediculicides=
Diagnostic agents
=Ophthalmic medicines=
=Radiocontrast media=
- Barium sulfate{{ref|Alpha|α}}
Disinfectants and antiseptics
=Antiseptics=
=Disinfectants=
Diuretics
Gastrointestinal medicines
- Pancreatic enzymes{{ref|Alpha|α}}
=Antiulcer medicines=
=Antiemetic medicines=
- Dexamethasone
- Metoclopramide
- Ondansetron
- Aprepitant{{ref|Alpha|α}}
=Anti-inflammatory medicines=
No listings in this section.
=Laxatives=
No listings in this section.
=Medicines used in diarrhoea=
- Oral rehydration salts + zinc sulfate (Co-packaged)
==Oral rehydration==
==Medicines for diarrhoea==
Medicines for endocrine disorders
=Adrenal hormones and synthetic substitutes=
=Androgens=
No listings in this section.
=Estrogens=
No listings in this section.
=Progestogens=
No listings in this section.
=Medicines for diabetes=
==Insulins==
==Oral hypoglycaemic agents==
- Metformin{{ref|Alpha|α}}
=Medicines for hypoglycaemia=
=Thyroid hormones and antithyroid medicines=
Immunologicals
=Diagnostic agents=
- Tuberculin, purified protein derivative (PPD)
=Sera and immunoglobulins=
- Anti-rabies virus monoclonal antibodies
- Antivenom immunoglobulinExact type to be defined locally.
- Diphtheria antitoxin
- Equine rabies immunoglobulin
=Vaccines=
Recommendations for all
- BCG vaccine
- Diphtheria vaccine
- Haemophilus influenzae type b vaccine
- Hepatitis B vaccine
- HPV vaccine
- Measles vaccine
- Pertussis vaccine
- Pneumococcal vaccine
- Poliomyelitis vaccine
- Rotavirus vaccine
- Rubella vaccine
- Tetanus vaccine
Recommendations for certain regions
- Japanese encephalitis vaccineRecommended for certain regions
- Yellow fever vaccine
- Tick-borne encephalitis vaccine
Recommendations for some high-risk populations
- Cholera vaccineRecommended for some high-risk populations
- Dengue vaccine
- Hepatitis A vaccine
- Meningococcal meningitis vaccine
- Rabies vaccine
- Typhoid vaccine
Recommendations for immunization programmes with certain characteristics
Muscle relaxants (peripherally-acting) and cholinesterase inhibitors
- Neostigmine
- Suxamethonium
- Vecuronium
- Pyridostigmine{{ref|Alpha|α}}
Ophthalmological preparations
=Anti-infective agents=
- Aciclovir
- Azithromycin
- ErythromycinInfections due to Chlamydia trachomatis or Neisseria gonorrhoeae.
- GentamicinAlternatives limited to amikacin, kanamycin, netilmicin, and tobramycin
- Natamycin
- OfloxacinAlternatives limited to 4th level ATC chemical subgroup (S01AE Fluoroquinolones)
- TetracyclineAlternatives limited to chlortetracycline and oxytetracycline
=Anti-inflammatory agents=
=Local anaesthetics=
=Miotics and antiglaucoma medicines=
No listings in this section.
=Mydriatics=
=Anti-vascular endothelial growth factor (VEGF) preparations=
No listings in this section.
Medicines for reproductive health and perinatal care
=Contraceptives=
No listings in this section.
=Ovulation inducers=
No listings in this section.
=Uterotonics=
No listings in this section.
=Antioxytocics (tocolytics)=
No listings in this section.
=Other medicines administered to the mother=
No listings in this section.
=Medicines administered to the neonate=
Peritoneal dialysis solution
- Intraperitoneal dialysis solution (of appropriate composition){{ref|Alpha|α}}
Medicines for mental and behavioural disorders
=Medicines used in psychotic disorders=
- Chlorpromazine{{ref|Alpha|α}}
- Haloperidol{{ref|Alpha|α}}
=Medicines used in mood disorders=
==Medicines used in depressive disorders==
- Fluoxetine{{ref|Alpha|α}}
==Medicines used in bipolar disorders==
No listings in this section.
=Medicines for anxiety disorders=
No listings in this section.
=Medicines used for obsessive compulsive disorders=
No listings in this section.
=Medicines for disorders due to psychoactive substance use=
No listings in this section.
Medicines acting on the respiratory tract
=Antiasthmatic medicines=
Solutions correcting water, electrolyte and acid-base disturbances
=Oral=
=Parenteral=
=Miscellaneous=
Vitamins and minerals
Ear, nose and throat medicines
Medicines for diseases of joints
=Medicines used to treat gout=
No listings in this section.
=Disease-modifying agents used in rheumatoid disorders=
- Hydroxychloroquine{{ref|Alpha|α}}
- Methotrexate{{ref|Alpha|α}}
=Juvenile joint diseases=
=Dental preparations=
Notes
{{Reflist|group=note}}
References
{{reflist}}
Further reading
- {{cite book | vauthors=((World Health Organization)) | title=The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children) | year=2015 | publisher=World Health Organization | author-link = World Health Organization | isbn=9789240694941 | hdl=10665/189763 | issn=0512-3054 | location=Geneva | id=WHO technical report series; no. 994 | hdl-access=free }}
- {{cite book | vauthors = ((World Health Organization)) | title=The selection and use of essential medicines: report of the WHO Expert Committee, 2017 (including the 20th WHO Model List of Essential Medicines and the 6th Model List of Essential Medicines for Children) | author-link = World Health Organization | year=2017 | publisher=World Health Organization | isbn=978-92-4-121015-7 | hdl=10665/259481 | issn=0512-3054 | location=Geneva | id=WHO technical report series; no. 1006 | hdl-access=free }}
- {{cite book | vauthors = ((World Health Organization)) | year = 2019 | title = The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children) | publisher = World Health Organization | location = Geneva | author-link = World Health Organization | hdl = 10665/330668 | id = WHO technical report series;1021 | hdl-access=free | isbn = 9789241210300 | issn = 0512-3054 }}
External links
{{URL|https://list.essentialmeds.org/|eEML - Electronic Essential Medicines List }}
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