The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children[1] or EMLc[1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.[2][3]
The list is divided into core items and complementary items.[4] The core items are deemed to be the most cost-effective options for key health problems and are usable with little additional health care resources.[4] The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost–benefit ratio.[4]
The first list for children was created in 2007, and the list is in its 8th edition as of 2021[update].[5][4][6]
Note: An α indicates a medicine is on the complementary list.[4]
Anaesthetics, preoperative medicines and medical gases edit
General anaesthetics and oxygen edit
Inhalational medicines edit
Injectable medicines edit
Local anaesthetics edit
Preoperative medication and sedation for short-term procedures edit
Medical gases edit
Medicines for pain and palliative care edit
Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs) edit
- Ibuprofen[note 3]
- Paracetamol[note 4] (acetaminophen)
Opioid analgesics edit
Medicines for other symptoms common in palliative care edit
Antiallergics and medicines used in anaphylaxis edit
Antidotes and other substances used in poisonings edit
Non-specific edit
Specific edit
Anticonvulsants/antiepileptics edit
- Carbamazepine
- Diazepam
- Lamotrigine[note 11]
- Lorazepam[note 12]
- Midazolam[note 13]
- Phenobarbital
- Phenytoin[note 14]
- Valproic acid (sodium valproate)[note 15]
- Ethosuximideα
- Valproic acid (sodium valproate)α[note 15]
Anti-infective medicines edit
Anthelminthics edit
Intestinal anthelminthics edit
Antifilarials edit
Antischistosomals and other antinematode medicines edit
Cysticidal medicines edit
Antibacterials edit
Access group antibiotics edit
- Amikacin
- Amoxicillin
- Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)
- Ampicillin
- Benzathine benzylpenicillin
- Benzylpenicillin
- Cefalexin
- Cefazolin[note 17]
- Chloramphenicol[note 18]
- Clindamycin
- Cloxacillin[note 19][note 20]
- Doxycycline[note 21]
- Gentamicin
- Metronidazole
- Nitrofurantoin
- Phenoxymethylpenicillin (penicillin V)
- Procaine benzylpenicillin[note 22]
- Sulfamethoxazole/trimethoprim (sulfamethoxazole + trimethoprim)
- Trimethoprim
Watch group antibiotics edit
- Azithromycin
- Cefixime
- Cefotaxime[note 23]
- Ceftriaxone[note 24][note 25]
- Cefuroxime
- Ciprofloxacin
- Clarithromycin[note 26]
- Piperacillin/tazobactam (piperacillin + tazobactam)
- Vancomycin
- Ceftazidimeα
- Meropenemα[note 27]
- Vancomycinα
Reserve group antibiotics edit
Reserve antibiotics are last-resort antibiotics. The EML antibiotic book was published in 2022.[7][8][9]
Antileprosy medicines edit
Antituberculosis medicines edit
- Ethambutol
- Isoniazid
- Isoniazid/pyrazinamide/rifampicin (isoniazid + pyrazinamide + rifampicin)
- Isoniazid/rifampicin (isoniazid + rifampicin)
- Isoniazid/rifapentine (isoniazid + rifapentine)
- Pyrazinamide
- Rifampicin
- Rifapentine
- Amikacinα
- Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)α[note 28]
- Bedaquilineα
- Clofazimineα
- Cycloserineα[note 29]
- Delamanidα
- Ethionamideα[note 30]
- Levofloxacinα
- Linezolidα
- Meropenemα
- Moxifloxacinα
- P-aminosalicylic acidα
- Streptomycinα
Antifungal medicines edit
- Amphotericin B
- Fluconazole
- Flucytosine
- Griseofulvin
- Itraconazole[note 31]
- Nystatin
- Voriconazole[note 32]
- Micafunginα[note 33]
- Potassium iodideα
Antiviral medicines edit
Antiherpes medicines edit
Antiretrovirals edit
Nucleoside/nucleotide reverse transcriptase inhibitors edit
Non-nucleoside reverse transcriptase inhibitors edit
Protease inhibitors edit
Integrase inhibitors edit
Fixed-dose combinations of antiretroviral medicines edit
edit
- Isoniazid/pyridoxine/sulfamethoxazole/trimethoprim (isoniazid + pyridoxine + sulfamethoxazole + trimethoprim)
Other antivirals edit
Antihepatitis medicines edit
Medicines for hepatitis B edit
Nucleoside/Nucleotide reverse transcriptase inhibitors edit
Medicines for hepatitis C edit
Pangenotypic direct-acting antiviral combinations edit
- Daclatasvir[note 38]
- Daclatasvir/sofosbuvir (daclatasvir + sofosbuvir)
- Glecaprevir/pibrentasvir (glecaprevir + pibrentasvir)
- Sofosbuvir[note 39]
- Sofosbuvir/velpatasvir (sofosbuvir + velpatasvir)
Non-pangenotypic direct-acting antiviral combinations edit
No listings in this section.
Other antivirals for hepatitis C edit
No listings in this section.
Antiprotozoal medicines edit
Antiamoebic and antigiardiasis medicines edit
Antileishmaniasis medicines edit
Antimalarial medicines edit
For curative treatment edit
- Amodiaquine[note 41]
- Artemether[note 42]
- Artemether/lumefantrine (artemether + lumefantrine)[note 43]
- Artesunate[note 44]
- Artesunate/amodiaquine (artesunate + amodiaquine)[note 45]
- Artesunate/mefloquine (artesunate + mefloquine)
- Artesunate/pyronaridine tetraphosphate (artesunate + pyronaridine tetraphosphate)
- Chloroquine[note 46]
- Dihydroartemisinin/piperaquine phosphate (dihydroartemisinin + piperaquine phosphate)
- Doxycycline[note 47]
- Mefloquine[note 48]
- Primaquine[note 49]
- Quinine[note 50]
- Sulfadoxine/pyrimethamine (sulfadoxine + pyrimethamine)[note 51]
For chemoprevention edit
- Amodiaquine + sulfadoxine/pyrimethamine (Co-packaged)
- Chloroquine[note 52]
- Doxycycline
- Mefloquine
- Proguanil[note 53]
- Sulfadoxine/pyrimethamine (sulfadoxine + pyrimethamine)
Antipneumocystosis and antitoxoplasmosis medicines edit
Antitrypanosomal medicines edit
African trypanosomiasis edit
1st stage edit
2nd stage edit
American trypanosomiasis edit
Medicines for ectoparasitic infections edit
Antimigraine medicines edit
For treatment of acute attack edit
For prophylaxis edit
Immunomodulators and Antineoplastics edit
Immunomodulators for non-malignant disease edit
Antineoplastic and supportive medicines edit
Cytotoxic medicines edit
- Arsenic trioxideα
- Asparaginaseα[note 60]
- Bleomycinα
- Calcium folinateα
- Carboplatinα
- Cisplatinα
- Cyclophosphamideα
- Cytarabineα
- Dacarbazineα
- Dactinomycinα
- Daunorubicinα
- Doxorubicinα
- Etoposideα
- Fluorouracilα
- Hydroxycarbamideα
- Ifosfamideα
- Irinotecanα
- Mercaptopurineα
- Methotrexateα
- Oxaliplatinα
- Paclitaxelα
- Pegaspargaseα[note 60]
- Procarbazineα
- Realgar/Indigo naturalisα
- Tioguanineα
- Vinblastineα
- Vincristineα
- Vinorelbineα
Targeted therapies edit
Immunomodulators edit
Hormones and antihormones edit
Supportive medicines edit
Medicines affecting the blood edit
Antianaemia medicines edit
Medicines affecting coagulation edit
Other medicines for haemoglobinopathies edit
Blood products of human origin and plasma substitutes edit
Blood and blood components edit
Plasma-derived medicines edit
Human immunoglobulins edit
Blood coagulation factors edit
Plasma substitutes edit
Cardiovascular medicines edit
Antianginal medicines edit
No listings in this section.
Antiarrhythmic medicines edit
No listings in this section.
Antihypertensive medicines edit
Medicines used in heart failure edit
Antithrombotic medicines edit
No listings in this section.
Lipid-lowering agents edit
No listings in this section.
Dermatological medicines (topical) edit
Antifungal medicines edit
Anti-infective medicines edit
Anti-inflammatory and antipruritic medicines edit
Medicines affecting skin differentiation and proliferation edit
Scabicides and pediculicides edit
Diagnostic agents edit
Ophthalmic medicines edit
Radiocontrast media edit
Disinfectants and antiseptics edit
Antiseptics edit
Disinfectants edit
Diuretics edit
Gastrointestinal medicines edit
Antiulcer medicines edit
Antiemetic medicines edit
Anti-inflammatory medicines edit
No listings in this section.
Laxatives edit
No listings in this section.
Medicines used in diarrhoea edit
- Oral rehydration salts + zinc sulfate (Co-packaged)
Oral rehydration edit
Medicines for diarrhoea edit
Medicines for endocrine disorders edit
Adrenal hormones and synthetic substitutes edit
Androgens edit
No listings in this section.
Estrogens edit
No listings in this section.
Progestogens edit
No listings in this section.
Medicines for diabetes edit
Insulins edit
- Insulin injection (soluble)[note 60]
- Intermediate-acting insulin[note 60]
- Long-acting insulin analogues[note 81]
Oral hypoglycaemic agents edit
Medicines for hypoglycaemia edit
Thyroid hormones and antithyroid medicines edit
Immunologicals edit
Diagnostic agents edit
- Tuberculin, purified protein derivative (PPD)
Sera and immunoglobulins edit
- Anti-rabies virus monoclonal antibodies[note 60]
- Antivenom immunoglobulin[note 84]
- Diphtheria antitoxin
- Equine rabies immunoglobulin
Vaccines edit
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 vaccine[note 85]
- Yellow fever vaccine[note 85]
- Tick-borne encephalitis vaccine[note 85]
Recommendations for some high-risk populations
- Cholera vaccine[note 86]
- Dengue vaccine[note 86]
- Hepatitis A vaccine[note 86]
- Meningococcal meningitis vaccine[note 86]
- Rabies vaccine[note 86]
- Typhoid vaccine[note 86]
Recommendations for immunization programmes with certain characteristics
Muscle relaxants (peripherally-acting) and cholinesterase inhibitors edit
Ophthalmological preparations edit
Anti-infective agents edit
- Aciclovir
- Azithromycin
- Erythromycin[note 88]
- Gentamicin[note 89]
- Natamycin
- Ofloxacin[note 90]
- Tetracycline[note 91]
Anti-inflammatory agents edit
Local anaesthetics edit
Miotics and antiglaucoma medicines edit
No listings in this section.
Mydriatics edit
- Atropine[note 93]
- Epinephrine (adrenaline)α
Anti-vascular endothelial growth factor (VEGF) preparations edit
No listings in this section.
Medicines for reproductive health and perinatal care edit
Contraceptives edit
No listings in this section.
Ovulation inducers edit
No listings in this section.
Uterotonics edit
No listings in this section.
Antioxytocics (tocolytics) edit
No listings in this section.
Other medicines administered to the mother edit
No listings in this section.
Medicines administered to the neonate edit
Peritoneal dialysis solution edit
- Intraperitoneal dialysis solution (of appropriate composition)α
Medicines for mental and behavioural disorders edit
Medicines used in psychotic disorders edit
Medicines used in mood disorders edit
Medicines used in depressive disorders edit
Medicines used in bipolar disorders edit
No listings in this section.
Medicines for anxiety disorders edit
No listings in this section.
Medicines used for obsessive compulsive disorders edit
No listings in this section.
Medicines for disorders due to psychoactive substance use edit
No listings in this section.
Medicines acting on the respiratory tract edit
Antiasthmatic medicines edit
- Budesonide[note 96]
- Epinephrine (adrenaline)
- Salbutamol (albuterol)[note 97]
Solutions correcting water, electrolyte and acid-base disturbances edit
Oral edit
Parenteral edit
- Glucose
- Glucose with sodium chloride
- Potassium chloride
- Sodium chloride
- Sodium hydrogen carbonate
- Sodium lactate, compound solution
Miscellaneous edit
Vitamins and minerals edit
Ear, nose and throat medicines edit
Medicines for diseases of joints edit
Medicines used to treat gout edit
No listings in this section.
Disease-modifying agents used in rheumatoid disorders edit
Juvenile joint diseases edit
Dental preparations edit
Notes edit
- ^ Thiopental may be used as an alternative depending on local availability and cost.
- ^ No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
- ^ Not in children less than three months.
- ^ Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
- ^ Alternatives limited to hydromorphone and oxycodone.
- ^ For the management of cancer pain.
- ^ a b Alternatives limited to dolasetron, granisetron, palonosetron, and tropisetron
- ^ Alternatives limited to cetirizine and fexofenadine
- ^ There may be a role for sedating antihistamines for limited indications.
- ^ Alternatives limited to prednisone
- ^ For use as adjunctive therapy for treatment-resistant partial or generalized seizures.
- ^ Alternatives limited to diazepam and midazolam
- ^ For buccal administration when solution for oromucosal administration is not available.
- ^ The 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.
- ^ a b 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.
- ^ Oxamniquine is listed for use when praziquantel treatment fails.
- ^ > 1 month.
- ^ Only for the presumptive treatment of epidemic meningitis in children older than two years and in adults.
- ^ Alternatives 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.
- ^ Use in children <8 years only for life-threatening infections when no alternative exists.
- ^ Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
- ^ Third-generation cephalosporin of choice for use in hospitalized neonates.
- ^ Do not administer with calcium and avoid in infants with hyperbilirubinemia.
- ^ > 41 weeks corrected gestational age.
- ^ Erythromycin may be an alternative.
- ^ 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
- ^ For use only in combination with meropenem.
- ^ Terizidone may be an alternative
- ^ Prothionamide may be used as an alternative.
- ^ For 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.
- ^ For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis.
- ^ Alternatives limited to anidulafungin and caspofungin
- ^ for use in second-line regimens in accordance with WHO treatment guidelines
- ^ For the treatment of viral haemorrhagic fevers only.
- ^ Severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
- ^ For the treatment of cytomegalovirus retinitis (CMVr).
- ^ Pangenotypic when used in combination with sofosbuvir
- ^ Pangenotypic when used in combination with daclatasvir
- ^ Alternatives limited to tinidazole
- ^ To be used in combination with artesunate 50 mg.
- ^ For use in the management of severe malaria.
- ^ Not recommended in the first trimester of pregnancy or in children below 5 kg.
- ^ To be used in combination with either amodiaquine, mefloquine or sulfadoxine + pyrimethamine.
- ^ Other combinations that deliver the target doses required such as 153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be alternatives.
- ^ For use only for the treatment of Plasmodium vivax infection.
- ^ For use only in combination with quinine.
- ^ To be used in combination with artesunate 50 mg.
- ^ Only for use to achieve radical cure of Plasmodium vivax and Plasmodium ovale infections, given for 14 days.
- ^ For use only in the management of severe malaria, and should be used in combination with doxycycline.
- ^ Only in combination with artesunate 50 mg.
- ^ For use only for the treatment of Plasmodium vivax infection.
- ^ For use only in combination with chloroquine.
- ^ For the treatment of 1st and 2nd stage of human African trypanosomiasis due to Trypanosoma brucei gambiense infection.
- ^ To be used for the treatment of Trypanosoma brucei gambiense infection.
- ^ To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection.
- ^ To be used for the treatment of Trypanosoma brucei gambiense infection
- ^ Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection.
- ^ etanercept and infliximab are alternatives, including quality-assured biosimilars
- ^ a b c d e f including quality-assured biosimilars
- ^ including quality-assured biosimilars
- ^ Alternatives limited to prednisone
- ^ Alternatives limited to epoetin alfa, beta and theta, darbepoetin alfa, and their quality-assured biosimilars.
- ^ Alternatives are limited to nadroparin, dalteparin, and their quality-assured biosimilars.
- ^ Alternatives are limited to the oral form of deferasirox.
- ^ Polygeline, injectable solution, 3.5% is considered as equivalent.
- ^ Alternatives limited to 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
- ^ Alternatives limited to 4th level ATC chemical subgroup (D01AC Imidazole and triazole derivatives) excluding combinations
- ^ Alternatives limited to 4th level ATC chemical subgroup (D07AC Corticosteroids, potent (group III))
- ^ Alternatives limited to calcitriol and tacalcitol
- ^ Alternatives limited to podophyllotoxin
- ^ Alternatives limited to precipitated sulfur topical ointment
- ^ Alternatives limited to atropine and cyclopentolate
- ^ Alternatives limited to propanol
- ^ Alternatives limited to iodine
- ^ Alternatives limited to 4th level ATC chemical subgroup (D08AE Phenol and derivatives)
- ^ Alternatives limited to chlorothiazide and chlorthalidone
- ^ Alternatives limited to 4th level ATC chemical subgroup (A02BC Proton pump inhibitors) excluding combinations
- ^ Alternatives limited to 4th level ATC chemical subgroup (A02BA H2-receptor antagonists) excluding combinations
- ^ In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
- ^ Alternatives limited to insulin detemir, insulin degludec, and insulin glargine, including quality-assured biosimilars
- ^ Carbimazole is an alternative depending on local availability.
- ^ For use when alternative first-line treatment is not appropriate or available
- ^ Exact type to be defined locally.
- ^ a b c Recommended for certain regions
- ^ a b c d e f Recommended for some high-risk populations
- ^ a b c Recommended for immunisation programmes with certain characteristics
- ^ Infections due to Chlamydia trachomatis or Neisseria gonorrhoeae.
- ^ Alternatives limited to amikacin, kanamycin, netilmicin, and tobramycin
- ^ Alternatives limited to 4th level ATC chemical subgroup (S01AE Fluoroquinolones)
- ^ Alternatives limited to chlortetracycline and oxytetracycline
- ^ Alternatives limited to 4th level ATC chemical subgroup (S01HA Local anaesthetics) excluding cocaine and combinations
- ^ Alternatives limited to homatropine hydrobromide or cyclopentolate hydrochloride.
- ^ Alternatives limited to indometacin
- ^ Alternatives limited to prostaglandin E2
- ^ Alternatives limited to beclometasone, ciclesonide, flunisolide, fluticasone, and mometasone
- ^ Alternatives limited to terbutaline
- ^ Ergocalciferol can be used as an alternative.
- ^ Alternatives limited to ofloxacin
- ^ For use for rheumatic fever, juvenile arthritis, Kawasaki disease
References edit
- ^ a b "WHO Model Lists of Essential Medicines". World Health Organization. Retrieved 15 April 2021.
- ^ "Essential medicines". World Health Organization. Archived from the original on 2 October 2008. Retrieved 20 January 2017.
- ^ World Health Organization (2021). 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). Geneva: World Health Organization. hdl:10665/351172. ISBN 9789240041141. WHO technical report series;1035. License: CC BY-NC-SA 3.0 IGO.
- ^ a b c d e World Health Organization (2019). World Health Organization model list of essential medicines for children: 7th list 2019. Geneva. hdl:10665/325772. WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO.
{{cite book}}: CS1 maint: location missing publisher (link) - ^ World Health Organization (2021). World Health Organization model list of essential medicines for children: 8th list (2021). Geneva: World Health Organization. hdl:10665/345534. WHO/MHP/HPS/EML/2021.03.
- ^ World Health Organization (2019). 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. Geneva. hdl:10665/325773. WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO.
{{cite book}}: CS1 maint: location missing publisher (link) - ^ "The WHO Essential Medicines List Antibiotic Book". World Health Organization (WHO). 24 November 2021. Retrieved 6 October 2022.
- ^ The WHO AWaRe (Access, Watch, Reserve) antibiotic book. Geneva: World Health Organization (WHO). 2022. ISBN 978-92-4-006238-2. Retrieved 29 January 2023.
- ^ The WHO AWaRe (Access, Watch, Reserve) antibiotic book - Infographics. Geneva: World Health Organization (WHO). 2022. WHO/MHP/HPS/EML/2022.02. Retrieved 29 January 2023.
Further reading edit
- World Health Organization (2015). 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). Geneva: World Health Organization. hdl:10665/189763. ISBN 9789240694941. ISSN 0512-3054. WHO technical report series; no. 994.
- World Health Organization (2017). 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). Geneva: World Health Organization. hdl:10665/259481. ISBN 978-92-4-121015-7. ISSN 0512-3054. WHO technical report series; no. 1006.
- World Health Organization (2019). 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). Geneva: World Health Organization. hdl:10665/330668. ISBN 9789241210300. ISSN 0512-3054. WHO technical report series;1021.
