1 1040013064 AC42660100 ANBICYN F.C.TABLETS 625 中化台中 AMOXYCILLIN (TRIHYDRATE) 500, CLAVULANATE (POTASSIUM) 125 5.2 0 105/03/01 2 1050034788 A028613148 BISOLVON SOLUTION 2/ML (BROMHEXINE HYDROCHLORIDE) 臺灣百靈佳殷格翰 BROMHEXINE HCL 2.00/ML 內服液 50 ML 53 0 105/02/01 3 1050034788 A028614100 MEXITIL CAPSULES 100 (MEXILETINE HYDROCHLORIDE) 臺灣百靈佳殷格翰 MEXILETINE HCL 100.00 3.52 0 105/02/01 4 1050034788 A032572100 SACLONAL TABLETS 10 (HOMOCHLORCYCLIZINE ) P.J. 北進國際 HOMOCHLORCYCLIZINE 2HCL(=HOMOCLOMIN) 10.00 0.83 0 105/02/01 5 1050034788 A032702100 BIPERIDEN TABLET 2 K.Y. 洸洋 BIPERIDEN HCL 2.00 2.03 0 105/02/01 6 1050034788 A032783100 PEDERCON TABLETS 200 (FLAVOXATE) YUNG CHI 永吉 FLAVOXATE HCL 200.00 4.01 0 105/02/01 7 1050034788 A036490100 NOOGICA CAPSULES 400CHEN TA 成大藥品 PIRACETAM 400.00 膠囊 1.14 0 105/02/01 8 1050034788 A039032212 SULPIRIDE INJ. 25/ML 2ML 壽元 SULPIRIDE 25.00/ML 注射 2 ML 12.4 0 105/02/01 9 1050034788 A039065238 SODIUM BICARBONATE INJ. 70/ML 20ML 壽元 SODIUM BICARBONATE 70.00/ML 注射 20 ML 6 0 105/02/01 10 1050034788 A039084209 CEPANON FOR TAI YU (CEFOPERAZONE) 臺裕 CEFOPERAZONE (SODIUM) 1.00GM 乾粉注射 1 GM 170 0 105/02/01 11 1050034788 A039084277 CEPANON FOR TAI YU(CEFOPERAZONE) 臺裕 CEFOPERAZONE (SODIUM) 500.00 乾粉注射 500 101 0 105/02/01 12 1050034788 A043659100 NONSED TABLETS 10 L.O. 美時 CETIRIZINE DIHYDROCHLORIDE 10.00 1.02 0 105/02/01 13 1050034788 A043890100 PUROMIN TABLETS 5 TAI YU 臺裕 MEDROXYPROGESTERO NE ACETATE 5.00 0.98 0 105/02/01 14 1050034788 A0438901G0 PUROMIN TABLETS 5 TAI YU( 鋁箔 / 膠箔 ) 臺裕 MEDROXYPROGESTERO NE ACETATE 5.00 1.5 0 105/02/01 15 1050034788 A047155100 ACIDAM TABLET 瑩碩 BUTINOLIN PHOSPHATE 2.00 0 0 105/02/01 第 1 頁, 共 28 頁
16 1050034788 A052613263 TEICOCID LYOPHILIZED FOR IV 200 BEST 倍斯特 TEICOPLANIN 200.00 凍晶 注射 200 0 0 105/02/01 17 1050034788 B020881221 ETOPOSIDE-TEVA 20/ML 海喬 ETOPOSIDE 20.00/ML 注射 5 ML 237 0 105/02/01 18 1050034788 B020881229 ETOPOSIDE-TEVA 20/ML 海喬 ETOPOSIDE 20.00/ML 注射 10 ML 1486 0 105/02/01 19 1050034788 B020935221 LEUCOVORIN-TEVA 10/ML 海喬 FOLINATE(=LEUCOVORI N)(CALCIUM 5H2O) 10.00/ML 注射 5 ML 101 0 105/02/01 20 1050034788 B020935229 LEUCOVORIN-TEVA 10/ML 海喬 FOLINATE(=LEUCOVORI N)(CALCIUM 5H2O) 10.00/ML 注射 10 ML 136 0 105/02/01 21 1050034788 B020935238 LEUCOVORIN-TEVA 10/ML 海喬 FOLINATE(=LEUCOVORI N)(CALCIUM 5H2O) 10.00/ML 注射 20 ML 420 0 105/02/01 22 1050034788 B020935248 LEUCOVORIN TEVA 10/ML 海喬 FOLINATE(=LEUCOVORI N)(CALCIUM 5H2O) 10.00/ML 注射 50 ML 1039 0 105/02/01 23 1050034788 B020937238 ABIPLATIN 0.5/ML 海喬 CISPLATIN (=CIS- DDP=DDP) 0.50/ML 注射 20 ML 70 0 105/02/01 24 1050034788 B020937255 ABIPLATIN 0.5/ML 海喬 CISPLATIN (=CIS- DDP=DDP) 0.50/ML 注射 100 ML 350 0 105/02/01 25 1050034788 B020937263 ABIPLATIN 0.5/ML 海喬 CISPLATIN (=CIS- DDP=DDP) 0.50/ML 注射 200 ML 357 0 105/02/01 26 1050034788 B022828100 BETAMAC T50 興采 SULPIRIDE 50.00 1.33 0 105/02/01 27 1050034788 B022853212 CAPD/DPCA 11 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 2 L 184 0 105/02/01 28 1050034788 B022853214 CAPD/DPCA 11 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 2.5 L 201 0 105/02/01 29 1050034788 B022853221 CAPD/DPCA 11 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 5 L 284 0 105/02/01 30 1050034788 B022854212 CAPD/DPCA 12 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 2 L 184 0 105/02/01 第 2 頁, 共 28 頁
31 1050034788 B022854214 CAPD/DPCA 12 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 2.5 L 201 0 105/02/01 32 1050034788 B022854221 CAPD/DPCA 12 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 5 L 284 0 105/02/01 33 1050034788 B022855212 CAPD/DPCA 10 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 2 L 184 0 105/02/01 34 1050034788 B022855214 CAPD/DPCA 10 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 2.5 L 201 0 105/02/01 35 1050034788 B022855221 CAPD/DPCA 10 STAY SAFE PERITONEAL DIALYSIS SOLUTION 費森尤斯 SODIUM CHLORIDE 5.79/ML 透析用液 5 L 284 0 105/02/01 36 1050034788 B024216100 ALCALROLE CAPSULE 0.25 大正 CALCITRIOL 軟膠 (=DIHYDROXYCHOLECA 囊 LCIFEROL 1-ALPHA, 25-) 0.25MCG 2.66 0 105/02/01 37 1050034788 B025222100 CLOPILET 漢佑 CLOPIDOGREL 75.00 膜衣 35.3 0 105/02/01 38 1050034788 BC20943221 LASTET 臺灣日化 ETOPOSIDE 20.00/ML 注射 5 ML 254 0 105/02/01 39 1050034788 BC22893100 LIPIGEM TABLETS. 600 海喬 GEMFIBROZIL 600.00 2.68 0 105/02/01 40 1050034788 BC25202100 Amlodipine besilate - Teva 5mg Tablets 海喬 AMLODIPINE (BESYLATE) 5.00 6.8 0 105/02/01 41 1050034788 N002984209 PETOL 信東生技 PANTHENOL 100.00/ML 注射 1 ML 4.61 0 105/02/01 42 1040080957 AC17280151 ULEXIN FOR ORAL SUSPENSION (CEPHALEXIN) 瑞士新市廠 CEPHALEXIN (MONOHYDRATE) 25 /ML 懸液用顆粒 60 ML -- 124 105/02/01 43 1040052967 KC00678235 NORDITROPIN SIMPLEXX 5/1.5ML NOVO NORDISK A/S SOMATROPIN 注射 (BIOSYNTHETIC HUMAN GROWTH HORMONE) 10 IU/ML 15 IU 2408 0 105/04/01 44 1040061232 AC58335100 ENTIGIN FILM COATED TABLETS 0.5 永信台中幼獅廠 ENTECAVIR 0.5 128 137 105/04/01 45 1040062492 BC20798100 KLIOGEST NOVO NORDISK OESTROGEN (=ESTROGEN=ESTROGE NIC SUBSTANCE) 2 3.83 0 105/04/01 第 3 頁, 共 28 頁
46 1040062492 BC20843100 TRISEQUENS NOVO NORDISK ESTRADIOL 2 3.83 0 105/04/01 47 1040062492 BC22786100 ACTIVELLE NOVO NORDISK ESTRADIOL 1 3.44 0 105/04/01 48 1040062963 AC32530100 SOLANTIN S.C. TABLETS 25 (DIPYRIDAMOLE) 中化新豐 DIPYRIDAMOLE 25 糖衣 0.48 0 105/04/01 49 1040062963 AC325301G0 SOLANTIN S.C. TABLETS 25 (DIPYRIDAMOLE)( 鋁箔 / 膠箔 ) 中化新豐 DIPYRIDAMOLE 25 糖衣 0.48 0 105/04/01 50 1040063065 B026083100 CORYOL 40 FILM COATED TABLETS SALUTAS PHARMA GMBH GINKGO BILOBA FOLIUM EXTRACT 40 2.02 0 105/04/01 51 1040063239 BC23225100 NEXIUM TAB.20 ASTRAZE NECA ESOMEPRAZOLE (MAG. TRIHYDRATE) 20 4.75 0 105/04/01 52 1040076781 BC24252100 VYTORIN TABLETS 10/10 MSD Internationa l Gm EZETIMIBE 10 23.7 0 105/04/01 53 1040076854 AC21887421 LECORT IN ORAL BASE (TRIAMCINOLONE) 瑞士新市廠 TRIAMCINOLONE (ACETONIDE) 1 /GM 口內膏 5 GM 28.4 0 105/04/01 54 1040063283 A032805100 BUTANIDE TABLET 1 (BUMETANIDE) LITA BUMETANIDE 1 1.3 0 105/03/01 55 1040063283 A0362011G0 METFORMIN TABLET 500 LITA( 鋁箔 / 膠箔 ) METFORMIN HCL 500 1.5 0 105/03/01 56 1040063283 A038686100 GINBININ S.C TABLETS 9.6 (GINKGOFLAVONGLYCO SIDE) LITA GINKGO BILOBA EXTRACT 40 糖衣 2.02 0 105/03/01 57 1040063283 A0476121G0 CIMEWEI TABLETS 200 LITA( 鋁箔 / 膠 箔 ) CIMETIDINE 200 1.5 0 105/03/01 58 1040063283 A0476531G0 MOCOUGH CAPSULES LITA( 鋁箔 / 膠箔 ) POTASSIUM CRESOLSULFONATE 90 1.5 0 105/03/01 59 1040063283 A0483941G0 COTON TABLETS 500 LITA( 鋁箔 / 膠箔 ) MEFENAMIC ACID 500 1.5 0 105/03/01 第 4 頁, 共 28 頁
項次 發文號 健保代碼 藥品名稱 廠牌 成分及含量 型 規格原核定新核定量價價 生效日期 60 1040063283 AC32805100 BUTANIDE TABLET 1 (BUMETANIDE) LITA BUMETANIDE 1 -- 2.23 105/02/01 61 1040063283 AC362011G0 METFORMIN TABLET 500 LITA( 鋁箔 / 膠箔 ) METFORMIN HCL 500 -- 2 105/02/01 62 1040063283 AC386161G0 MECOMIN CAPSULES 0.5 (MECOBALAMIN) LITA( 鋁箔 / 膠箔 ) MECOBALAMIN 500 MCG -- 2 105/02/01 63 1040063283 AC38686100 GINBININ S.C TABLETS 9.6 (GINKGOFLAVONGLYCO SIDE) LITA GINKGO BILOBA EXTRACT 40 糖衣 -- 2.24 105/02/01 64 1040063283 AC476121G0 CIMEWEI TABLETS 200 LITA( 鋁箔 / 膠 箔 ) CIMETIDINE 200 -- 2 105/02/01 65 1040063283 AC476531G0 MOCOUGH CAPSULES LITA( 鋁箔 / 膠箔 ) POTASSIUM CRESOLSULFONATE 90 -- 2 105/02/01 66 1040063283 AC483941G0 COTON TABLETS 500 LITA( 鋁箔 / 膠箔 ) MEFENAMIC ACID 500 -- 2 105/02/01 67 1040063284 A001177100 LITALON TABLETS LITA NALIDIXIC ACID 500 2.25 0 105/03/01 68 1040063284 A029499100 TERSULTRAN TABLETS 2.5 (TERBUTALINE) LITA TERBUTALINE SULFATE 2.5 1 0 105/03/01 69 1040063284 A039277100 IBUFEN TABLETS 400 (IBUPROFEN)LITA IBUPROFEN 400 0.98 0 105/03/01 70 1040063284 A049711100 ALPUTON TABLETS 300 LITA ALLOPURINOL 300 2.74 0 105/03/01 71 1040063284 A057139100 SULPIRIDE TABLETS 200 LITA SULPIRIDE 200 1.99 0 105/03/01 72 1040063284 AC01177100 LITALON TABLETS LITA NALIDIXIC ACID 500 -- 2.25 105/02/01 73 1040063284 AC29499100 TERSULTRAN TABLETS 2.5 (TERBUTALINE) LITA TERBUTALINE SULFATE 2.5 -- 1.5 105/02/01 第 5 頁, 共 28 頁
項次 發文號 健保代碼 藥品名稱 廠牌 成分及含量 型 規格原核定新核定量價價 生效日期 74 1040063284 AC39277100 IBUFEN TABLETS 400 (IBUPROFEN)LITA IBUPROFEN 400 -- 1.5 105/02/01 75 1040063284 AC49711100 ALPUTON TABLETS 300 LITA ALLOPURINOL 300 -- 2.74 105/02/01 76 1040063284 AC57139100 SULPIRIDE TABLETS 200 LITA SULPIRIDE 200 -- 2.33 105/02/01 77 1040063463 AB03388100 HYDROCHLOROTHIAZID E TABLETS VPP HYDROCHLOROTHIAZID E 50 -- 1.5 105/02/01 78 1040063463 AB033881G0 HYDROCHLOROTHIAZID E TABLETS VPP( 鋁箔 / 膠 箔 ) HYDROCHLOROTHIAZID E 50 -- 2 105/02/01 79 1040063463 AB03389100 ACETAZOLAMIDE TABLETS 250 VPP ACETAZOLAMIDE 250 -- 1.5 105/02/01 80 1040063463 AB03976100 BISMUTH SUBCARBONATE TABLETS 324 VPP BISMUTH -- 1.5 105/02/01 SUBCARBONATE 324 81 1040063463 AB198751G0 CARDOLOL TABLETS 40 (PROPRANOLOL) V.P.P.( 鋁箔 / 膠箔 ) PROPRANOLOL HCL 40 -- 2 105/02/01 82 1040063463 AB23037100 CARDOLOL TABLETS 10 (PROPRANOLOL) VPP PROPRANOLOL HCL 10 -- 1.5 105/02/01 83 1040063463 AB230371G0 CARDOLOL TABLETS 10 (PROPRANOLOL) VPP ( 鋁箔 / 膠箔 ) PROPRANOLOL HCL 10 -- 2 105/02/01 84 1040063463 AB29729100 SUCRAL TABLETS 500 VPP (SUCRALFATE) SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 500 -- 1.5 105/02/01 85 1040063463 AB297291G0 SUCRAL TABLETS 500 VPP ( 鋁箔 / 膠箔 ) SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 500 -- 2 105/02/01 86 1040063463 AC03388100 HYDROCHLOROTHIAZID E TABLETS VPP HYDROCHLOROTHIAZID E 50 1.5 0 105/03/01 87 1040063463 AC033881G0 HYDROCHLOROTHIAZID E TABLETS VPP( 鋁箔 / 膠 箔 ) HYDROCHLOROTHIAZID E 50 2 0 105/03/01 第 6 頁, 共 28 頁
項次 發文號 健保代碼 藥品名稱 廠牌 成分及含量 型 規格原核定新核定量價價 生效日期 88 1040063463 AC03389100 ACETAZOLAMIDE TABLETS 250 VPP ACETAZOLAMIDE 250 1.5 0 105/03/01 89 1040063463 AC03976100 BISMUTH SUBCARBONATE TABLETS 324 VPP BISMUTH 1.5 0 105/03/01 SUBCARBONATE 324 90 1040063463 AC198751G0 CARDOLOL TABLETS 40 (PROPRANOLOL) V.P.P.( 鋁箔 / 膠箔 ) PROPRANOLOL HCL 40 2 0 105/03/01 91 1040063463 AC23037100 CARDOLOL TABLETS 10 (PROPRANOLOL) VPP PROPRANOLOL HCL 10 1.5 0 105/03/01 92 1040063463 AC230371G0 CARDOLOL TABLETS 10 (PROPRANOLOL) VPP (28 粒 / 瓶裝 ) PROPRANOLOL HCL 10 2 0 105/03/01 93 1040063463 AC29729100 SUCRAL TABLETS 500 VPP (SUCRALFATE) SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 500 1.5 0 105/03/01 94 1040063463 AC297291G0 SUCRAL TABLETS 500 VPP ( 鋁箔 / 膠箔 ) SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 500 2 0 105/03/01 95 1040063536 AA55243100 OKPINE F.C. TABLETS 5(28 粒 / 鋁箔盒裝 ) 南光 OLANZAPINE 5 膜衣 -- 67 105/02/01 96 1040063536 AB45412100 NOOPOL F.C. TABLETS 1200 N.K. 南光 PIRACETAM 1200 膜衣 -- 2.67 105/02/01 97 1040063536 AB49556100 YOU-JET F.C. TABLETS 100 南光 SERTRALINE(AS HYDROCHLORIDE) 100 -- 25.1 105/02/01 98 1040063536 AC45412100 NOOPOL F.C. TABLETS 1200 N.K. 南光 PIRACETAM 1200 膜衣 2.67 0 105/03/01 99 1040063536 AC49556100 YOU-JET F.C. TABLETS 100 南光 SERTRALINE(AS HYDROCHLORIDE) 100 25.1 0 105/03/01 100 1040063536 AC55243100 OKPINE F.C. TABLETS 5 南光 OLANZAPINE 5 膜衣 56 0 105/03/01 101 1040063628 AB49770221 NOESIN TAI YU (PIRACETAM) 台裕 PIRACETAM 200 /ML 注射 5 ML -- 15 105/02/01 102 1040063628 AB49770229 NOESIN TAI YU (PIRACETAM) 台裕 PIRACETAM 200 /ML 注射 10 ML -- 33.7 105/02/01 第 7 頁, 共 28 頁
103 1040063628 AC49770221 NOESIN TAI YU (PIRACETAM) 台裕 PIRACETAM 200 /ML 注射 規格原核定新核定生效日期量價價 5 ML 15 0 105/03/01 104 1040063628 AC49770229 NOESIN TAI YU (PIRACETAM) 台裕 PIRACETAM 200 /ML 注射 10 ML 33.7 0 105/03/01 105 1040063649 A047773329 MUROZO LOTION 0.1% W/W 歐帕生技 MOMETASONE FUROATE 1 /GM 洗 10 ML 32.7 0 105/03/01 106 1040063649 A047773343 MUROZO LOTION 0.1% W/W 歐帕生技 MOMETASONE FUROATE 1 /GM 洗 30 ML 187 0 105/03/01 107 1040063649 AC47773329 MUROZO LOTION 0.1% W/W 歐帕生技 MOMETASONE FUROATE 1 /GM 洗 10 ML -- 32.7 105/02/01 108 1040063649 AC47773343 MUROZO LOTION 0.1% W/W 歐帕生技 MOMETASONE FUROATE 1 /GM 洗 30 ML -- 187 105/02/01 109 1040063720 BC24920214 BALANCE 2.3% GLUCOSE, 1.25 MMOL/L CALCIUM, SOLUTION FOR PERITONEAL DIALYSIS FRESEM GLUCOSE ANHYDROUS 22.73 /ML 透析用液 2.5 L -- 226 105/02/01 110 1040063720 BC24921214 BALANCE 4.25% GLUCOSE, 1.25 MMOL/L CALCIUM, SOLUTION FOR PERITONEAL DIALYSIS FRESEM GLUCOSE ANHYDROUS 42.5 /ML 透析用液 2.5 L -- 226 105/02/01 111 1040063720 BC24922214 BALANCE 1.5% GLUCOSE, 1.25 MMOL/L CALCIUM, SOLUTION FOR PERITONEAL DIALYSIS FRESEM GLUCOSE ANHYDROUS 15 /ML 透析用液 2.5 L -- 226 105/02/01 112 1040063940 A0195571G0 PURINOL TABLETS (ALLOPURINOL) ROYAL( 鋁箔 / 膠箔 ) 皇佳製 ALLOPURINOL 100 1.5 0 105/03/01 113 1040063940 A0438021G0 LYDICON CAPSULES ROYAL 皇佳製 LYSOZYME (CHLORIDE) 20 1.5 0 105/03/01 114 1040063940 AC195571G0 PURINOL TABLETS (ALLOPURINOL) ROYAL( 鋁箔 / 膠箔 ) 皇佳製 ALLOPURINOL 100 -- 2 105/02/01 115 1040063940 AC201151G0 TRIDERGEN TABLETS (DIHYDROERGOTOXINE MESYLATE) ROYAL 皇佳製 DIHYDROERGOTOXINE METHANESULFONATE 1.5 -- 2 105/02/01 116 1040063940 AC438021G0 LYDICON CAPSULES ROYAL( 鋁箔 / 膠箔 ) 皇佳製 LYSOZYME (CHLORIDE) 20 -- 2 105/02/01 第 8 頁, 共 28 頁
117 1040063976 BA26482100 EC-PRAM 20 (ESCITALOPRAM F.C. TABLETS 20)(30 粒 / 鋁箔盒裝 ) HETERO LABS UNIT V ESCITALOPRAM (AS OXALATE) 20 -- 37.6 105/02/01 118 1040063976 BA26483100 EC-PRAM 10 (ESCITALOPRAM F.C. TABLETS 10)(30 粒 / 鋁箔盒裝 ) HETERO LABS UNIT V ESCITALOPRAM (AS OXALATE) 10 -- 21 105/02/01 119 1040064007 A000849100 ERYTHROMYCIN ESTOLATE CAPSULES LITA ERYTHROMYCIN (ESTOLATE) 250 1.43 0 105/03/01 120 1040064007 A003084100 FUZIN CAPSULES LITA BUTYLSCOPOLAMINE BROMIDE (=HYOSCINE BUTYLBROMIDE) 10 0.96 0 105/03/01 121 1040064007 A003266100 D.X. CAPSULES LITA DOXYCYCLINE (HCL) 100 1.21 0 105/03/01 122 1040064007 A007936100 BORGAL TABLETS LITA TRIMETHOPRIM 80 0.9 0 105/03/01 123 1040064007 A014842100 DEXTROMETHORPHAN TABLETS 30 LITA DEXTROMETHORPHAN HBR 30 0.82 0 105/03/01 124 1040064007 A014925100 ANETHOLE CAPSULES LITA ANETHOLE TRITHIONE 25 0.98 0 105/03/01 125 1040064007 A015394100 METHYLSCOPOLAMINE METHYLSULFATE TABLETS LITA METHSCOPOLAMINE METHYLSULFATE 1 1.11 0 105/03/01 126 1040064007 A017713100 MEBENDAZOLE TABLETS LITA MEBENDAZOLE 100 1.1 0 105/03/01 127 1040064007 A026303100 ZUCERINE TABLETS 250 (TRANEXAMIC ACID) LITA TRANEXAMIC ACID 250 1.3 0 105/03/01 128 1040064007 A031507100 DUORIDONE TABLETS 10 (DOMPERIDONE) LITA DOMPERIDONE 10 0.86 0 105/03/01 129 1040064007 AC00849100 ERYTHROMYCIN ESTOLATE CAPSULES LITA ERYTHROMYCIN (ESTOLATE) 250 -- 2.15 105/02/01 第 9 頁, 共 28 頁
130 1040064007 AC03084100 FUZIN CAPSULES LITA BUTYLSCOPOLAMINE BROMIDE (=HYOSCINE BUTYLBROMIDE) 10 -- 1.5 105/02/01 131 1040064007 AC03266100 D.X. CAPSULES LITA DOXYCYCLINE (HCL) 100 -- 1.5 105/02/01 132 1040064007 AC07936100 BORGAL TABLETS LITA TRIMETHOPRIM 80 -- 1.5 105/02/01 133 1040064007 AC14842100 DEXTROMETHORPHAN TABLETS 30 LITA DEXTROMETHORPHAN HBR 30 -- 1.5 105/02/01 134 1040064007 AC14925100 ANETHOLE CAPSULES LITA ANETHOLE TRITHIONE 25 -- 1.5 105/02/01 135 1040064007 AC15394100 METHYLSCOPOLAMINE METHYLSULFATE TABLETS LITA METHSCOPOLAMINE METHYLSULFATE 1 -- 1.57 105/02/01 136 1040064007 AC17713100 MEBENDAZOLE TABLETS LITA MEBENDAZOLE 100 -- 1.51 105/02/01 137 1040064007 AC26303100 ZUCERINE TABLETS 250 (TRANEXAMIC ACID) LITA TRANEXAMIC ACID 250 -- 1.52 105/02/01 138 1040064007 AC31507100 DUORIDONE TABLETS 10 (DOMPERIDONE) LITA DOMPERIDONE 10 -- 1.5 105/02/01 139 1040064150 B022357100 VESANOID SOFT GELATIN CAPSULES 10 CATALEN T GERMAN Y EB TRETINOIN 10 軟 141 0 105/03/01 140 1040064150 BC22357100 VESANOID SOFT GELATIN CAPSULES 10 CATALEN T GERMAN Y EB TRETINOIN 10 軟 -- 141 105/02/01 141 1040064194 AB49977209 YUPIME POWDER FOR 中化台南三廠 CEFEPIME (AS 乾粉 HYDROCHLORIDE) 1 GM 注射 1 GM -- 425 105/02/01 142 1040064194 AB49977212 YUPIME POWDER FOR 中化台南三廠 CEFEPIME (AS 乾粉 HYDROCHLORIDE) 2 GM 注射 2 GM -- 676 105/02/01 第 10 頁, 共 28 頁
143 1040064194 AB49977277 YUPIME POWDER FOR 中化台南三廠 CEFEPIME (AS HYDROCHLORIDE) 500 乾粉注射 500 -- 279 105/02/01 144 1040064194 AC49977209 YUPIME POWDER FOR 中化台南三廠 CEFEPIME (AS 乾粉 HYDROCHLORIDE) 1 GM 注射 1 GM 425 0 105/03/01 145 1040064194 AC49977212 YUPIME POWDER FOR 中化台南三廠 CEFEPIME (AS 乾粉 HYDROCHLORIDE) 2 GM 注射 2 GM 676 0 105/03/01 146 1040064194 AC49977277 YUPIME POWDER FOR 中化台南三廠 CEFEPIME (AS HYDROCHLORIDE) 500 乾粉注射 500 279 0 105/03/01 147 1040064195 A029515100 SUCRA TABLETS 500 H.S. (SUCRALFATE) 華興化學 SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 500 1.1 0 105/03/01 148 1040064195 AC29515100 SUCRA TABLETS 500 H.S. (SUCRALFATE) 華興化學 SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 500 -- 1.5 105/02/01 149 1040064273 B024183100 SEROQUEL TABLETS 300 ASTRA ZENECA UK LIMI QUETIAPINE (AS FUMARATE) 300 65 0 105/03/01 150 1040064273 B025004213 BYETTA 0.25 /ML USA BAXTER PHAR EXENATIDE 0.25 /ML 注射 2.4 ML 2875 0 105/03/01 151 1040064273 B025004297 BYETTA 0.25 /ML USA BAXTER PHAR EXENATIDE 0.25 /ML 注射 1.2 ML 2853 0 105/03/01 152 1040064273 B025220100 ONGLYZA FILM-COATED TABLETS 2.5 BRISTOL SAXAGLIPTIN 2.5 膜衣 15.9 0 105/03/01 153 1040064273 B025221100 ONGLYZA FILM-COATED TABLETS 5 BRISTOL SAXAGLIPTIN 5 膜衣 26.5 0 105/03/01 154 1040064273 B025440100 VIMOVO DELAYED RELEASE TABLETS 500/20 PATHEON NAPROXEN 500 PHARMAC EUTIC 緩釋 9.5 0 105/03/01 155 1040064273 B025453100 KOMBIGLYZE XR TABLETS 5/1000 BRISTOL SAXAGLIPTIN 5 持續性藥效 23 0 105/03/01 156 1040064273 B025454100 KOMBIGLYZE XR TABLETS 5/500 BRISTOL SAXAGLIPTIN 5 持續性藥效 23 0 105/03/01 第 11 頁, 共 28 頁
157 1040064273 B025455100 KOMBIGLYZE XR TABLETS 2.5/1000 BRISTOL SAXAGLIPTIN 2.5 持續性藥效 13.2 0 105/03/01 158 1040064273 BC24183100 SEROQUEL TABLETS 300 ASTRAZE QUETIAPINE (AS NECA FUMARATE) 300 PHARMAC E -- 65 105/02/01 159 1040064273 BC25004213 BYETTA 0.25 /ML USA BAXTER PHAR EXENATIDE 0.25 /ML 注射 2.4 ML -- 2875 105/02/01 160 1040064273 BC25004297 BYETTA 0.25 /ML USA BAXTER PHAR EXENATIDE 0.25 /ML 注射 1.2 ML -- 2853 105/02/01 161 1040064273 BC25220100 ONGLYZA FILM-COATED TABLETS 2.5 BRISTOL SAXAGLIPTIN 2.5 膜衣 -- 15.9 105/02/01 162 1040064273 BC25221100 ONGLYZA FILM-COATED TABLETS 5 BRISTOL SAXAGLIPTIN 5 膜衣 -- 26.5 105/02/01 163 1040064273 BC25440100 VIMOVO DELAYED RELEASE TABLETS 500/20 PATHEON NAPROXEN 500 PHARMAC EUTIC 緩釋 -- 9.5 105/02/01 164 1040064273 BC25453100 KOMBIGLYZE XR TABLETS 5/1000 BRISTOL SAXAGLIPTIN 5 持續性藥效 -- 23 105/02/01 165 1040064273 BC25454100 KOMBIGLYZE XR TABLETS 5/500 BRISTOL SAXAGLIPTIN 5 持續性藥效 -- 23 105/02/01 166 1040064273 BC25455100 KOMBIGLYZE XR TABLETS 2.5/1000 BRISTOL SAXAGLIPTIN 2.5 持續性藥效 -- 13.2 105/02/01 167 1040064276 B021277429 VIDISIC GEL GERHAM CARBOMER 眼用 (=CARBOPOL=CARBOXY 凝膠 POLYMETHYLENE) 2 /GM 10 GM 124 0 105/03/01 168 1040064276 B023681421 DEXAGEL EYE DROPS GERHAM DEXAMETHASONE 1 /GM 眼用凝膠 5 GM 101 0 105/03/01 169 1040064276 B024330429 Liposic eye gel GERHAM CARBOMER 眼用 (=CARBOPOL=CARBOXY 凝膠 POLYMETHYLENE) 2 /GM 10 GM 124 0 105/03/01 第 12 頁, 共 28 頁
170 1040064276 BC21277429 VIDISIC GEL GERHAM CARBOMER 眼用 (=CARBOPOL=CARBOXY 凝膠 POLYMETHYLENE) 2 /GM 規格原核定新核定生效日期量價價 10 GM -- 124 105/02/01 171 1040064276 BC23681421 DEXAGEL EYE DROPS GERHAM DEXAMETHASONE 1 /GM 眼用凝膠 5 GM -- 101 105/02/01 172 1040064276 BC24330429 Liposic eye gel GERHAM CARBOMER 眼用 (=CARBOPOL=CARBOXY 凝膠 POLYMETHYLENE) 2 /GM 10 GM -- 124 105/02/01 173 1040064339 AC58775100 PREON TAB 明德 PREDNISOLONE 5 -- 1.5 105/02/01 174 1040064340 AB44449100 AVERINE TABLETS 40 羅得 ALVERINE CITRATE 67 -- 2.73 105/02/01 175 1040064340 AC44449100 AVERINE TABLETS 40 羅得 ALVERINE CITRATE 67 2.73 0 105/03/01 176 1040064415 A005054100 INDOCINE CAPSULES 西德 INDOMETHACIN 25 膠囊 0.87 0 105/03/01 177 1040064415 A016816100 CYPRODINE TABLETS (CYPROHEPTADINE HCL) 西德 CYPROHEPTADINE HCL 4 0.7 0 105/03/01 178 1040064415 A019899100 DACTJIN F.C. TABLETS SHITEH 西德 TRIMETHOPRIM 80 膜衣 0.9 0 105/03/01 179 1040064415 A030058100 EROMYCIN F.C. TABLET 250 SHITEH 西德 ERYTHROMYCIN 250 1.43 0 105/03/01 180 1040064415 A031219100 BISTOR CAPSULE 西德 (DOXYCYCLINE) SHITEH DOXYCYCLINE (HCL) 100 1.21 0 105/03/01 181 1040064415 A031300100 FORMAX ENTERIC- MICRO-ENCAPSULED CAPSULE 50 SHITEN (DICLOFENAC) 西德 DICLOFENAC SODIUM 50 腸溶 0.93 0 105/03/01 182 1040064415 A032170335 ALLERCURE CREAM SHITEH 西德 NEOMYCIN (SULFATE) 5 /GM 乳膏 15 GM 24.9 0 105/03/01 第 13 頁, 共 28 頁
183 1040064415 A033774100 DAILY-PLUS CHEWABLE TABLET 0.5 (HYDROXOCOBALAMIN ACETATE )SHITEH 西德 HYDROXOCOBALAMIN ACETATE 0.5 咀嚼 1 0 105/03/01 184 1040064415 A038502337 B.&N. ISOCON-F CREAM SHITEH 西德 DIFLUCORTOLONE VALERATE 1 /GM 乳膏 18 GM 49.8 0 105/03/01 185 1040064415 A041474300 HEALING BUCCAL TABLET 0.025SHITEH(TRIAMI CINOLONE ACETONIDE) 西德 TRIAMCINOLONE (ACETONIDE) 0.025 口腔 7.4 0 105/03/01 186 1040064415 AC05054100 INDOCINE CAPSULES 西德 INDOMETHACIN 25 膠囊 -- 1.5 105/02/01 187 1040064415 AC16816100 CYPRODINE TABLETS (CYPROHEPTADINE HCL) 西德 CYPROHEPTADINE HCL 4 -- 1.5 105/02/01 188 1040064415 AC19899100 DACTJIN F.C. TABLETS SHITEH 西德 TRIMETHOPRIM 80 膜衣 -- 1.5 105/02/01 189 1040064415 AC30058100 EROMYCIN F.C. TABLET 250 SHITEH 西德 ERYTHROMYCIN 250 -- 2.15 105/02/01 190 1040064415 AC31219100 BISTOR CAPSULE 西德 (DOXYCYCLINE) SHITEH DOXYCYCLINE (HCL) 100 -- 1.5 105/02/01 191 1040064415 AC31300100 FORMAX ENTERIC- MICRO-ENCAPSULED CAPSULE 50 SHITEN (DICLOFENAC) 西德 DICLOFENAC SODIUM 50 腸溶 -- 1.5 105/02/01 192 1040064415 AC32170335 ALLERCURE CREAM SHITEH 西德 NEOMYCIN (SULFATE) 5 /GM 乳膏 15 GM -- 24.9 105/02/01 193 1040064415 AC33774100 DAILY-PLUS CHEWABLE TABLET 0.5 (HYDROXOCOBALAMIN ACETATE )SHITEH 西德 HYDROXOCOBALAMIN ACETATE 0.5 咀嚼 -- 1.5 105/02/01 194 1040064415 AC38502337 B.&N. ISOCON-F CREAM SHITEH 西德 DIFLUCORTOLONE VALERATE 1 /GM 乳膏 18 GM -- 60 105/02/01 195 1040064415 AC41474300 CARBOXE HEALING BUCCAL TABLET 0.025 SHITEH (TRIAMCINOLONE ACETONIDE) 西德 TRIAMCINOLONE (ACETONIDE) 0.025 口腔 -- 7.4 105/02/01 第 14 頁, 共 28 頁
項次 發文號 健保代碼 藥品名稱 廠牌 成分及含量 型 規格原核定新核定量價價 生效日期 196 1040064435 AC58800100 OXOMINE TABLETS 100 H.S. 華興 OXOLAMINE CITRATE 100 -- 1.5 105/02/01 197 1040064498 AC45228321 MIZTIN CREAM MEIDER 明德 NYSTATIN 100000 IU/GM 乳膏 5 GM -- 14.7 105/02/01 198 1040064649 BC26573100 QUETIAPINE-TEVA 25 FILM-COATED TABLETS TEVA QUETIAPINE (AS PHARMAC FUMARATE) 25 EUTICAL -- 11.9 105/02/01 199 1040064823 A041036100 CINRIZIN TABLETS 25 KOJAR(CINNARIZINE) 國嘉幼獅三廠 CINNARIZINE 25 0.69 0 105/03/01 200 1040064823 AC41036100 CINRIZIN TABLETS 25 KOJAR(CINNARIZINE) 國嘉幼獅三廠 CINNARIZINE 25 -- 1.5 105/02/01 201 1040064828 AC58784100 STALOP F.C. TABLETS 10 YU SHENG 優生 ESCITALOPRAM (AS OXALATE) 10 -- 18.8 105/02/01 202 1040064829 AC58640412 KOULELE ORABASE 1/G SOUNLIN (DEXAMETHASONE) 明德 DEXAMETHASONE 1 /GM 口內膏 2 GM -- 41 105/02/01 203 1040064829 AC58640421 KOULELE ORABASE 1/G SOUNLIN (DEXAMETHASONE) 明德 DEXAMETHASONE 1 /GM 口內膏 5 GM -- 55 105/02/01 204 1040064829 AC58640426 KOULELE ORABASE 1/G SOUNLIN (DEXAMETHASONE) 明德 DEXAMETHASONE 1 /GM 口內膏 8 GM -- 61 105/02/01 205 1040064830 BA25890100 MOSMASS TABLETS 70(4 粒 / 鋁箔盒裝 ) RAFARM SA ALENDRONATE 70 -- 221 105/02/01 206 1040064830 BC25890100 MOSMASS TABLETS 70 RAFARM SA ALENDRONATE 70 221 0 105/03/01 207 1040064832 B016350212 VERPAMIL 2.5/ML ORION CORPORA TION VERAPAMIL HCL 2.5 /ML 注射 2 ML 65 0 105/03/01 208 1040064832 BC16350212 VERPAMIL 2.5/ML ORION CORPORA TION VERAPAMIL HCL 2.5 /ML 注射 2 ML -- 65 105/02/01 209 1040064885 AA57880100 ROPICIN F.C. TABLETS 10(28 粒 / 鋁箔盒裝 ) 瑞士新市廠 ROSUVASTATIN CALCIUM 10 -- 23.5 105/02/01 210 1040064885 AC57880100 ROPICIN F.C. TABLETS 10 瑞士新市廠 ROSUVASTATIN CALCIUM 10 19.7 0 105/03/01 211 1040064888 AC46442151 SHECO SOLUTION CENTER 晟德 CODEINE PHOSPHATE 0.6 /ML 內服液 60 ML -- 25 105/02/01 第 15 頁, 共 28 頁
212 1040064888 AC46442157 SHECO SOLUTION CENTER 晟德 CODEINE PHOSPHATE 0.6 /ML 內服液 120 ML -- 25 105/02/01 213 1040065041 AA58235100 BESTAN 300 FILM- COATED TABLETS(28 粒 / 鋁箔盒裝 ) 健亞 IRBESARTAN 300 膜衣 -- 15.9 105/02/01 214 1040065041 AC58235100 BESTAN 300 FILM- COATED TABLETS 健亞 IRBESARTAN 300 膜衣 13.6 0 105/03/01 215 1040065043 AA47170212 IRINO SOLUTION FOR I.V. INFUSION 臺灣東洋中壢廠 IRINOTECAN HYDROCHLORIDE TRIHYDRATE 20 /ML 注射 2 ML -- 2729 105/02/01 216 1040065043 AA47170221 IRINO SOLUTION FOR I.V. INFUSION 臺灣東洋中壢廠 IRINOTECAN HYDROCHLORIDE TRIHYDRATE 20 /ML 注射 5 ML -- 5677 105/02/01 217 1040065043 AB47170212 IRINO SOLUTION FOR I.V. INFUSION 臺灣東洋中壢廠 IRINOTECAN HYDROCHLORIDE TRIHYDRATE 20 /ML 注射 2 ML 2550 0 105/03/01 218 1040065043 AB47170221 IRINO SOLUTION FOR I.V. INFUSION 臺灣東洋中壢廠 IRINOTECAN HYDROCHLORIDE TRIHYDRATE 20 /ML 注射 5 ML 4997 0 105/03/01 219 1040065044 AA44508229 OXALIP (10 毫 升 / 瓶裝 ) 臺灣東洋中壢廠 OXALIPLATIN 5 /ML 注射 10 ML -- 2754 105/02/01 220 1040065044 AA44508238 OXALIP (20 毫 升 / 瓶裝 ) 臺灣東洋中壢廠 OXALIPLATIN 5 /ML 注射 20 ML -- 7373 105/02/01 221 1040065044 AB44508229 OXALIP 臺灣東洋 中壢廠 OXALIPLATIN 5 /ML 注射 10 ML 2426 0 105/03/01 222 1040065044 AB44508238 OXALIP 臺灣東洋 中壢廠 OXALIPLATIN 5 /ML 注射 20 ML 6847 0 105/03/01 223 1040065048 BC26541221 CISATRACURIUM KABI 2/ML SOLUTION FOR /INFUSION Fresenius ATRACURIUM ( Kabi Manuf BESYLATE CIS-) 2 /ML 注射 5 ML -- 61 105/02/01 224 1040065054 BC23963209 DBL CYTARABINE HOSPIRA CYTARABINE 100 AUSTRALI /ML A 注射液 1 ML -- 109 105/02/01 225 1040065054 BC23963221 DBL CYTARABINE HOSPIRA CYTARABINE 100 AUSTRALI /ML A 注射液 5 ML -- 347 105/02/01 第 16 頁, 共 28 頁
226 1040065054 BC23963229 DBL CYTARABINE HOSPIRA CYTARABINE 100 AUSTRALI /ML A 注射液 規格原核定新核定生效日期量價價 10 ML -- 499 105/02/01 227 1040065124 BB26515100 AROMATT 1 HETERO (ANASTROZOLE TABLETS LABS 1) LIMITED, ANASTROZOLE 1 -- 71 105/02/01 228 1040065163 A016712100 ANTISEMIN TABLETS 優良化學 製藥 CYPROHEPTADINE HCL 4 0.7 0 105/03/01 229 1040065163 A022274100 UFUNIN TABLETS 優良化學 製藥 LOPERAMIDE HCL 2 0.94 0 105/03/01 230 1040065163 AC16712100 ANTISEMIN TABLETS 優良化學 製藥 CYPROHEPTADINE HCL 4 -- 1.5 105/02/01 231 1040065163 AC22274100 UFUNIN TABLETS 優良化學 製藥 LOPERAMIDE HCL 2 -- 1.5 105/02/01 232 1040065180 AC58810100 BRECALIN HARD CAPSULE 75 歐帕生技 PREGABALIN 75 膠囊 -- 20 105/02/01 233 1040065237 AB44463100 SEMI-NAX F.C. TAB. 10 D.T 南光 ZOLPIDEM HEMITARTRATE 10 -- 2.51 105/02/01 234 1040065237 AC44463100 SEMI-NAX F.C. TAB. 10 D.T 南光 ZOLPIDEM HEMITARTRATE 10 2.51 0 105/03/01 235 1040065264 BC26537100 CO-ALVOPREL 300/25 FILM- COATED TABLETS GENEPHA RM S.A. IRBESARTAN 300 -- 12.7 105/02/01 236 1040065317 AB58628100 Q-PINE XR EXTENDED- RELEASE TABLETS 200 TAI YU 台裕 QUETIAPINE FUMARATE 230.26 持續性藥效 -- 44.7 105/02/01 237 1040065317 AC58628100 Q-PINE XR EXTENDED- RELEASE TABLETS 200 TAI YU 台裕 QUETIAPINE FUMARATE 230.26 持續性藥效 44.7 0 105/03/01 238 1040065318 A0403021G0 DESPUTIN TABLETS 30TAI YU(AMBROXOL HYDROCHLORIDE)( 鋁箔 / 膠箔 ) 臺裕製造 AMBROXOL 1.5 0 105/03/01 HYDROCHLORIDE 30 239 1040065318 AB403021G0 DESPUTIN TABLETS 30TAI YU(AMBROXOL HYDROCHLORIDE)( 鋁箔 / 膠箔 ) 臺裕製造 AMBROXOL -- 2 105/02/01 HYDROCHLORIDE 30 第 17 頁, 共 28 頁
240 1040065322 AC265261G0 DOGMATYL F.C. TABLETS 50 (SULPIRIDE)( 鋁箔 / 膠箔 ) 聯亞生技新竹二廠 SULPIRIDE 50 -- 2 105/02/01 241 1040065348 BB26613100 ALVOTINIB 100 FILM- COATED TABLETS REMEDIC A LTD. IMATINIB MESYLATE 100 -- 563 105/02/01 242 1040065348 BB26614100 ALVOTINIB 400 FILM- COATED TABLETS REMEDIC A LTD. IMATINIB MESYLATE 400 -- 1800 105/02/01 243 1040065365 A047646100 DINSIA SOFT CAPSULES 300 漁人 VALPROIC ACID 300 軟 8 0 105/03/01 244 1040065365 AC47646100 DINSIA SOFT CAPSULES 300 漁人 VALPROIC ACID 300 軟 -- 8 105/02/01 245 1040065381 BC17560100 PRESOLOL TABLETS 100 ALPHAPH ARM PTY. LTD. LABETALOL HCL 100 -- 3.02 105/02/01 246 1040065493 A021709221 TRANEXAMIC ACID S.Y. 壽元製 TRANEXAMIC ACID 50 /ML 注射 5 ML 9.7 0 105/03/01 247 1040065493 A032105321 FUCON CREAM S.Y. 壽元製 ECONAZOLE NITRATE 10 /GM 乳膏 5 GM 11.7 0 105/03/01 248 1040065493 AC21709221 TRANEXAMIC ACID S.Y. 壽元製 TRANEXAMIC ACID 50 /ML 注射 5 ML -- 15 105/02/01 249 1040065493 AC32105321 FUCON CREAM S.Y. 壽元製 ECONAZOLE NITRATE 10 /GM 乳膏 5 GM -- 11.7 105/02/01 250 1040065601 A001604212 HOROMPELIN ORIENTAL METOCLOPRAMIDE 5 /ML 注射 2 ML 7.1 0 105/03/01 251 1040065601 A022840209 ATROPINE SULFATE INJCETION ORIENTAL ATROPINE SULFATE 1 /ML 注射 1 ML 3 0 105/03/01 252 1040065601 A040792238 LYSIMIN LYSINE L- HCL 20 /ML 注射 20 ML 12 0 105/03/01 253 1040065601 A042138238 VITAMIN C 250/ML (ASCORBIC ACID) ORIENTAL ASCORBIC ACID (=VIT C) 250 /ML 注射 20 ML 9.2 0 105/03/01 254 1040065601 A046936229 OXYTOCIN 10IU/ML OXYTOCIN 10 IU/ML 注射 10 IU 6.8 0 105/03/01 255 1040065601 AC01604212 HOROMPELIN ORIENTAL METOCLOPRAMIDE 5 /ML 注射 2 ML -- 15 105/02/01 256 1040065601 AC22840209 ATROPINE SULFATE INJCETION ORIENTAL ATROPINE SULFATE 1 /ML 注射 1 ML -- 15 105/02/01 第 18 頁, 共 28 頁
257 1040065601 AC40792238 LYSIMIN LYSINE L- HCL 20 /ML 注射 規格原核定新核定生效日期量價價 20 ML -- 15 105/02/01 258 1040065601 AC42138221 VITAMIN C 250/ML (ASCORBIC ACID) ORIENTAL ASCORBIC ACID (=VIT C) 250 /ML 注射 5 ML -- 15 105/02/01 259 1040065601 AC42138238 VITAMIN C 250/ML (ASCORBIC ACID) ORIENTAL ASCORBIC ACID (=VIT C) 250 /ML 注射 20 ML -- 15 105/02/01 260 1040065601 AC46936229 OXYTOCIN 10IU/ML OXYTOCIN 10 IU/ML 注射 10 IU -- 15 105/02/01 261 1040065601 N006377229 AMINOPHYLLIN ORIENTAL AMINOPHYLLINE (=COROPHYLLIN) 25 /ML 注射 10 ML 6.3 0 105/03/01 262 1040065601 N008393209 METHOXINE M METHOXYPHENAMINE HCL 50 /ML 注射 1 ML 4.44 0 105/03/01 263 1040065601 N008393212 METHOXINE M METHOXYPHENAMINE HCL 50 /ML 注射 2 ML 8 0 105/03/01 264 1040065601 NC06377229 AMINOPHYLLIN ORIENTAL AMINOPHYLLINE (=COROPHYLLIN) 25 /ML 注射 10 ML -- 15 105/02/01 265 1040065601 NC07725209 ACTIBISIX PYRIDOXAL 5- PHOSPHATE 10 /ML 注射 1 ML -- 15 105/02/01 266 1040065601 NC08393209 METHOXINE M METHOXYPHENAMINE HCL 50 /ML 注射 1 ML -- 15 105/02/01 267 1040065601 NC08393212 METHOXINE M METHOXYPHENAMINE HCL 50 /ML 注射 2 ML -- 15 105/02/01 268 1040065602 A018589209 NEO-ERGO ORIENTAL METHYLERGONOVINE MALEATE 0.2 /ML 注射 1 ML 12.5 0 105/03/01 269 1040065602 A034626209 MECO B12 0.5/ML (MECOBALAMIN) ORIENTAL MECOBALAMIN 500 MCG/ML (=UG/ML) 注射 1 ML 7.9 0 105/03/01 270 1040065602 A046490238 DIPROFEN PROPOFOL 10 /ML 注射 20 ML 56 0 105/03/01 271 1040065602 A048442238 DIPROFEN 20/ML PROPOFOL 20 /ML 注射 20 ML 105 0 105/03/01 272 1040065602 AC18589209 NEO-ERGO ORIENTAL METHYLERGONOVINE MALEATE 0.2 /ML 注射 1 ML -- 19.4 105/02/01 第 19 頁, 共 28 頁
273 1040065602 AC34626209 MECO B12 0.5/ML (MECOBALAMIN) ORIENTAL MECOBALAMIN 500 MCG/ML (=UG/ML) 注射 規格原核定新核定生效日期量價價 1 ML -- 15.5 105/02/01 274 1040065602 AC34626212 MECO B12 0.5/ML (MECOBALAMIN) ORIENTAL MECOBALAMIN 500 MCG 注射 2 ML -- 15.5 105/02/01 275 1040065602 AC46490238 DIPROFEN PROPOFOL 10 /ML 注射 20 ML -- 64 105/02/01 276 1040065602 AC48442238 DIPROFEN 20/ML PROPOFOL 20 /ML 注射 20 ML -- 105 105/02/01 277 1040065602 N006854212 PHENINE-H METHIONINE DL- 20 /ML 注射 2 ML 4.2 0 105/03/01 278 1040065602 N008389212 METHIVITAN-S THIAMINE HCL (=THIAMINE CHLORIDE HYDROCHLORIDE) 5 /ML 注射 2 ML 3 0 105/03/01 279 1040065602 N009053238 METHIVITAN METHIONINE DL- 30 /ML 注射 20 ML 6 0 105/03/01 280 1040065602 NC06852212 ACTAMIN FORTE THIAMINE PHOSPHORIC ACID ESRER CHLORIDE HCL 10 /ML 注射 2 ML -- 15 105/02/01 281 1040065602 NC06852221 ACTAMIN FORTE THIAMINE PHOSPHORIC ACID ESRER CHLORIDE HCL 10 /ML 注射 5 ML -- 15 105/02/01 282 1040065602 NC06854212 PHENINE-H METHIONINE DL- 20 /ML 注射 2 ML -- 15 105/02/01 283 1040065602 NC08389212 METHIVITAN-S THIAMINE HCL (=THIAMINE CHLORIDE HYDROCHLORIDE) 5 /ML 注射 2 ML -- 15 105/02/01 284 1040065602 NC09053238 METHIVITAN METHIONINE DL- 30 /ML 注射 20 ML -- 15 105/02/01 285 1040065629 BA25248143 APO-RISPERIDONE SOLUTION, 1/ML(30ML/ 塑膠瓶裝 ) APOTEX INC. - RICHMO RISPERIDONE 1 /ML 內服液 30 ML -- 789 105/02/01 286 1040065629 BC25248143 APO-RISPERIDONE SOLUTION, 1/ML APOTEX INC. - RICHMO RISPERIDONE 1 /ML 內服液 30 ML 675 0 105/03/01 第 20 頁, 共 28 頁
287 1040065795 KC00959248 ALBURX TM 20 CSL BEHRING AG ALBUMIN HUMAN 200 /ML 注射液 規格原核定新核定生效日期量價價 50 ML -- 1212 105/02/01 288 1040065795 KC00959255 ALBURX TM 20 CSL BEHRING AG ALBUMIN HUMAN 200 /ML 注射液 100 ML -- 1963 105/02/01 289 1040065796 KC00960248 ALBURX TM 25 CSL BEHRING AG ALBUMIN HUMAN 250 /ML 注射液 50 ML -- 1480 105/02/01 290 1040065797 KC00965248 PRIVIGEN CSL BEHRING AG IMMUNOGLOBULIN HUMAN 100 /ML 注射液 50 ML -- 9000 105/02/01 291 1040065797 KC00965255 PRIVIGEN CSL BEHRING AG IMMUNOGLOBULIN HUMAN 100 /ML 注射液 100 ML -- 18000 105/02/01 292 1040065797 KC00965263 PRIVIGEN CSL BEHRING AG IMMUNOGLOBULIN HUMAN 100 /ML 注射液 200 ML -- 36000 105/02/01 293 1040065873 AC58564100 DIABEX TABLETS Y.C. 元宙 METFORMIN HCL 500 -- 1.5 105/02/01 294 1040065897 BC26514100 PMS-PREGABALIN CAPSULES 75 PHARMAS CIENCE INC. PREGABALIN 75 -- 17.8 105/02/01 295 1040065900 BC26491100 MOXETERO (MOXIFLOXACIN HCL TABLETS 400) HETERO LABS UNIT V MOXIFLOXACIN HYDROCHLORIDE 400 -- 84 105/02/01 296 1040065901 BC26566100 BICATERO 50 HETERO LABS LIMITED, BICALUTAMIDE 50 -- 105 105/02/01 297 1040065975 AB39223209 CEFULIN FOR (CEFTAZIDIME) 瑞士新市廠 CEFTAZIDIME 1000 乾粉注射 1 GM -- 63 105/02/01 298 1040065975 AB39223212 CEFULIN FOR (CEFTAZIDIME) 瑞士新市廠 CEFTAZIDIME 2000 乾粉注射 2 GM -- 400 105/02/01 299 1040065975 AB39223277 CEFULIN FOR (CEFTAZIDIME) 瑞士新市廠 CEFTAZIDIME 500 乾粉注射 500 -- 32.3 105/02/01 300 1040065975 AC39223209 CEFULIN FOR (CEFTAZIDIME) 瑞士新市廠 CEFTAZIDIME 1000 乾粉注射 1 GM 63 0 105/03/01 第 21 頁, 共 28 頁
301 1040065975 AC39223212 CEFULIN FOR (CEFTAZIDIME) 瑞士新市廠 CEFTAZIDIME 2000 乾粉注射 規格原核定新核定生效日期量價價 2 GM 400 0 105/03/01 302 1040065975 AC39223277 CEFULIN FOR (CEFTAZIDIME) 瑞士新市廠 CEFTAZIDIME 500 乾粉注射 500 32.3 0 105/03/01 303 1040066020 AC58819100 LETRAMASE F.C. TABLETS 2.5 中化新豐製 LETROZOLE 2.5 -- 40 105/02/01 304 1040066021 AA57322100 ENVIR F.C. TABLETS 0.5(30 粒 / 鋁箔盒裝 ) 中化新豐製 ENTECAVIR 0.5 -- 155 105/02/01 305 1040066021 AC57322100 ENVIR F.C. TABLETS 0.5 中化新豐製 ENTECAVIR 0.5 137 0 105/03/01 306 1040066027 BA24545100 SERLIN 50 TABLETS(28 粒 / 鋁箔盒裝 ) CADILA HEALTHC ARE LI SERTRALINE(AS HYDROCHLORIDE) 50 -- 11.7 105/02/01 307 1040066027 BB24545100 Serlin 50 Tablets CADILA HEALTHC ARE LI SERTRALINE(AS HYDROCHLORIDE) 50 11.7 0 105/03/01 308 1040066093 AB44374100 YOU-JET F.C. TABLETS 50 南光 SERTRALINE(AS HYDROCHLORIDE) 50 -- 11.7 105/02/01 309 1040066093 AC44374100 YOU-JET F.C. TABLETS 50 南光 SERTRALINE(AS HYDROCHLORIDE) 50 11.7 0 105/03/01 310 1040066094 AA56787100 OKPINE F.C. TABLETS 10 (28 粒 / 鋁箔裝 ) 南光 OLANZAPINE 10 膜衣 -- 128 105/02/01 311 1040066094 AA58033238 5-FU 50/ML(20ML/ 玻璃瓶 裝 ) 南光 FLUOROURACIL 50 /ML 注射 20 ML -- 115 105/02/01 312 1040066094 AA58033248 5-FU 50/ML(50ML/ 玻璃瓶 裝 ) 南光 FLUOROURACIL 50 /ML 注射 50 ML -- 230 105/02/01 313 1040066094 AA58033255 5-FU 50/ML(100ML/ 玻璃瓶 裝 ) 南光 FLUOROURACIL 50 /ML 注射 100 ML -- 414 105/02/01 314 1040066094 AC56787100 OKPINE F.C. TABLETS 10 南光 OLANZAPINE 10 膜衣 108 0 105/03/01 315 1040066094 AC58033238 5-FU 50/ML 南光 FLUOROURACIL 50 /ML 注射 20 ML 115 0 105/03/01 第 22 頁, 共 28 頁
316 1040066094 AC58033248 5-FU 50/ML 南光 FLUOROURACIL 50 /ML 注射 規格原核定新核定生效日期量價價 50 ML 230 0 105/03/01 317 1040066094 AC58033255 5-FU 50/ML 南光 FLUOROURACIL 50 /ML 注射 100 ML 414 0 105/03/01 318 1040066094 NA10222209 ESCOPAN N.K. (1ML/ 玻璃安瓿裝 ) 南光 BUTYLSCOPOLAMINE BROMIDE (=HYOSCINE BUTYLBROMIDE) 20 /ML 注射 1 ML -- 15 105/02/01 319 1040066094 NC10222209 ESCOPAN N.K. 南光 BUTYLSCOPOLAMINE BROMIDE (=HYOSCINE BUTYLBROMIDE) 20 /ML 注射 1 ML 15 0 105/03/01 320 1040066111 BC26604100 ESOMEPRAZOL STADA 40 STADA- VN JOINT VENTU ESOMEPRAZOLE (MAG. TRIHYDRATE) 40 -- 12 105/02/01 321 1040066117 K000875221 RECORMON SOLUTION FOR IN PRE- FILLED SYRINGE 5000IU VETTER PHARMA- FERTIG EPOETIN BETA (GENETICAL RECOMBINANT) 5 KIU 注射 5 KIU 910 0 105/03/01 322 1040066117 K000876212 RECORMON SOLUTION FOR IN PRE- FILLED SYRINGE 2000IU VETTER PHARMA- FERTIG EPOETIN BETA (GENETICAL RECOMBINANT) 2 KIU 注射 2 KIU 396 0 105/03/01 323 1040066117 K000940229 RECORMON SOLUTION FOR IN PRE- VETTER PHARMA- FILLED SYRINGE 10000 IU FERTIG VETTER, GERMANY EPOETIN BETA (GENETICAL RECOMBINANT) 10 KIU 注射 10 KIU 1604 0 105/03/01 324 1040066117 KC00875221 RECORMON SOLUTION FOR IN PRE- FILLED SYRINGE 5000IU VETTER PHARMA- FERTIG EPOETIN BETA (GENETICAL RECOMBINANT) 5 KIU 注射 5 KIU -- 910 105/02/01 325 1040066117 KC00876212 RECORMON SOLUTION FOR IN PRE- FILLED SYRINGE 2000IU VETTER PHARMA- FERTIG EPOETIN BETA (GENETICAL RECOMBINANT) 2 KIU 注射 2 KIU -- 396 105/02/01 326 1040066117 KC00940229 RECORMON SOLUTION FOR IN PRE- VETTER PHARMA- FILLED SYRINGE 10000 IU FERTIG VETTER, GERMANY EPOETIN BETA (GENETICAL RECOMBINANT) 10 KIU 注射 10 KIU -- 1604 105/02/01 327 1040066216 BC26616100 ESOMEPRAZOL STADA 20 STADA- VN JOINT VENTU ESOMEPRAZOLE PELLET 22% 20 -- 2.51 105/02/01 328 1040066259 A033027100 TRICOLINE TABLETS 世達 TRIMETOQUINOL HCL 3 3(TRIMETOQUINO)S.D. 1.05 0 105/03/01 第 23 頁, 共 28 頁
項次 發文號 健保代碼 藥品名稱 廠牌 成分及含量 型 規格原核定新核定量價價 生效日期 329 1040066259 AC33027100 TRICOLINE TABLETS 3(TRIMETOQUINO)S.D. 世達 TRIMETOQUINOL HCL 3 -- 1.5 105/02/01 330 1040066263 AC414991G0 CIRZODONE TABLET 50 SINPHAR(TRAZODONE HYDROCHLORIDE)( 鋁箔 / 膠箔 ) 杏輝 ( 宜蘭廠 ) TRAZODONE -- 2 105/02/01 HYDROCHLORIDE 50 331 1040066326 BC22920100 ETUMINE TABLETS 40 (CLOTIAPINE) Famar L Aigle CLOTHIAPINE 40 -- 6.8 105/02/01 332 1040066343 A024115100 DICLOFENAC ENTERIC COATED TABLETS Y.C. 明大 DICLOFENAC SODIUM 25 腸溶 0.9 0 105/03/01 333 1040066343 AC24115100 DICLOFENAC ENTERIC COATED TABLETS Y.C. 明大 DICLOFENAC SODIUM 25 腸溶 -- 1.5 105/02/01 334 1040066352 AC47314429 BRIMO OPHTHALMIC SOLUTION 0.2% PATRON 臺灣派頓 BRIMONIDINE TARTRATE 2 /ML 點眼液 10 ML -- 410 105/02/01 335 1040066404 AC58813100 ROZININ F.C. TABLETS 20 瑞士新市廠 ROSUVASTATIN CALCIUM 20 -- 30.5 105/02/01 336 1040066405 AB49457100 GLUCOFIT ER TABLETS 500 SWISS 瑞士新市廠 METFORMIN HCL 500 持續性藥效 -- 1.71 105/02/01 337 1040066405 AB494571G0 GLUCOFIT ER TABLETS 500 SWISS ( 鋁箔 / 膠箔 ) 瑞士新市廠 METFORMIN HCL 500 持續性藥效 -- 2 105/02/01 338 1040066405 AC49457100 GLUCOFIT ER TABLETS 500 SWISS 瑞士新市廠 METFORMIN HCL 500 持續性藥效 1.71 0 105/03/01 339 1040066407 AC58817100 TAMOKAS PROLONGED 歐帕生技 TAMSULOSIN HCL 0.4 RELEASE TABLETS 0.4 持續性藥效 -- 17.9 105/02/01 340 1040066409 BC26581100 LETROZOLE-ACEPHARM F.C. TABLETS 2.5 SYNTHON LETROZOLE 2.5 -- 37.9 105/02/01 341 1040066411 AB57737100 DIVOSHOT EXTENDED- RELEASE TABLETS 250 TWI 安成國際中壢廠 DIVALPROEX (SODIUM) 250 持續釋放 -- 4.55 105/02/01 342 1040066412 AA56670100 VOSAA F.C. TABLETS 80(28 粒鋁箔盒裝 ) 中化新豐製 VALSARTAN 80 10.1 0 105/03/01 第 24 頁, 共 28 頁
343 1040066412 AA57343100 VOSAA F.C. TABLETS 160(28 粒 / 鋁箔盒裝 ) 中化新豐製 VALSARTAN 160 12.7 0 105/03/01 344 1040066412 AB56670100 VOSAA F.C. TABLETS 80 中化新豐製 VALSARTAN 80 0 10.1 105/02/01 345 1040066412 AB57343100 VOSAA F.C. TABLETS 160 中化新豐製 VALSARTAN 160 -- 12.7 105/02/01 346 1040066413 AA51598100 ATOTY F.C. TABLETS 10 (30 粒 / 鋁箔盒裝 ) 中化新豐製 ATORVASTATIN (CALCIUM) 10 -- 19.3 105/02/01 347 1040066413 AC51598100 ATOTY F.C. TABLETS 10 中化新豐製 ATORVASTATIN (CALCIUM) 10 14.5 0 105/03/01 348 1040066414 AA57103100 LOSARTAN F.C. TABLETS 50 CYH (28 粒 / 鋁箔膠 箔 ) 中化新豐製 LOSARTAN POTASSIUM 50 9.3 0 105/03/01 349 1040066414 AA57237100 LOSA&HYDRO F.C. TABLETS 50/12.5 CYH (28 粒 / 鋁箔膠箔 ) 中化新豐製 LOSARTAN POTASSIUM 50 9.3 0 105/03/01 350 1040066414 AB57103100 LOSARTAN F.C. TABLETS 50 CYH 中化新豐製 LOSARTAN POTASSIUM 50 0 9.3 105/02/01 351 1040066414 AB57237100 LOSA&HYDRO F.C. TABLETS 50/12.5 CYH 中化新豐製 LOSARTAN POTASSIUM 50 0 9.3 105/02/01 352 1040068008 AC57185261 CRAVIT IV SOLUTION FOR INFUSION 5/ML 健亞 LEVOFLOXACIN (HEMIHYDRATE) 5 /ML 注射 150 ML 874 0 105/04/01 353 104AE00447 BC24667100 JANUVIA 50 F.C. TABLETS MERCK SHARP & DOHME SITAGLIPTIN (AS MONOHYDRATE PHOSPHATE SALT) 50 -- 15.5 105/02/01 354 1040036890 BC24407100 Tarceva Film-Coated tablets 150mg Kremers Urban Pharma ERLOTINIB HYDROCHLORIDE 150 1251 1190 105/02/01 355 1040036890 BC25071100 TARCEVA FILM-COATED TABLETS 150 ITALY ROCHE S.P.A. ERLOTINIB HYDROCHLORIDE 150 1251 1190 105/02/01 356 1040045170 BC25217100 REVLIMID CAPSULES 5 CELGENE LENALIDOMIDE 5 INTERNAT IONA 8545 8251 105/02/01 357 1040068265 B023901216 BALANCE 1.5% GLUCOSE, 1.75 MMOL/L CALCIUM, PERITONEAL DIALYSIS SOLUTION FRESEM GLUCOSE MONOHYDRATE 16.5 /ML 透析用液 3 L 146 0 105/04/01 第 25 頁, 共 28 頁
358 1040068265 B023906216 BALANCE 4.25% GLUCOSE, 1.75 MMOL/L CALCIUM, PERITONEAL DIALYSIS SOLUTION FRESEM GLUCOSE MONOHYDRATE 46.75 /ML 透析用液 3 L 146 0 105/04/01 359 1040068265 B023907216 BALANCE 2.3% GLUCOSE, 1.75 MMOL/L CALCIUM, PERITONEAL DIALYSIS SOLUTION FRESEM GLUCOSE MONOHYDRATE 25 /ML 透析用液 3 L 146 0 105/04/01 360 1040069164 B022825209 CEFROM POWDER FOR I.V 1GM PATHEO CEFPIROME 1000 乾粉 注射 1 GM 356 0 105/02/01 361 1040069384 A000842100 ENPURIN S.C. TABLETS VEI MIN 明大 BROMELAIN 50 糖衣 3.36 0 105/03/01 362 1040069384 A025002329 EPICORT CREAM VEIMIN 明大 ECONAZOLE NITRATE 10 /GM 乳膏 10 GM 19.5 0 105/03/01 363 1040069533 A027717206 RINDERON SUSPENSION 5/ML 鹽野義 BETAMETHASONE ACETATE 4 /ML 注射 0.5 ML 11.9 0 105/03/01 364 1040069788 A038892229 ASPIRIN POWDER FOR 0.9GM (LYSINE ACETYLSALICYLATE) LITA ACETYLSALICYLATE (LYSINE) 500 乾粉注射 500 9.9 0 105/02/01 365 1040069939 A032736238 WILCON LYO- 20 (FAMOTIDINE) UNION 聯邦製 FAMOTIDINE 20 凍晶 注射 20 31.5 0 105/02/01 366 1040069946 A043855100 NORESTRIN TABLETS 華盛頓 ESTRADIOL 2 3.83 0 105/02/01 367 1040070013 A001856100 ERYTHROMYCIN CAPSULES 250 WAH FOO 政德 ERYTHROMYCIN (ESTOLATE) 250 1.43 0 105/03/01 368 1040070013 A004957100 KANFUYEN CAPSULES 政德 CEPHALEXIN (MONOHYDRATE) 250 1.14 0 105/03/01 369 1040070013 A015201100 ANKOCILLIN CAPSULES 500 W.F. 政德 AMOXYCILLIN (TRIHYDRATE) 500 1.29 0 105/03/01 370 1040070051 BC24203265 SYNTHAMINE 14, 8.5% AMINO ACID IV INFUSION WITHOUT ELECTROLYTE, SOLUTION FOR INFUSION 8.5% W/V BHCL ARGININE L- 9.78 /ML 注射 250 ML 151 0 105/02/01 第 26 頁, 共 28 頁
371 1040070051 BC24271209 OLICLINOMEL N6-900 E EMULSION FOR INFUSION( 依仿單含熱量 1015KCAL) BAXTER S.A. GLUCOSE 300 /ML 注射 1 L 874 0 105/02/01 372 1040070051 BC24271210 OLICLINOMEL N6-900 E EMULSION FOR INFUSION( 依仿單含熱量 1525KCAL) BAXTER S.A. GLUCOSE 300 /ML 注射 1.5 L 1273 0 105/02/01 373 1040070051 BC24271212 OLICLINOMEL N6-900 E EMULSION FOR INFUSION( 依仿單含熱量 2030KCAL) BAXTER S.A. GLUCOSE 300 /ML 注射 2 L 1697 0 105/02/01 374 1040070178 B022826240 HEPARIN SODIUM- FRESENIUS 5000IU/ML Fresenius HEPARIN SODIUM 5000 Kabi Manuf U/ML (UNIT/ML) 注射 25 KIU 92 0 105/02/01 375 1040070178 B022826299 HEPARIN SODIUM- FRESENIUS 5000IU/ML Fresenius HEPARIN SODIUM 5000 Kabi Manuf IU/ML 注射 1 KIU 1.28 0 105/02/01 376 1040070178 B022827221 HEPARIN SODIUM- FRESENIUS 1000IU/ML Fresenius HEPARIN SODIUM 1000 Kabi Manuf U/ML (UNIT/ML) 注射 5 KIU 38.3 0 105/02/01 377 1040070188 A043788321 BISZOLE CREAM S.L 信隆 BIFONAZOLE 10 /GM 乳膏 5 GM 23.7 0 105/02/01 378 1040070188 A043788329 BISZOLE CREAM S.L 信隆 BIFONAZOLE 10 /GM 乳膏 10 GM 68 0 105/02/01 379 1040070188 A043788338 BISZOLE CREAM S.L 信隆 BIFONAZOLE 10 /GM 乳膏 20 GM 81 0 105/02/01 380 1040070614 Y000006263 CEREZYME 200UNITS GENZYME IMIGLUCERASE 200 U (UNIT) 凍晶注射 200 U (UNIT ) 39758 0 105/03/01 381 1040070781 A016963221 SIVKORT STERILE SUSPENSION 40 (TRIAMCINOLONE) 壽元製 TRIAMCINOLONE (ACETONIDE) 40 /ML 注射 5 ML 44.4 0 105/03/01 382 1040070781 AC16963209 SIVKORT STERILE SUSPENSION 40 (TRIAMCINOLONE) 壽元製 TRIAMCINOLONE (ACETONIDE) 40 /ML 注射 1 ML 23 0 105/03/01 383 1040070781 AC16963212 SIVKORT STERILE SUSPENSION 40 (TRIAMCINOLONE) 壽元製 TRIAMCINOLONE (ACETONIDE) 40 /ML 注射 2 ML 23.8 0 105/03/01 384 1040070781 AC16963229 SIVKORT STERILE SUSPENSION 40 (TRIAMCINOLONE) 壽元製 TRIAMCINOLONE (ACETONIDE) 40 /ML 注射 10 ML 57 0 105/03/01 第 27 頁, 共 28 頁
385 1040070857 X000135237 PROLEUKIN FOR BOEHRIN GER INGELHEI M ALDESLEUKIN 18 MIU/ML 凍晶注射 18 MIU 11935 0 106/02/01 386 1050050252 BC21253100 SEGLOR 5 CAPSULES SANOFI DIHYDROERGOTAMINE METHANESULPHONATE 5 10.3 0 105/03/01 387 1040067082 AC47486197 HAO GRANULES FOR ORAL SOLUTION 1200 Y.C. 元宙 PIRACETAM 1200 內服 顆粒 1.2 GM 4.88 6 105/04/01 388 1040067179 AC37570109 ULSAMIN FINE GRANULES 900/GM (BASIC ALUMINUM SUCROSE SULFATE) 政德 SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 900 /GM 細粒 1 GM 3.65 6 105/04/01 389 1040067271 BC24857109 Ulban A Gran. TOWA PHAR. SUCRALFATE(=BASIC ALUMINUM SUCROSE SULFATE) 900 /GM 內服顆粒 1 GM 3.65 6 105/04/01 390 1040067609 AC55263197 NOOPOL GRANULES FOR ORAL SOLUTION 1200 南光 PIRACETAM 1200 內服 顆粒 1.2 GM 4.88 6 105/04/01 391 1040068291 AC48082197 SYNTAM GRANULES FOR 優良 PIRACETAM 1200 內服 ORAL SOLUTION 1200 顆粒 1.2 GM 4.37 6 105/04/01 第 28 頁, 共 28 頁