WitsMed: HIV Supportive Formulary 2017
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1 WitsMed: HIV Supportive Formulary 2017 Who we are WitsMed (referred to as the Scheme ), registration number 1282, is the medical scheme that you are a member of. This is a non-profit organisation, registered with the Council for Medical Schemes. Discovery Health (Pty) Ltd (referred to as the administrator ) is a separate company and an authorised financial services provider (registration number 1997/013480/07). We take care of the administration of your membership for the Scheme. Contact us You can call us on or visit for more information. This document lists the Antiretroviral Drugs that are on the HIV ARV Formulary list of the HIVCare Programme for 2017.
2 HIVCare Programme 2017 Disclaimer The information contained in this document is subject to change. The HIVCare Programme is governed by WitsMed Rules, administered by Discovery Health (Pty) Ltd. The utilisation of the benefits and programmes associated with the HIVCare Programme is subject to specific conditions and rules. Members must ensure that they are familiar with these rules and conditions. Any instructions or advice on medicines and the management of the member s condition are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill and judgement of the member s doctor, pharmacist or other healthcare professional. WitsMed reserves the right to change how we cover treatment on the programme at any time. WitsMed Network Option HIV Supportive Formulary Condition NAPPI_6 Product Name Strength Form Fungal Apex-fluconazole 200mg CAP Fungal Zydus fluconazole 200mg CAP Fungal Flucoric 200mg CAP Fungal Insep 200mg CAP Fungal Sandoz ketoconazole 200mg TAB Fungal Gulf fluconazole 200mg CAP Fungal Auro fluconazole 200mg CAP Fungal Candacide u/1mL SUS Fungal Canstat oral SUS Fungal Nystacid SUS HIV - Related Azithromycin zydus 500mg TAB HIV - Related Zithrogen 500mg TAB HIV - Related Adco-acyclovir 200mg TAB HIV - Related Lovire 200mg DSP HIV - Related Acitab-200 dt 200mg DSP HIV - Related Acyclovir biotech 200mg TAB HIV - Related Lovire 400mg DSP HIV - Related Acitab-400 dt 400mg DSP HIV - Related Cyclivex 400mg TAB HIV - Related Apex-acyclovir 400mg TAB HIV - Related Aciclovir sandoz 400mg TAB
3 Condition NAPPI_6 Product Name Strength Form HIV - Related Benzathinepen 1,2mu-fresenius INJ HIV - Related Benzathinepen 2,4mu-fresenius INJ HIV - Related Triaphin vial 15ml 1g INJ HIV - Related Adco ceftriaxone powder for 1g INJ injection HIV - Related Rociject-powder for injection 1g INJ HIV - Related Gulf ceftriaxone powder for 1g INJ injection HIV - Related Triaphin vial 5ml 250mg INJ HIV - Related Cpl alliance ciprofloxacin 500mg TAB HIV - Related Biotech ciprofloxacin 500mg TAB HIV - Related Cifran mg TAB HIV - Related Ciprogen 500mg TAB HIV - Related Loxip 500mg TAB HIV - Related Ciprol 500mg TAB HIV - Related Flopro 500mg TAB HIV - Related Canex vag 1% VCR HIV - Related Fungispor (1 applicator) VCR HIV - Related Gyno pevaryl 150mg VAT HIV - Related Xeramel 250mg CAP HIV - Related Purmycin 250mg CAP HIV - Related Eryko 250mg TAB HIV - Related Adco-erythromycin 250mg CAP HIV - Related Amzole 400mg TAB HIV - Related Suprazole 400mg TAB HIV - Related Bemetrazole 400mg TAB HIV - Related Anaerobyl 400mg TAB HIV - Related Bio-metronidazole 400mg TAB HIV - Related Metazol 400mg TAB HIV - Related Nucotet 250mg CAP HIV - Related Pharmatet (yellow/orange) 250mg CAP HIV - Related Novocillin 10ml 300mg/1mL INJ HIV - Related Novocillin 20ml 300mg/1mL INJ HIV - Related Clarihexal 500mg TAB HIV - Related Co-trim SUS HIV - Related Ilvitrim SUS HIV - Related Xerazole SUS HIV - Related Doctrim SUS HIV - Related Purbac SUS
4 Condition NAPPI_6 Product Name Strength Form HIV - Related Ilvitrim TAB HIV - Related Nucotrim TAB HIV - Related Trixazole 480mg TAB HIV - Related Lagatrim 480mg TAB HIV - Related Trimethox TAB HIV - Related Sandoz co-trimoxazole TAB 800mg/160mg HIV - Related Purbac ds 960mg TAB HIV - Related Durobac 'ds' 960mg TAB HIV - Related Klarithran 500mg TAB HIV - Related Klarizon 500mg TAB HIV - Related Klaryvid 500mg TAB HIV - Related Klaribin 500mg TAB HIV - Related Mylan clarithromycin 500mg TAB Peripheral Neuropathy Sandoz amitriptyline 25mg TAB Peripheral Neuropathy Gulf amitriptyline 25mg TAB Peripheral Neuropathy Zeptol 200mg TAB Peripheral Neuropathy Pyridoxine 25mg TAB Peripheral Neuropathy Pyridoxine 25mg TAB Peripheral Neuropathy Be-tabs pyridoxine hcl 25mg TAB Peripheral Neuropathy Trepiline 25mg TAB Dapsone 100mg TAB Winthrop isoniazid 100mg TAB Ebsar 2-ds 300/150 TAB Rifinah 150mg/75mg TAB Pyrazide 500mg TAB Rifinah 150/ mg;150mg TAB Antib-4 TAB Rimactane 150mg CAP
5 Complaints process You may lodge a complaint or query with WitsMed directly on or address a complaint in writing directly to the Principal Officer. Should your complaint remain unresolved, you may lodge a formal dispute by following WitsMed internal disputes process. Members, who wish to approach the Council for Medical Schemes for assistance, may do so in writing to: Council for Medical Schemes Complaints Unit, Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion, 0157 or complaints@medicalschemes.com. Customer Care Centre: /website
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