PyeongChang 2018 Paralympic Winter Games Formulary [NOTE: The WADA status and notes will be rechecked in November 2017 as they may change for 2018.] ] This formulary contains the list of medications that will be provided at the polyclinic in the Paralympic Village for the PyeongChang 2018 Paralympic Games. The formulary serves as the basis of the Pharmaceuticals Guide. Medication 1. Analgesic and Anti-Inflammatory 1.1 Analgesic Acetaminophen Tablet 500mg Codeine Tablet 20mg Morphine Tablet 10mg Prohibited in-competition Morphine Injection 5mg Prohibited in-competition Oxycodone Tablet 5mg Prohibited in-competition Tramadol Tablet 100mg Tramadol Injection 50mg 1.2 Anti-Inflammatory 1.2.1 COX-2 Inhibitor Celecoxib Capsule 200mg 1.2.2 NSAID Acetylsalicylic Acid Tablet 500mg Diclofenac Tablet 50mg Diclofenac Capsule 75mg Diclofenac Injection 75mg Diclofenac Gel 10mg/gram Ibuprofen Tablet 200mg Ketoprofen Patch 30mg/patch Ketorolac Injection 100mg 1
Naproxen Capsule 200mg 1.3 Antimigraine Sumatriptan Tablet 50mg 1.4 Muscle Relaxant Methocarbamol Tablet 250mg Methocarbamol Injection 500mg 2. Antihistamine Cetririzine Tablet 10mg Chlorpheniramine Tablet 2mg Chlorpheniramine Injection 4mg 3. Antimicrobial 3.1 Antibiotic 3.1.1 Beta lactam 3.1.1.1 Penicillin Amoxicillin Capsule 500mg Amoxicillin/Clavunate Tablet 500mg Ampicillin/Sulbactam Tablet 375mg Benzylpenicillin Sodium Injection 1.2M IU 3.1.1.2 Cephalosporin 3.1.1.2.1 1st Generation Cefadroxil Capsule 500mg 2
3.1.1.2.2 2 nd Generation Cefaclor Capsule 250mg 3.1.1.2.3 3 rd Generation Cefixime Capsule 100mg 3.1.2 Macrolides Azithromycin Tablet 250mg 3.1.3 Quinolones Ciprofloxacin Tablet 250mg 3.1.4 Sulfonamides Sulfamethoxazole/Trimethoprim Tablet 400mg/80mg 3.1.5 Tetracyclines Doxycycline Tablet 100mg 3.1.6 Nitroimidazoles Metronidazole Tablet 250mg 3.2 Antivirals Aciclovir Tablet 200mg Oseltamivir Capsule 75mg Valaciclovir Tablet 500mg 3
3.3 Antifungals Itraconazole Tablet 100mg 4. Cardiovascular 4.1 Anti-anginal Nitroglycerin Spray 150mg/ml 4.2 Anti-arrythmic Amiodarone Tablet 200mg Digoxin Tablet 0.25mg Flecainide Tablet 50mg Propafenone Tablet 150mg Verapamil Tablet 40mg 4.3 Anti-hypertensives 4.3.1 Beta-blocker Atenolol Tablet 25mg Prohibited in certain sports (Refer to Current WADA Prohibited List for details) 4.3.2 ACE Inhibitor Enalapril Tablet 10mg Ramipril Tablet 5mg 4.3.3 Alpha Adrenergic Blocker Doxazocin 2mg 4
4.3.4 Angiotensin Receptor Blocker Candesartan Tablet 8mg 4.3.5 Calcium Channel Blocker Amlodipine Tablet 5mg Nifedipine Capsule 5mg 4.4 Antihyperlipidemic Atorvastatin Tablet 10mg 4.5 Diuretic 4.5.1 Loop Furosemide Tablet 40mg Prohibited 4.5.2 Potassium Sparing Spironolactone Tablet 25mg Prohibited 4.5.3 Thiazide Hydrochlorothiazide Tablet 25mg Prohibited 5. Central Nervous System 5.1 Anticonvulsant Carbamazepine Tablet 200mg Gabapentin Capsule 100mg Phenobarbital Tablet 30mg Topiramate Tablet 25mg 5
5.2 Antidepressant 5.2.1 Noradrenergic Specific Serotonergic Antidepressant (NaSSA) Mirtazapine Tablet 15mg 5.2.2 Serotonin Norepinephrine Reuptake Inhibitor (SNRI) Venlafaxine Capsule 75mg 5.2.3 Serotonin Antagonist Reuptake Inhibitor (SARI) Trazodone Tablet 25mg 5.2.4 Selective Serotonin Reuptake Inhibitor (SSRI) Escitalopram Tablet 5mg Fluoxetine Capsule 20mg 5.2.5 Tricyclic Antidepressant(TCA) Amitriptyline Tablet 10mg 5.3 Anxiolytic/Hypnotic Diazepam Tablet 2mg Diazepam Injection 5mg/ml Lorazepam Tablet 1mg Zolpidem Tablet 5mg 6
6. Dermatological Agent 6.1 Anti-acne Benzoyl peroxide Cream 50mg/gram 6.2 Antibiotic Fusidic Acid Ointment 20mg/gram Neomycin Ointment 3.5mg/gram Silver Sulfadiazine Cream 10mg/gram 6.3 Antifungal Clotrimazole Cream 10mg/gram Terbinafine Hydrochloride 1% Cream 10mg/gram 6.4 Antiviral Aciclovir Cream 50mg/gram 6.5 Glucocorticosteroid Hydrocortisone 1% Lotion 10mg/ml Prednicarbate 0.25% Ointment 2.5mg/gram Triamcinolone Acetonide Ointment 1mg/gram 6.6 Gynecological Clotrimazole Pessary 100mg Metronidazole/Spiramycin Pessary 125mg/750k IU 7
6.7 Local Anesthetic Lidocaine Injection 20mg/ml 6.8 Local Anesthetic/Antihistamines Dibucaine/Diphenhydramine Liquid 4.5mg, 9mg/ml 6.9 Moisturizing Agent Emollient Lip-Relief Lubricant Sun protection 6.10 Rectal Hydrocortisone Acetate/Lidocaine 5mg,30mg/gram Prohibited in-competition when used rectally 6.11 Miscellaneous Agent Topical Menthol Sun protection 7. Otorhinolaryngology 7.1 Antibiotic Ofloxacin Liquid(Topical) 3mg/ml 7.2 Antibiotic/Glucocorticosteroid Ciprofloxacin/Fluocinolone acetonide Liquid(Topical) 3mg,0.25mg/ml 8
7.3 Decongestant Oxymetazoline Spray 500ug/15ml 7.4 Glucocorticosteroid Beclomethasone dipropionate Spray 20mg/ml when used by nasal route 7.5 Miscellaneous Chlorhexidine gluconate/ Oxybuprocaine Liquid 0.25ml/ 0.01g/100ml Throat Lozenges Tablet 8. Gastrointestinal 8.1 Antacid Calcium Carbonate/Sodium Alginate/Sodium Bicarbonate Tablet 80mg/250mg/130mg 8.2 Antidiarrheal Lactobacillus Acidophilus Capsule 150mg Loperamide Capsule 2mg 8.3 Antiemetic Dimenhydrinate/Caffeine Tablet 25mg/30mg Metoclopramide Tablet 3.84mg Ondansetron Tablet 4mg Ondansetron Injection 4mg/2ml 9
8.4 Antispasmodics Scopolamine Butylbromide Tablet 10mg 8.5 Antiulcer 8.5.1 H2 Receptor Blocker Ranitidine Tablet 75mg 8.5.2 Proton Pump Inhibitor Esomeprazole Tablet 20mg 8.6 Laxatives Magnesium Hydroxide Tablet 500mg 9. Hematological 9.1 Anticoagulant Aspirin Tablet 100mg Warfarin Tablet 2mg Warfarin Tablet 5mg 9.2 Platelet Aggregation Inhibitor Clopidogrel Tablet 75mg 9.3 Hemostatic Agent Vitamin K Injection 10mg/ml 10
9.4 Iron Supplement Ferrous Sulfate Tablet 80mg Ferric Hydroxide Sucrose Complex Injection 20mg/ml 10. Hormones & Antagonists 10.1 Glucocorticosteroid Dexamethasone Injection 5mg Prohibited by intravenous or intramuscular routes Hydrocortisone Injection 100mg Prohibited by intravenous or intramuscular routes Prednisolone Tablet 5mg Prohibited Methylprednisolone Injection 125mg Prohibited by intravenous or intramuscular routes 10.2 Anti-diabetic medication 10.2.1 Sulfonylurea Gliclazide Tablet 80mg 10.2.2 Biguanide Metformin Tablet 500mg 10.2.3 Glucagon Glucagon Injection 1mg 11
10.3 Insulin Insulin Lispro Injection 100IU/ml Prohibited Insulin(Humulin R) Injection 100IU/ml Prohibited Insulin Glargine Injection 100IU/ml Prohibited 10.4 Contraceptives Levonorgestrel Tablet 1.5mg 10.5 Thyroid Hormones Levothyroxine Tablet 100mcg 11. Miscellaneous 11.1 Uricosuric Citric Acid/Potassium Citrate Tablet 1002mg/3300mg 11.2 Urinary Tract Antispasmodic Oxybutynin Chloride Tablet 5mg 11.3 Potassium Supplement Potassium Chloride Injection 1.49g/20ml 11.4 Oral rehydration Oral Rehydration Salt Preparation 12
11.5 Oral Glucose Oral Glucose Oral 12. Ophthalmic 12.1 Antibiotic Ofloxacin Liquid(Topical) 3mg/ml 12.2 Antibiotic/Glucocorticosteroid Neomycin/ Polymyxin/ Dexamethasone Liquid(Topical) 3.5mg/ 6000IU/ 1mg per 1ml 12.3 Antihistamine Olopatadine Liquid(Topical) 1.1mg/ml 12.4 Anti-inflammatory Ketorolac Tromethamine Liquid(Topical) 5mg/ml 12.5 Glucocorticosteroid Dexamethasone Liquid(Topical) 1mg/ml 12.6 Anesthetics Proparacaine Liquid (Topical) 5mg/ml 13
12.7 Mydriatic Tropicamide Liquid (Topical) 10mg/ml 12.8 Ocular Irrigation Ocular Normal Saline Liquid (Topical) 20ml 12.9 Ocular Lubricant Carboxymethylcellulose Liquid(Topical) 2.5mg/0.5ml 13. Parenteral 13.1 Diluent Sodium Chloride Injection 500ml ** Sterile Water Injection 10ml ** **The intravenous infusion or injection of more than 50 ml/ 6 hours of any substance is a prohibited unless it is received during a hospital admission, a surgical procedure, or a clinical investigation, even if the substance itself is not prohibited. 13.2 Fluid or Nutrition Replacement Dextrose 5%/NaCl 0.9% Injection 500ml ** Dextrose 5%/NaCl 0.9%/KCl 20mEq Injection 500ml ** Glucose 50% Injection 100ml ** Normal Saline Injection 500ml ** **The intravenous infusion or injection of more than 50 ml/ 6 hours of any substance is a prohibited unless it is received during a hospital admission, a surgical procedure, or a clinical investigation, even if the substance itself is not prohibited. 14
13.3 Local Anesthetic Lidocaine Injection 10mg/ml Lidocaine/Epinephrine Injection 20mg/0.0091mg/ml 13.4 Miscellaneous Potassium Chloride Injection 1.491g/20ml 14. Respiratory 14.1 Anticholinergic Tiotropium bromide Inhaler 28.27mg/100ml 14.2 Antitussive Dextromethorphan/Guaifenesin Tablet 7.5mg/40mg 14.3 Bronchodilator Salbutamol nebules Liquid 2.5mg/2.5ml Salbutamol sulfate Inhaler 5mg/ml up to a maximum of 1600 micrograms over 24 hours, not to exceed 800 micrograms every 12 hours 14.4 Bronchodilator/Glucocorticosteroid Vilanterol/Fluticasone furoate Inhaler 1ug/4ug/mg Prohibited 14.5 Glucocorticosteroid Fluticasone propionate Inhaler 100ug/12.5mg 15
14.6 Leukotriene Antagonist Montelukast Tablet 5mg 14.7 Miscellaneous (Cold & Flu) Thera-Flu(Acetaminophen, Pheniramine, Phenylephrine) Tablet 650/20/10mg/per bag 15. Vaccine Tetanus/Diptheria Injection 20IU/2IU/ml Tetanus Immunoglobulin Injection 250IU/ml 16. Emergency Medication Atropine Sulfate Injection 0.5mg/ml Amiodarone Injection 150mg/3ml Epinephrine Injection 1mg/ml Prohibited except in medical emergency Ketamine Injection 10mg/ml Lidocaine Injection 20mg/ml Midazolam Injection 5mg Naloxone Injection 2mg Rocuronium Injection 10mg/ml NOTE: **The intravenous infusion or injection of more than 50 ml/ 6 hours of any substance is a prohibited unless it is received during a hospital admission, a surgical procedure, or a clinical investigation, even if the substance itself is not prohibited. 16