CARDIOMYOPATHY REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION. * REQUEST FOR ANGIO-TENSIN RECEPTOR BLOCKER WILL REQUIRE MOTIVATION Drug Class Active Ingredient Trade Name ACE inhibitors Captopril Tab 12.5 MG CAPTOHEXAL 12.5MG Captopril Tab 25 MG Captopril Tab 50 MG Enalapril Maleate Tab 10 MG Enalapril Maleate Tab 2.5 MG Enalapril Maleate Tab 5 MG Enalapril Maleate Tab 20 MG CAPOTEN 25MG TAB ADCO-CAPTOPRIL 25MG ZAPTO 25MG TAB SANDOZ CAPTOPRIL 25MG BIO-CAPTOPRIL 25MG MERCK-CAPTOPRIL 25MG ZAPTO 50MG TAB ALAPREN 10MG TAB CIPLATEC 10MG HR-ENALAPRIL 10MG PHARMAPRESS 10MG HR-ENALAPRIL 2.5MG CIPLATEC 5MG ENAP 5MG TAB HYPACE 5MG ALAPREN 20MG TAB ENAP 20MG TAB HR-ENALAPRIL 20MG
Lisinopril Tab 2.5 MG Lisinopril Tab 5 MG Lisinopril Tab 10 MG Lisinopril Tab 20 MG AUSTELL LISINOPRIL 2.5MG HEXAL-LISINOPRIL 5MG TAB PRILOSIN 5MG TAB SINOPREN 5MG TAB ZEMAX 5MG ZEPROSIL 10MG TAB HEXAL-LISINOPRIL 10MG TAB ZEPROSIL 10MG TAB SINOPREN 20MG TAB ACE inhibitors/diuretics Captopril & Hydrochlorothiazide Tab 25-1 CAPTORETIC HS TAB Captopril & Hydrochlorothiazide Tab 50-2 Enalapril Maleate & Hydrochlorothiazide Lisinopril & Hydrochlorothiazide Tab 10- Lisinopril & Hydrochlorothiazide Tab 20- CAPTORETIC TAB ZAPTO-CO TAB ENAP-CO TAB PHARMAPRESS CO HEXAL-LISINOPRIL CO 10MG LISORETIC 10/12.5 ZETOMAX-CO 10/12.5MG HEXAL-LISINOPRIL CO 20MG LISORETIC 20/12.5 ZETOMAX-CO 20/12.5MG Angiotensin receptor antagonists* Candesartan Cilexetil Tab 8 MG ATACAND 8MG TAB Candesartan Cilexetil Tab 16 MG ATACAND 16MG TAB Eprosartan Mesylate Tab 600 MG TEVETEN 600 Telmisartan Tab 40 MG MICARDIS 40MG
Telmisartan Tab 80 MG MICARDIS 80MG Valsartan Tab 80 MG DIOVAN 80MG F/COAT TAB TAREG 80MG TAB Valsartan Tab 160 MG DIOVAN 160MG F/COATED TA TAREG 160MG TAB Angiotensin receptor antagonists/diuretics* Candesartan Cilexetil-Hydrochlorothiazide ATACAND PLUS 16/12.5MG Telmisartan-Hydrochlorothiazide Tab 40-12.5 Telmisartan-Hydrochlorothiazide Tab 80-12.5 CO-MICARDIS 40/12.5MG CO-MICARDIS 80/12.5MG Valsartan-Hydrochlorothiazide Tab 80-12.5 MG CO-DIOVAN 80/12.5MG Valsartan-Hydrochlorothiazide Tab 160-12.5 MGCO-DIOVAN 160/12.5MG Valsartan-Hydrochlorothiazide Tab 160-25 MG CO-DIOVAN 160MG PLUS Platelet Aggregation Inhibitors Aspirin Dispersible Tab 300 MG ASPIRIN SOLUBLE 300MG TAB Aspirin Tab 125 MG Aspirin Tab 300 MG Aspirin Delayed Release 81 MG Aspirin Dispersible 100 MG LO-ASPIRIN 125MG TAB BE-TABS ASPIRIN 300MG TAB ASPIRIN 300MG TAB GULF ASPIRIN ECOTRIN 81 MG MYOPRIN Coumarin - Oral Anticoagulant Warfarin Sodium Tab 5 MG WARFARIN 5MG TAB
Beta-receptor blockers Atenolol Tab 50 MG IVAX-ATENOLOL 50 B-BLOCK 50MG HEXABLOK 50MG TAB SANDOZ ATENOLOL 50 TENOPRESS 50MG TAB Atenolol Tab 100 MG B-BLOCK 100MG HEXABLOK 100MG TAB SANDOZ ATENOLOL 100 TENOPRESS 100MG TAB Propranolol HCl Tab 10 MG Propranolol HCl Tab 40 MG Sotalol HCl Tab 80 MG Sotalol HCl Tab 160 MG INDOBLOK 10MG PRODOROL 10MG TB SANDOZ-PROPRANOLOL 10 PUR-BLOKA 10MG TAB INDOBLOK 40MG PRODOROL 40MG TAB SANDOZ PROPRANOLOL 40 PUR-BLOKA 40MG TAB SOTAHEXAL 80MG TAB SOTAHEXAL 160MG TAB Beta-receptor blockers/diuretics Atenolol & Chlorthalidone Tab 50-12.5 MG SANDOZ CO-TENIDONE 50/12. Atenolol & Chlorthalidone Tab 100-25 MG SANDOZ CO-TENIDONE 100/25
Alpha- and beta-receptor blockers Carvedilol Tab 6.25 MG CARVETREND 6.25MG TAB MERCK-CARVEDILOL 6.25MG TAB Carvedilol Tab 12.5 MG Carvedilol Tab 25 MG CARVETREND 12.5MG TAB CARLOC 12.5MG TAB MERCK-CARVEDILOL 12.5MG TAB CARVEDILOL-HEXAL 12.5MG CARVETREND 25MG TAB CARLOC 25MG TAB MERCK-CARVEDILOL 25MG TAB CARVEDILOL-HEXAL 25MG TAB Cardiac glycosides Digoxin Elixir 0.05 MG/ML LANOXIN PAED.05MG/ML SYR Digoxin Tab 0.0625 MG Digoxin Tab 0.25 MG LANOXIN 0.0625MG PG TAB LANOXIN 0.25MG TAB PURGOXIN 0.25MG TAB Direct acting vasodilators Hydralazine HCl Tab 10 MG HYPERPHEN 10MG TAB Hydralazine HCl Tab 25 MG SANDOZ HYDRALAZINE 25 Hydralazine HCl Tab 50 MG HYPERPHEN 50MG TAB Diuretics Amiloride & Hydrochlorothiazide Tab 2.5- AMILORETIC HS TAB Amiloride & Hydrochlorothiazide Tab 5-50 BETARETIC TAB ADCO-RETIC TAB AMILORETIC TAB SPEC-CO-AMILORIDE TAB
Furosemide Cap 40 MG Furosemide Tab 40 MG Hydrochlorothiazide Tab 25 MG Hydrochlorothiazide-Potassium Chloride T Indapamide Tab 2.5 MG Spironolactone Tab 25 MG Spironolactone Tab 100 MG Triamterene & Hydrochlorothiazide Tab 50 AQUARID 40MG CAP SANDOZ FUROSEMIDE 40 MG DIURESIX 40MG TAB HEXAZIDE 25MG TAB URIREX-K TAB DAPTRIL 2.5MG TAB LIXAMIDE 2.5MG TAB MERCK-INDAPAMIDE 2.5 TABS SANDOZ SPIRONOLACTONE 25M SPIRACTIN 100MG TAB RENEZIDE TAB ROLAB-TRIAMTERENE HCT Organic nitrates Isosorbide Dinitrate SL Tab 5 MG SANDOZ-ISOSORBIDE 5 Isosorbide Dinitrate Tab 10 MG SANDOZ ISOSORBIDE 10 Isosorbide Dinitrate Tab 30 MG SANDOZ ISOSORBIDE 30 Isosorbide Mononitrate Tab 20 MG Nitroglycerin SL Tab 0.5 MG ELANTAN 20MG TAB ANGISED 0.5MG TAB Potassium Potassium Chloride Tab CR 8 meq PLENISH K 600MG TAB (only with potassium deleting diuretics) SANDOZ K-600
PRIOR TO CHRONIC REGISTRATION, ALL FORMULARY DRUGS ARE SUBJECT TO SCHEME RULES,MAXIMUM MEDICAL AID PRICE (MMAP), CLINICAL PROTOCOLS AND CHANGES IN PRODUCTS AND PRICES.