📝 แบบฟอร์ม DUE
ยาที่ต้องแนบใบ DUE จำนวน 26 รายการ (15 แบบฟอร์ม)
📥 Controlled ATB
Piperacillin 4 g/ Tazobactam 500 mg inj. (EDง)
Cefoperazone 1 g/Sulbactam 500 mg inj. (EDง)
Fosfomycin 4 g inj. (EDง)
Vancomycin 500 g inj. (EDง)
Imipenem 500 mg/Cilastatin 500 mg inj. (EDง)
Meropenem 1g inj. (EDง)
Ertapenem 1 g inj. (EDง)
Sulbactam 2 g inj. (NED)
📥 Restricted ATB
Linezolid 600 tab. (EDจ2)
Colistin 150 mg inj. (EDง)
Polymyxin B 50 mg inj. (NED)
Tigecycline 1 g inj. (NED)
Ceftazidime 2 g + avibactam 0.5 g (EDจ2)
📥 20% Human albumin (EDง/NED) [IPD only]
📥 Ciclosporin 25 mg, 100 mg soft-gelatin cap. (NED) ในเคสไต [Nephro clinic/CAPD]
📥 Crystalline glucosamine sulfate + Chrondroitin sulfate GS 750 + CS 600 mg (NED) [Ortho/Rehab clinic]
📥 Denosumab 60mg, Teriparatide 600mcg inj. (NED) [Ortho/Rehab/Geriatric clinic]
📥 EPO (EDจ2/NED) [Nephro clinic และห้องไตเทียม]
📥 Finerenone 20mg tab. (NED)
📥 GLP-1 analog; Dulaglutide 1.5mg, Semaglutide 1mg, Tirzepatide 5 mg inj. (NED)
📥 GnRH agonist; Leuprorelin acetate 11.25mg, Triptorelin pamoatesterile 11.25mg inj. (EDง) [Uro clinic]
📥 Ketoanalogues (nitrogen-free essential amino acid) & essential amino acids 600 mg tab. (NED) [Nephro clinic/CAPD]
📥 NOACs; Apixaban 5 mg tab. (NED), Edoxaban 60 mg tab. (NED) [Warfarin clinic & IPD]
📥 Pantoprazole 40 mg inj. (EDค)
📥 Parenteral Nutrition; B-fluids 1 L, Smof Kabiven 1 L, Smof Kabiven Peripheral 1.9 L, OliClinomel N7-1000E inj, (EDง)
📥 Sevelamer carbonate 800 mg tab. (NED) [Nephro clinic และห้องไตเทียม]