Table 3.

Most frequently prescribed single drugs products not included in the National List of Essential Medicines 2015 in any strength or dosage form

Drug	Number of Prescriptions (percentage of n=4838), n (%)	Equivalent/alternative in NLEM 2015	Number of prescriptions (percentage of n=4838), n (%)	Equivalent/alternative in WHO EML 2019	Remarks/suggestions
Levocetirizine	258 (5.33)	Cetirizine	152 (3.14)	□Loratadine*	No advantage over cetirizine, more expensive[6,7]
Famotidine	71 (1.47)	Ranitidine	271 (5.60)	□Ranitidine	Can be considered for inclusion in NLEM[7,8]
Itraconazole	53 (1.10)	Fluconazole	21 (0.43)	Itraconazole	Can be considered for inclusion in NLEM[9,10,11]
Methylcobalamin	49 (1.01)	Hydroxocobalamin	36 (0.74)	Hydroxocobalamin	May be inferior/nonsuperior to Hydroxocobalamin[12]
Drotaverine	46 (0.95)	Nil†	-	Nil	Therapeutic role not well established[13]
Losartan	43 (0.89)	Telmisartan	49 (1.01)	□Losartan	Lesser efficacy compared to telmisartan14,15
Esomeprazole	40 (0.83)	Omeprazole	187 (3.87)	□Omeprazole	No advantage over omeprazole[8,16,17]
Rabeprazole	38 (0.79)
Olanzapine	35 (0.72)	Risperidone, clozapine	38 (0.79) 4 (0.08)	Risperidone, clozapine (complementary list)	Subject expert opinion required
Vildagliptin	33 (0.68)	Metformin, glimepiride	289 (5.97) 113 (2.34)	Metformin, □Gliclazide	Subject expert opinion required
Dextromethorphan	33 (0.68)	Nil		Nil‡	Doubtful efficacy, risk of adverse effects and abuse[18]
Total	699 (14.45)		1156 (23.89)

*The square box symbol (□) indicates similar clinical performance within a pharmacological class. ^†No phosphodiesterase 4 inhibitor is listed in NLEM 2015 or WHO EML 2019. ^‡No antitussive is listed in NLEM 2015 or WHO EML 2019. Codeine is listed in WHO EML 2019 as an analgesic. NLEM=National List of Essential Medicines, EML=Essential Medicines List, WHO=World Health Organization