WHO Model List of Essential Medicines for Children

The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children[1] or EMLc[1]) is a list, proposed by the World Health Organization (WHO), of the most effective and safe medicines for use in children up to 12 years of age needed to meet the most important needs in a basic health-care system.[2] The list is divided into core items and complementary items. The core items are deemed to be the most cost effective options for key health problems and are usable with little additional health care resources. The complementary items frequently require additional infrastructure such as specially trained health care providers or diagnostic equipment. The first list for children was created in 2007, and the list is in its 7th edition as of 2019.[3][4]

For the adult list, see WHO Model List of Essential Medicines.

Note: In the following article, an α indicates the medicine is a complementary item, for which specialized diagnostic or monitoring and/or specialist training are needed. An item may also be listed as complementary on the basis of higher costs and/or a less attractive cost/benefit ratio.

Anaesthetics

Inhalational medicines

Injectable medicines

Local anaesthetics

Preoperative medication and sedation for short-term procedures

Medical gases

Medicines for pain and palliative care

Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)
A skeletal model of the chemical structure of aspirin

Opioid analgesics

Medicines for other symptoms common in palliative care

Antiallergics and medicines used in anaphylaxis

Antidotes and other substances used in poisonings

Non-specific

Specific

Anticonvulsants/antiepileptics

Anti-infective medicines

Intestinal antihelminthics
A skeletal model of the chemical structure of albendazole

Antifilarials

Antischistosomals and other antinematode medicines

Access group antibiotics

Watch group antibiotics

Reserve group antibiotics

Antileprosy medicines

Antituberculosis medicines
Pure crystals of ethambutol

Antifungal medicines

Antiherpes medicines
Nucleoside/nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Two capsules of atazanavir
Integrase inhibitors

Other antivirals
Nucleoside/Nucleotide reverse transcriptase inhibitors
Medicines for hepatitis C

No listings in this section.

Antiamoebic and antigiardiasis medicines

Antileishmaniasis medicines
For curative treatment
For chemoprevention

Antipneumocystosis and antitoxoplasmosis medicines
African trypanosomiasis
1st stage
2nd stage
American trypanosomiasis

Medicines for ectoparasitic infections

Antimigraine medicines

For treatment of acute attack

For prophylaxis

Immunomodulators and Antineoplastics

Immunomodulators for non-malignant disease

Cytotoxic medicines

Targeted therapies

Immunomodulators

Hormones and antihormones

Supportive medicines

Antiparkinsonism

No listings in this section.

Medicines affecting the blood

Antianaemia medicines

Medicines affecting coagulation

Other medicines for haemoglobinopathies

Blood products of human origin and plasma substitutes

Blood and blood components
Bag containing one unit of fresh frozen plasma

Human immunoglobulins

Blood coagulation factors

Plasma substitutes

Cardiovascular medicines

Antianginal medicines

No listings in this section.

Antiarrhythmic medicines

No listings in this section.

Antihypertensive medicines

Medicines used in heart failure

Antithrombotic medicines

No listings in this section.

Lipid-lowering agents

No listings in this section.

Dermatological medicines (topical)

Antifungal medicines

Anti-infective medicines

Anti-inflammatory and antipruritic medicines

Medicines affecting skin differentiation and proliferation

Scabicides and pediculicides

Diagnostic agents

Ophthalmic medicines

Radiocontrast media

Disinfectants and antiseptics

Antiseptics

Disinfectants

Diuretics

Gastrointestinal medicines

Antiulcer medicines

Antiemetic medicines

Anti-inflammatory medicines

No listings in this section.

Laxatives

No listings in this section.

Medicines used in diarrhoea

Oral rehydration

Medicines for diarrhoea

Medicines for endocrine disorders

Adrenal hormones and synthetic substitutes

Androgens

No listings in this section.

Estrogens

No listings in this section.

Progestogens

No listings in this section.

Insulins

Oral hypoglycaemic agents

Medicines for hypoglycaemia

Thyroid hormones and antithyroid medicines

Immunologicals

Diagnostic agents

Sera and immunoglobulins

Vaccines
A vial of oral cholera vaccine

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

Ophthalmological preparations

Anti-infective agents

Anti-inflammatory agents

Local anaesthetics

Miotics and antiglaucoma medicines

No listings in this section.

Mydriatics

Anti-vascular endothelial growth factor (VEGF) preparations

No listings in this section.

Medicines for reproductive health and perinatal care

Contraceptives

No listings in this section.

Ovulation inducers

No listings in this section.

Uterotonics

No listings in this section.

Antioxytocics (tocolytics)

No listings in this section.

Other medicines administered to the mother

No listings in this section.

Medicines administered to the neonate

Peritoneal dialysis solution

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

Medicines used in depressive disorders

Medicines used in bipolar disorders

No listings in this section.

Medicines for anxiety disorders

No listings in this section.

Medicines used for obsessive compulsive disorders

No listings in this section.

Medicines for disorders due to psychoactive substance use

No listings in this section.

Medicines acting on the respiratory tract

Antiasthmatic medicines

Solutions correcting water, electrolyte and acid-base disturbances

Oral

Parenteral

Miscellaneous

Vitamins and minerals

Ear, nose and throat medicines

Medicines for diseases of joints

Medicines used to treat gout

No listings in this section.

Disease-modifying agents used in rheumatoid disorders

Juvenile joint diseases

Notes
  1. Thiopental may be used as an alternative depending on local availability and cost.
  2. No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
  3. Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
  4. Alternatives limited to hydromorphone and oxycodone.
  5. There may be a role for sedating antihistamines for limited indications.
  6. as adjunctive therapy for treatment-resistant partial or generalized seizures.
  7. for buccal administration when solution for oromucosal administration is not available
  8. cloxacillin, dicloxacillin and flucloxacillin are preferred for oral administration due to better bioavailability.
  9. Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
  10. single agent trimethoprim may be an alternative for lower urinary tract infection.
  11. also listed for single-dose treatment of trachoma and yaws.
  12. 3rd generation cephalosporin of choice for use in hospitalised neonates.
  13. Do not administer with calcium and avoid in infants with hyperbilirubinaemia.
  14. erythromycin may be an alternative
  15. For treatment of latent TB infection (LTBI) only
  16. Prothionamide may be used as an alternative.
  17. For treatment of chronic pulmonary aspergillosis, acute invasive aspergillosis, histoplasmosis, sporotrichosis, paracoccidiodomycosis, mycoses caused by T. marneffei and chromoblastomycosis; and prophylaxis of histoplasmosis and infections caused by T. marneffei in AIDS patients.
  18. For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis.
  19. for use in second-line regimens in accordance with WHO treatment guidelines
  20. For the treatment of viral haemorrhagic fevers only.
  21. Severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
  22. For the treatment of cytomegalovirus retinitis (CMVr).
  23. To be used in combination with artesunate 50 mg.
  24. For use in the management of severe malaria.
  25. Not recommended in the first trimester of pregnancy or in children below 5 kg.
  26. To be used in combination with either amodiaquine, mefloquine or sulfadoxine + pyrimethamine.
  27. Other combinations that deliver the target doses required such as 153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be alternatives.
  28. For use only for the treatment of P.vivax infection.
  29. For use only in combination with quinine.
  30. To be used in combination with artesunate 50 mg.
  31. Only for use to achieve radical cure of P.vivax and P.ovale infections, given for 14 days.
  32. For use only in the management of severe malaria, and should be used in combination with doxycycline.
  33. Only in combination with artesunate 50 mg.
  34. For use only for the treatment of P.vivax infection.
  35. For use only in combination with chloroquine.
  36. For the treatment of 1st and 2nd stage of human African trypanosomiasis due to Trypanosoma brucei gambiense infection.
  37. To be used for the treatment of Trypanosoma brucei gambiense infection.
  38. To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection.
  39. To be used for the treatment of Trypanosoma brucei gambiense infection
  40. Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection.
  41. including quality-assured biosimilars
  42. including quality-assured biosimilars
  43. the square box applies to epoetin alfa, beta and theta, darbepoetin alfa, and their respective biosimilars
  44. Alternatives are limited to nadroparin and dalteparin
  45. Deferasirox oral form may be an alternative, depending on cost and availability.
  46. Polygeline, injectable solution, 3.5% is considered as equivalent.
  47. In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
  48. carbimazole is an alternative depending on local availability.
  49. for use in patients for whom alternative first-line treatment is not appropriate or available
  50. Exact type to be defined locally.
  51. Recommended for certain regions
  52. Recommended for some high-risk populations
  53. Recommended for immunisation programmes with certain characteristics
  54. Infections due to Chlamydia trachomatis or Neisseria gonorrhoeae.
  55. Or homatropine (hydrobromide) or cyclopentolate (hydrochloride).
  56. Ergocalciferol can be used as an alternative.
  57. For use for rheumatic fever, juvenile arthritis, Kawasaki disease

References
  1. "WHO Model Lists of Essential Medicines". WHO.int. The current versions are the 21st WHO Essential Medicines List (EML) and the 7th WHO Essential Medicines List for Children (EMLc) updated in June 2019.
  2. "Essential medicines". World Health Organization. Retrieved 20 January 2017.
  3. World Health Organization (2019). World Health Organization model list of essential medicines for children: 7th list 2019. Geneva. hdl:10665/325772. WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO.
  4. World Health Organization (2019). Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines. Geneva. hdl:10665/325773. WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO.

Further reading
  • World Health Organization (2019). The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. hdl:10665/330668. ISBN 9789241210300. ISSN 0512-3054. WHO technical report series;1021.

eEML - Electronic Essential Medicines List

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