浙江省基本医疗保险和工伤保险药品目录乙类药浙江省基本医疗保险和工伤保险药品目录乙类药品增补品种表品增补品种表（西药部分）（西药部分）药品名称药品名称序序号号医保序医保序号号中文名称中文名称英文名称英文名称剂型剂型支付范围限支付范围限定定11.1.1.3呋布西林Furbucillin注射剂21.1.1.3阿莫西林双氯西林Amoxillin and Dicloxacillin胶囊剂31.1.2.2.2头孢唑林舒巴坦Cefazolin and Sulbactam注射剂41.1.2.3.1头孢他美酯Cefetamet Pivoxil片剂限非限定支付的同类药物无效51.1.2.3.2头孢地嗪Cefodizime注射剂限二线抗菌药物用药61.1.4西索米星Sisomicin注射剂71.1.4卡那霉素Kanamycin注射剂81.1.7克拉霉素Clarithromycin缓释片，胶囊剂，颗粒剂,干混悬剂91.2.1复方磺胺嘧啶Compoud Sulfadiazine片剂101.2.2司帕沙星Sparfloxacin胶囊剂111.3.1对氨基水杨酸异烟肼Sodium Aminosalicylate and Isoniazid片剂121.3.1利福定Rifandine胶囊剂131.4.2两性霉素 B 脂质体（脂质体两性霉素 B）Amphotericin B Liposome注射剂限二线抗菌药物用药。
141.5.1金刚乙胺Rimantadine片剂152.2复方双氢青蒿素Compoud Dihydroartemisinin片剂163.1丹皮酚Paeonol注射剂173.1右旋布洛芬Dexibuprofen栓剂183.1二氟尼柳Diflunisal胶囊剂193.2复方别嘌醇Compound Allopurinol片剂204复方曲马多Compound Tramadol片剂215.2普鲁卡因肾上腺素Procaine and Epinephrine注射剂226.1芦丁Rutoside片剂236.2碳酸钙维生素 D3Vitamin D3 and Calcium Carbonate咀嚼片△246.2葡萄糖酸锌Granulae Zinci Gluconatis片剂, 粉剂△257.1.1复方氨基酸（8-11）Compound Amino Acid [8-11]胶囊剂限慢性肝、肾疾病268.1特利加压素Terlipressin注射剂278.2复方倍他米松Compound Betamethasone注射剂288.5.1甘精胰岛素Insulin glargine注射剂限内分泌科或内分泌专科医生，且限用于Ⅲ期糖尿病。
298.5.1门冬胰岛素Insulin aspart注射剂限内分泌科或内分泌专科医生，且限用于Ⅲ期糖尿病308.5.1赖脯胰岛素Insulin lispro注射剂限内分泌科或内分泌专科医生，且限用于Ⅲ期糖尿病318.5.2.1格列齐特(Ⅱ)Gliclazide（Ⅱ）片剂328.8高血糖素Glucagon注射剂338.8伏格列波糖Voglibose片剂348.8木糖醇Xylitoy粉剂限糖尿病肠内营养辅助用药359.1雷公藤内酯Triptolide软膏剂369.1聚肌胞Polyinosinic-Polycytidylic Acid注射剂每个疗程不超过2mg×26支；每年结算年度使用不超过2个疗程379.2卡介菌多糖、核酸制剂BCG Polysaccharide and Nacleic Acid Preparation注射剂限慢性支气管炎，哮喘3810.1.1伊达比星Idarubicin注射剂限急性淋巴细胞性白血病或急性非淋巴细胞性白血病3910.1.2奈达铂Nedaplatin注射剂4010.1.4伊立替康Irinotecan注射剂限结肠癌，直肠癌，小细胞肺癌4110.1.5复方环磷酰胺Compound Cyclophosphamide 片剂4210.3氨磷汀Amifostine注射剂4310.3甘氨双唑Glycididazole注射剂4411.1地氯雷他定Desloratadine片剂4512.1吡贝地尔Piribedil缓释片4612.3拉莫三嗪Lamotrigine片剂4712.3奥卡西平Oxcarbazepine片剂4812.4桂哌齐特Cinepazide注射剂4912.4依达拉奉Edarvaone注射剂5012.8多奈哌齐Donepezil胶囊剂限阿尔茨海默病(Alzheimer’s Disease)5112.8卡巴拉汀Rivastigmine胶囊剂限阿尔茨海默病(Alzheimer’s Disease)5213.1舒托必利Sultopride片剂5313.2坦度螺酮Tandospirone片剂5413.3米氮平Mirtazapine片剂5514.1厄多司坦Erdosteine胶囊剂5614.1标准桃金娘油Myrtle Standardized胶囊剂5714.2愈酚待因Potassium Guaiacol sulfonate and Codeine Phosphate口服溶液剂5814.2美司坦Mecysteine片剂5914.3塞曲司特Seratrodast片剂6014.3复方甲氧那明Compound Methoxyphenamine胶囊剂6114.3复方异丙托溴铵Compound Ipratropium Bromide吸入剂6215.1.1瑞巴派特Rebamipide片剂6315.1.1尿囊素铝Aldioxa口服常释剂型，颗粒剂6415.1.1呱仑酸钠/L-谷酰胺Sodium gualenate/L-glutamine缓释控释剂型6515.1.1丙谷胺Proglumide片剂6615.1.1替普瑞酮Teprenone胶囊剂6715.2米曲菌胰酶Oryz-Aspergillus and Pancreatin片剂6815.3.1屈他维林Drotaverine注射剂6915.5复方牛胎肝提取物Compound Embryonic Bovine 口服常释剂型Liver Extract 7015.5腺苷蛋氨酸Ademetionine注射剂7115.8氨基水杨酸Aminosalicylic Acid肠溶片7215.8酪酸梭菌活菌Clostridum Butyricum 片剂，口服散剂限菌群失调。
7315.8奥沙拉秦Olsalazine胶囊剂7416.2腺苷Adenosine注射剂7516.4尼索地平Nisoldipine片剂，缓释胶囊7616.7复方卡托普利Compound Captopril片剂7716.8坎地沙坦酯Candesartan Cilexetil片剂限非限定支付的抗高血压药无效或不能耐受病人，心力衰竭，急性心肌梗塞，糖尿病性肾病7816.9单硝酸异山梨酯Isosorbide Mononitrate缓释片，分散片7916.11维生素 E 烟酸酯Vitamin E Nicotinicate胶囊限经饮食控制无效的高脂血症8016.11藻酸双酯钠Alginic Sodium Diester胶囊剂8116.11弹性酶Elastase Enteric-coated肠溶胶囊剂8216.11多烯酸乙酯Ethyl Polyenoare胶丸8316.12辅酶 QCoenzyme Q胶丸8417.3氨苯蝶啶氢氯噻嗪Triamterene and Hydrochlorothiazide 片剂8517.4萘哌地尔Naftopidil片剂8618.1白眉蛇毒血凝酶Hemocoagulase注射剂8718.1维生素 K4Vitamin K4片剂8818.3右旋糖酐20Dextran 20注射剂8918.4.1多糖铁复合物Iron Polysaccharide Complex 胶囊9018.4.2重组人白细胞介素-11Recombinant Human Interleukin-11注射剂使用其它药物无效的血小板减少症，且血小板计数低于20×109/L。
9119果糖Fructose注射剂9219转化糖InvertSugar注射剂9320.1.1.2复方酮康唑Compound Ketoconazole软膏剂9420.1.1.2复方克霉唑Compound Clotrimazole软膏剂9520.1.2异维 A 酸Erythromycin Estolate Suspension凝胶剂9620.1.3卤米松三氯生Halometasone and Triclosan软膏剂9720.1.3糠酸莫米松Mometasone Furoate软膏剂9820.1.4复方炉甘石Compound Calamine散剂9920.1.4双氯芬酸二乙铵Diclofenac Diethylamine软膏剂，凝胶剂10020.1.4复方肝素钠尿囊素Campound Haparin Sodium and Allantoin软膏剂10120.1.4钙泊三醇Calcipotriol软膏剂10220.2.1.1妥布霉素地塞米松Tobramyin-Dexmethasone滴眼剂,眼膏剂10320.2.1.2复方碘苷Compound Idoxuridine眼膏剂10420.2.3四环素泼尼松Compound Tetracyline and Prednisone 眼膏剂10520.2.4氨碘肽Amiotide滴眼剂10620.2.4复方噻吗洛尔Compound Timolol滴眼剂10720.3呋麻Ephedrine and Nitrofurazone滴鼻剂10820.3复方薄荷脑Compound Menthol吸入剂10920.3西地碘Cydiodine片剂△11020.3奈甲唑啉Naphazoline Hydrochloride滴鼻剂11120.5.1米非司酮Mifepristone片剂限子宫肌瘤。
11220.5.2双唑泰Metronidazole栓剂11320.6放射性碘[125I]化钠Sodium Iodide[125I]口服液体剂11420.6锝[99mTC]焦磷酸盐Technetium[99MTC] Pyrophosphate注射剂11521.3复方氯解磷定Compound Pralidoxime Chloride注射剂11622.1.2碘羟拉葡胺Meglumine Ioxitalamate 注射剂11723金黄色葡萄球菌滤液制剂Staphylococcus Aureas Filtrate Preparation注射剂限以适应证之一，且每个疗程不超过500×30支，每个结算年度使用不超过2个疗程①骨折及陈旧性骨折；②恶性肿瘤放疗或化疗辅助性治疗1185.3.2.1安痛定Antondine注射剂1195.3.2.2苯甲酸钠咖啡因Caffeine and Sodium Benzoate注射剂、粉剂1206.1.3复合维生素BCompound Vitamin B注射剂、溶液剂1216.1.4呋喃硫胺Fursultiamine注射剂1226.1.5呋喃硫胺Fursultiamine片剂1236.1.6复方芦丁Compound Rutoside片剂12410.3.7甲基斑蝥胺Methylcantharidimide片剂12511.1H1.8氯苯那敏Chlorphenamine注射剂12615.3.1.9复方庆大霉素普鲁卡因Compound Gentamycin Sulfate胶囊剂12715.5.10叶绿素铜钠Sodium Cupper Chlorophyllin片剂(胶囊剂)12816.9.11复方罗布麻Compound Apocyne Venete片剂12916.12.12三磷酸腺苷(ATP)Adenosine Triphosphate片剂13018.1.13酚磺乙胺Dicynone片剂13118.5.14小檗胺Berbamine片剂13220.1.4.1 5复方苦参水杨酸Compound Flavescent Sophora and Salicylic Acid散剂1。