165种西药最高零售价格及暂行最高零售价格表

2023年12月3日发(作者：哪里有北京212吉普车专卖店)

附表1：165种西药最高零售价格及暂行最高零售价格表金额单位：元序号12目录序号1424名称阿莫西林/克拉维酸钾头孢呋辛酯剂型片剂片剂规格125mg/62.5mg*6片125mg*24片单位盒盒最高零售价格29.844.1备注头孢呋辛钠注射剂1.5g瓶57.1塞浦路斯麦道甘美大药厂342630头孢美唑钠头孢克肟注射剂胶囊剂干混悬剂500mg(冻干粉)100mg*12粒50mg*3袋瓶盒盒35.354.613.2塞浦路斯麦道甘美大药厂中美上海施贵宝制药有限公司534头孢哌酮钠注射剂2g瓶63.2639头孢吡肟注射剂0.5g（溶媒结晶）15mg:5ml（含玻璃酸钠）200mg(冻干粉)300mg(冻干粉)12.5mg:5ml(含玻璃酸钠)125mg*6片125mg*12片125mg*24片200mg*4片150mg（冻干粉）100mg:5g200mg:10g瓶80.7784749妥布霉素硫酸依替米星滴眼剂注射剂注射剂支瓶瓶支盒盒盒盒瓶支支17.41021396.513.325.950.41211.214.524.69105157氯霉素阿奇霉素滴眼剂肠溶片肠溶片肠溶片1166克林霉素阴道泡腾片注射剂1270夫西地酸乳膏剂乳膏剂序号目录序号名称剂型乳膏剂规格300mg:15g20mg*14片30mg:10ml400mg*5片200mg*5片24mg:8ml500mg*7片500mg*1片500mg*2片10g(1%)400mg*3粒50mg*12袋50mg*18袋50mg*36袋125mg*4粒125mg*10粒250mg500mg500mg(溶媒结晶)900mg50ml(3%)60ml(3%)300mg*14粒300mg*28粒单位支盒支盒盒支盒盒盒支盒盒盒盒盒盒瓶瓶瓶瓶瓶瓶盒盒最高零售价格33.6361034.820.537.327.21223.41.222.912.21835.115.544.53.66.17.39.523.226.711.322.0备注3诺氟沙星氧氟沙星加替沙星膜剂滴眼剂片剂片剂滴眼剂161787107左氧氟沙星克霉唑片剂阴道片阴道片乳膏剂1819108117硝酸咪康唑利巴韦林阴道软胶囊泡腾颗粒泡腾颗粒泡腾颗粒20119泛昔洛韦胶囊剂胶囊剂21162赖氨匹林注射剂注射剂注射剂注射剂22163布洛芬缓释混悬剂缓释混悬剂缓释胶囊缓释胶囊序号2324目录序号163165名称洛芬待因(布洛芬可待因)吲哚美辛剂型片剂控释胶囊控释胶囊规格212.5mg(200mg/12.5mg)*10片75mg*12粒75mg*24粒750mg*10粒750mg*20粒750mg*30粒240mg*20粒240mg*24片240mg*28片240mg*30片750mg*6片750mg*12片750mg*18片750mg*30片400mg*36片氯唑沙宗125mg/对乙酰氨基酚150mg*36片4mg*16片7.5mg*6片100mg*30粒50mg*10片50mg*20片100mg*20片0.5mg*100片4.2mg*5贴单位盒盒盒盒盒盒盒盒瓶盒盒盒盒盒盒最高零售价格21.415.630.254.510615746.15563.868.133.36596.115723.5备注25167氨基葡萄糖胶囊剂胶囊剂胶囊剂胶囊剂片剂片剂片剂片剂片剂片剂片剂26169贝诺酯片剂27176复方氯唑沙宗片剂盒17.828183氯诺昔康美洛昔康片剂片剂胶囊剂分散片分散片分散片盒盒盒盒盒盒盒盒22.414.454.213.927.147.6132431台湾景德制药股份有限公司29187尼美舒利3031193196秋水仙碱芬太尼片剂透皮贴剂序号目录序号名称剂型透皮贴剂规格8.4mg*5贴0.4mg*6片0.4mg*10粒505mg(500mg/5mg)*10粒75mg:10ml90mg:10ml120mg:10ml240mg:100ml100mg:2ml*10支10g（溶媒结晶）20g（溶媒结晶）20.65g:200ml60mg*7片60mg*10片500mg*30片5mg*30粒30mg*12粒30mg*48片120mg*10片500ug*60片15mg*30片4mg*12粒单位盒盒盒盒支瓶瓶瓶盒瓶瓶瓶盒盒盒盒盒盒盒盒盒盒最高零售价格71825.963.761.338.544.355.293.828.81572674058.695.965229.510.33924.9备注32202草乌甲素片剂胶丸3334204229对乙酰氨基酚羟考酮(氨酚羟考酮)罗哌卡因胶囊剂注射剂注射剂注射剂注射剂3536250260烟酸丙氨酰谷氨酰胺注射剂注射剂注射剂3738262305复方氨基酸18-B雷洛昔芬注射剂片剂片剂394甲羟孕酮格列吡嗪那格列奈片剂缓释胶囊胶囊剂片剂片剂424344325328329瑞格列奈吡格列酮罗格列酮片剂分散片胶囊剂55.46943.6序号45目录序号337名称阿仑膦酸钠剂型片剂片剂规格10mg*12片70mg*1片200mg*100粒300mg:5ml60mg（冻干粉）0.5mg*12片10mg*50粒500mg（冻干粉）单位盒盒盒支瓶盒盒瓶最高零售价格72.929.554713998816.1167166备注46340氯膦酸二钠胶囊剂注射剂47484959帕米膦酸二钠甲钴胺环孢素吗替麦考酚酯注射剂片剂软胶囊注射剂51352西罗莫司重组人干扰素a－2a（酵母）胸腺肽重组人白介素-2口服溶液20ml(1mg/1ml)瓶863525354353356357注射剂肠溶片注射剂注射剂600万IU（冻干粉）5mg*30片50万单位:0.4ml100万单位:0.8ml1mg(冻干粉)2mg(冻干粉)20mg*2粒50mg*14片50mg*28片50mg*30片15g:15mg瓶盒瓶瓶瓶瓶盒盒盒盒支76.556.787.0148.08.614.65386.655397高三尖杉酯碱注射剂注射剂5657402411长春瑞宾比卡鲁胺软胶囊片剂片剂片剂58426维A酸乳膏剂序号目录序号名称剂型软膏剂规格10g:10mg 10mg*10袋8mg(冻干粉)0.5单位*5支（冻干粉）2单位(冻干粉)30mg:5ml25mg*24片100mg*48片300mg（270mg/27mg/3mg)*36片50ug*24粒5mg*14片200mg*16片30mg:30ml1mg*30片1mg*24片2mg:2ml50mg*12片10ml:20mg（以西肽普兰计）*10支20mg*12片单位支盒瓶盒瓶支盒盒最高零售价格12.233.763.315287.75.030.549.9备注596氯雷他定尼莫地平血凝酶颗粒剂注射剂注射剂注射剂626364469475490倍他司汀黄豆苷元茴拉西坦注射剂片剂分散片65499米格来宁片剂盒3.86667686975531533544548石杉碱甲奥氮平喹硫平利培酮艾司唑仑劳拉西泮氯硝西泮曲唑酮西酞普兰胶囊剂片剂片剂溶液剂片剂片剂注射剂片剂口服溶液剂片剂盒盒盒瓶盒盒支盒盒盒29.216664.1981.819.14.743.179.179.3序号75目录序号552名称氨溴索剂型糖浆口服溶液规格600mg:100ml30mg:10ml*15支500mg:10ml*10支(无糖)100mg:20ml单位瓶盒盒盒最高零售价格22.22029.729.5备注7677554566羧甲司坦沙丁胺醇口服液雾化溶液剂吸入用溶液剂颗粒剂注射剂片剂肠溶片注射剂片剂滴眼剂注射剂胶囊剂胶囊剂78583异丙托溴铵500ug:2ml*10支150mg（以Bi计算）*18袋200mg(冻干粉)150mg*30片30mg*7片40mg（冻干粉）0.1g*100片2.5mg:5ml1mg（冻干粉）5mg*12粒5mg*24粒5mg*10粒2mg（冻干粉）2mg:100ml5mg（冻干粉）盒60.0勃林格殷格翰国际公司(英国)798687593597599618619胶体果胶铋西咪替丁雷尼替丁兰索拉唑泮托拉唑乳酶生消旋山莨菪碱格拉司琼莫沙必利盒瓶瓶盒瓶袋支瓶盒盒盒瓶瓶瓶39.23.5560.272.31.410.526.518.135.285.991.293.2158增加治疗术后恶心呕吐适应症增加治疗术后恶心呕吐适应症增加治疗术后恶心呕吐适应症88621托烷司琼胶囊剂注射剂注射剂注射剂序号89目录序号626名称硫酸镁复方甘草甜素（复方甘草酸苷）复方甘草甜素（复方甘草酸铵S）还原型谷胱甘肽剂型注射剂规格2.5g（溶媒结晶）甘草酸苷20mg/甘氨酸200mg/盐酸半胱氨酸10mg(冻干粉)250ml：甘草酸单铵盐80mg/盐酸半胱氨酸60mg/甘氨酸800mg1.0g（冻干粉）2.0g（冻干粉）100mg*18粒200mg:2ml600mg:100ml200mg（冻干粉）50mg*60片50mg*48片100mg*24片450mg*24片400mg*24片1g*7枚2mg（冻干粉）1.5mg:30ml25mg:250ml单位瓶最高零售价格4.2备注90640注射剂瓶16.3640注射液瓶51.391642注射剂注射剂瓶瓶盒支瓶瓶盒盒盒盒盒盒瓶瓶瓶35.96154.68.731.847.661.949.843.547.759.827023121.712092643苦参素（苦参总碱）软胶囊注射剂注射剂9394644649硫普罗宁水飞蓟宾注射剂片剂片剂片剂9596657666地奥司明美沙拉嗪片剂肠溶片栓剂979899667672696生长抑素[14肽]地高辛尼卡地平注射剂酏剂注射剂序号100101目录序号699703名称美托洛尔卡维地洛剂型胶囊剂片剂片剂规格50mg*30粒6.25mg*24片12.5mg*24片2.5mg*4贴10mg*14粒5mg*12片75mg*28片75mg*20片81.25mg(75mg/6.25mg)*20片162.5mg(150mg/12.5mg)*7粒162.5mg(150mg/12.5mg)*10粒20mg*28片100mg*50片40mg*28片20mg:5ml20mg*30片20mg*15片20mg*60片100mg*12粒单位盒盒盒盒盒盒盒盒盒盒最高零售价格18.921.937.1105.041.116.857.755.750.831.5备注4可乐定贝那普利马来酸依那普利厄贝沙坦透皮贴剂胶囊剂分散片片剂分散片106725厄贝沙坦氢氯噻嗪片剂胶囊剂胶囊剂盒44.4136738替米沙坦阿魏酸哌嗪单硝酸异山梨酯片剂分散片缓释片注射剂盒盒盒支盒盒盒盒46.432.367.82745.123.18828.5110745曲美他嗪片剂片剂片剂111757非诺贝特胶囊（Ⅱ）序号目录序号名称剂型胶囊（Ⅱ）规格100mg*20粒10mg*14片10mg*14粒60mg(冻干粉)60mg:100ml60mg:5ml30mg:2ml150mg:10ml20mg(冻干粉)12mg*60片12mg*24片20mg(冻干粉)10mg*6片2mg*12片2mg*24片250mg*30片20mg（冻干粉）40mg（冻干粉）30万单位*24粒单位盒盒瓶瓶瓶支支支瓶瓶瓶瓶盒盒盒盒瓶瓶盒最高零售价格46.631.83348.355.741.724.684.23.510.24.24626.752.8103.035.59.716.451.9备注112763辛伐他汀片剂滴丸7环磷腺苷环磷腺苷葡胺注射剂注射剂注射剂注射剂注射剂4呋塞米螺内酯注射剂片剂片剂8788791托拉塞米奥昔布宁托特罗定注射剂缓释片分散片分散片12氨甲环酸卡巴克络（卡络磺钠）片剂注射剂注射剂122809蚓激酶肠溶胶囊序号目录序号名称剂型肠溶胶囊肠溶胶囊规格60万单位*24粒60万单位*30粒25mg*30片25mg*45片25mg*60片0.4mg*62片0.4mg*93片6000IU:1ml600mg:100ml300ug（水针）100ug（水针）200ug（水针）300mg:10ml*6支1.46g:2g*12袋1g:10g15mg:15g10mg:5ml12.5mg:5ml8mg:8ml单位盒盒盒盒盒瓶瓶瓶瓶支支支盒盒支支支支支最高零售价格88.210915.52330.322.433.18810.73851662825.4201.423.178.245.414.3备注123819右旋糖酐铁分散片分散片分散片124825叶酸片剂片剂6827828重组人促红素（CHO细胞）肌苷[重组]人粒细胞集落刺激因子注射剂注射剂注射剂注射剂注射剂7849857875902906911曲克芦丁枸橼酸钾硫软膏丁酸氢化可的松酒石酸溴莫尼定倍他洛尔双氯芬酸钠口服溶液颗粒剂软膏剂乳膏滴眼剂滴眼剂滴眼剂序号目录序号名称剂型滴眼剂规格5mg:5ml（含玻璃酸钠）30mg:3ml（附针管,关节腔内注射）36000AU（外用）2.5mg:10ml5.4g:15ml13.56g:20ml33.9g:50ml17.5g:50ml单位支支瓶支瓶瓶瓶瓶最高零售价格1621746.133.339.991.7190186备注829431000玻璃酸钠(透明质酸钠)注射剂重组人牛碱性成纤维细胞生冻干粉针剂长因子羟甲唑啉聚甲酚磺醛碘佛醇滴眼剂溶液剂注射剂注射剂1401001碘海醇注射剂1411002碘帕醇注射剂60g(I):200ml瓶602上海博莱科信谊药业有限责任公司上海博莱科信谊药业有限责任公司注射剂破伤风免疫球蛋白氨酚伪麻II氨咖黄敏74g(I):200ml瓶72628B40B44注射剂片剂胶囊剂250单位:2.5ml复方*12片278mg*10粒每片含对乙酰氨基酚250mg:盐酸伪麻黄碱30mg:氢溴酸右美沙芬15mg:愈创木酚甘油醚100mg*12片100ml120ml愈创木酚甘油醚100mg,氢溴酸右美沙芬10mg*12粒瓶盒盒72.112.80.5145B53酚美愈伪麻分散片盒11.5146147B66B94复方桔梗麻黄碱糖浆（II）右美沙芬愈创甘油醚愈美糖浆剂糖浆剂瓶瓶8.729.5148B99胶囊剂盒12.3序号目录序号名称剂型颗粒剂规格愈创木酚甘油醚100mg,氢溴酸右美沙芬15mg*6袋愈创木酚甘油醚100mg,氢溴酸右美沙芬15mg*12袋250mg*45粒1mg（冻干粉）10mg（冻干粉）30mg:250ml0.5g*30片复方*10枚5g*6袋10g*12袋10g*18袋300mg*12袋20粒复方*12粒复方*24粒100mg（冻干粉）单位盒最高零售价格7.8备注颗粒剂盒15.2149150B116B130碳酸钙胸腺五肽胶囊剂注射剂注射剂盒瓶瓶瓶盒盒盒盒盒盒盒盒盒瓶8.635.720814020.726.837.514.621.626.51711.622.63154155B137B178B204B211B229去甲斑蝥素铝碳酸镁复方次没食子酸铋II车前番泻复方胃蛋白酶注射剂咀嚼片栓剂颗粒剂颗粒剂颗粒剂156157158B233B247B248复方胰酶维U颠茄铝维U颠茄铝镁散剂胶囊剂胶囊剂胶囊剂159B254氨力农注射剂序号目录序号名称剂型规格单位最高零售价格备注暂定。符合新标准，含二十碳五烯酸乙酯（C22H34O2)和二十二碳六烯酸乙酯（C24H36O2)总和不得少于80％160B258多烯酸乙酯软胶囊500mg*30粒瓶35.74B287B292B328B330水杨酸苯酚卡泊三醇碘酊聚维酮碘贴剂搽剂酊剂溶液溶液2cm*7cm*5片1.5mg:30ml40ml5g:50ml10g:100ml100ml300ml盒瓶瓶盒瓶瓶瓶11613.821.837.19.526.2165B331复方氯己定含漱剂含漱剂