The WHO Model List of Essential Medicines for Children (a.k.a. Essential Medicines List for Children or EMLc), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe for children up to twelve years of age to meet the most important needs in a health system.
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 either require additional infrastructure, such as specially trained health care providers, or diagnostic equipment or have a lower benefit–cost ratio.
The first list for children was created in 2007, and the list is in its 10th edition .
Note: An α indicates a medicine is on the complementary list.
Anaesthetics, preoperative medicines and medical gases General anaesthetics and oxygen Inhalational medicines Isoflurane Nitrous oxidePiped nitrous oxide is a major source of atmospheric pollution from healthcare facilities. Point-of-care cylinders are the preferred delivery system over centrally-supplied (piped) delivery systems Oxygen Sevoflurane
Injectable medicines Ketamine PropofolThiopental is an alternative
Local anaesthetics Bupivacaine Lidocaine Lidocaine/epinephrine (lidocaine + epinephrine (adrenaline))
Preoperative medication and sedation for short-term procedures Atropine Midazolam Morphine
Medical gases OxygenNo more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
Medicines for pain and palliative care
Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs) IbuprofenNot in children less than three months. ParacetamolNot recommended for anti‐inflammatory use due to lack of proven benefit to that effect. (acetaminophen)
Opioid analgesics MorphineHydromorphone and oxycodone are alternatives
Complementary: MethadoneFor the management of cancer pain
Medicines for other common symptoms in palliative care Amitriptyline Cyclizine Dexamethasone Diazepam Docusate sodium Hyoscine hydrobromide Lactulose MidazolamMay be used for buccal administration when solution for oromucosal administration is not available OndansetronDolasetron, granisetron, palonosetron, and tropisetron are alternatives Senna
Antiallergics and medicines used in anaphylaxis Dexamethasone Epinephrine (adrenaline) Hydrocortisone LoratadineCetirizine and fexofenadine are alternativesThere may be a role for sedating antihistamines for limited indications. PrednisolonePrednisone is an alternative
Antidotes and other substances used in poisonings
Non-specific Charcoal, activatedAlternative formulations of activated charcoal may be used if granules are not available
Specific Acetylcysteine Atropine Calcium gluconate Naloxone
Complementary: Deferoxamine Dimercaprol Fomepizole Sodium calcium edetate Succimer
Medicines for neurological disorders
Medicines for central nervous system disorders
Antiseizure medicines Carbamazepine Diazepam LamotrigineFor use as adjunctive therapy for treatment-resistant partial or generalized seizures. Levetiracetam LorazepamDiazepam (injection) and midazolam (injection) are alternatives Magnesium sulfateFor use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders Midazolam Phenobarbital Phenytoin Prednisolone Valproic acid (sodium valproate)Valproic acid (sodium valproate) is not recommended in women and girls of childbearing potential owing to the high risk of birth defects and neurodevelopmental disorders in children exposed to valproic acid (sodium valproate) in the womb
Complementary: Ethosuximide Levetiracetam Valproic acid (sodium valproate)
Medicines for multiple sclerosis No listings in this section.
Medicines for parkinsonism No listings in this section.
Medicines for cerebral palsy Complementary: Baclofen
Medicines for headache disorders
Medicines for acute migraine attacks Ibuprofen Paracetamol (acetaminophen)The presence of both 120 mg/5 mL and 125 mg/5mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided
Medicines for migraine prophylaxis Propranolol
Medicines for cluster headache No listings in this section.
Medicines for central nervous system infections
Medicines for bacterial central nervous system infections Amoxicillin Ampicillin Benzylpenicillin CefotaximeThird-generation cephalosporin of choice for use in hospitalized neonates CeftriaxoneDo not administer with calcium and avoid in infants with hyperbilirubinemia> 41 weeks corrected gestational age ChloramphenicolOnly for the presumptive treatment of epidemic meningitis in children older than two years Gentamicin
Complementary: Meropenem> three months
Medicines for viral central nervous system infections Aciclovir
Medicines for peripheral nervous system disorders
Medicines for Guillain-Barré syndrome
Complementary: Normal immunoglobulin
Medicines for myasthenia gravis Neostigmine
Complementary: Pyridostigmine
Anti-infective medicines
Anthelminthics
Intestinal anthelminthics
Albendazole Ivermectin Levamisole Mebendazole Niclosamide Praziquantel Pyrantel
Antifilarials Albendazole Diethylcarbamazine IvermectinMoxidectin is an alternative
Antischistosomals and other antinematode medicines PraziquantelArpraziquantel is an alternative Triclabendazole
Complementary: OxamniquineFor use when praziquantel treatment fails.
Cysticidal medicines
Complementary: Albendazole Mebendazole Praziquantel
Antibacterials
Access group antibiotics Amikacin Amoxicillin Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid) Ampicillin Benzathine benzylpenicillin Benzylpenicillin Cefalexin Cefazolin> 1 month. ChloramphenicolOnly for the presumptive treatment of epidemic meningitis in children older than two years. Clindamycin CloxacillinAlternatives are 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)Cloxacillin, dicloxacillin, and flucloxacillin are preferred for oral administration due to better bioavailability DoxycyclineUse in children <8 years only for life-threatening infections when no alternative exists. Gentamicin Metronidazole Nitrofurantoin Phenoxymethylpenicillin (penicillin V) Procaine benzylpenicillinProcaine 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. Sulfamethoxazole/trimethoprim (sulfamethoxazole + trimethoprim) Trimethoprim
Watch group antibiotics Azithromycin Cefixime CefotaximeThird-generation cephalosporin of choice for use in hospitalized neonates. Ceftriaxone Cefuroxime Ciprofloxacin ClarithromycinErythromycin is an alternative. Piperacillin/tazobactam (piperacillin + tazobactam) VancomycinVancomycin powder for injection may also be used for oral administration
Complementary: Ceftazidime MeropenemImipenem/cilastatin is an alternative for complicated intraabdominal infections and high-risk febrile neutropenia only. Meropenem is the preferred choice for acute bacterial meningitis in neonates Vancomycin
Reserve group antibiotics
Complementary: Ceftazidime/avibactam (ceftazidime + avibactam) Ceftolozane/tazobactam (ceftolozane + tazobactam) Colistin Fosfomycin Linezolid Polymyxin B
Antileprosy medicines Clofazimine Dapsone Rifampicin
Antituberculosis medicines Amikacin Amoxicillin/clavulanic acid (amoxicillin + clavulanic acid)For use only in combination with meropenem Bedaquiline Clofazimine Cycloserine Delamanid Ethambutol EthionamideProthionamide is an alternative for multidrug-resistant tuberculosis Isoniazid Isoniazid/pyrazinamide/rifampicin (isoniazid + pyrazinamide + rifampicin) Isoniazid/rifampicin (isoniazid + rifampicin) Isoniazid/rifapentine (isoniazid + rifapentine) Levofloxacin Linezolid MeropenemImipenem/cilastatin is an alternative Moxifloxacin Moxifloxacin P-aminosalicylate sodium Pyrazinamide Rifampicin Rifapentine Streptomycin
Antifungal medicines Amphotericin B Fluconazole Flucytosine Griseofulvin ItraconazoleFor treatment of chronic pulmonary aspergillosis, histoplasmosis, sporotrichosis, paracoccidioidomycosis, mycoses caused by T. marneffei and chromoblastomycosis; and prophylaxis of histoplasmosis and infections caused by T. marneffei in AIDS patients Nystatin VoriconazoleFor treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis
Complementary: MicafunginAnidulafungin and caspofungin are alternatives Potassium iodide
Antiviral medicines
Antiherpes medicines Aciclovir
Antiretrovirals
Nucleoside/nucleotide reverse transcriptase inhibitors Lamivudine Zidovudine
Non-nucleoside reverse transcriptase inhibitors Nevirapine> six weeks
Protease inhibitors Darunavir> three years Lopinavir/ritonavir (lopinavir + ritonavir) Ritonavir
Integrase inhibitors Dolutegravir≥ 4 weeks and ≥ 3 kg; ≥ 25 kg RaltegravirFor use in second-line regimens in accordance with WHO treatment guidelines
Fixed-dose combinations of antiretroviral medicines Abacavir/dolutegravir/lamivudine (abacavir + dolutegravir + lamivudine) Abacavir/lamivudine (abacavir + lamivudine) Lamivudine/zidovudine (lamivudine + zidovudine)
Medicines for prevention of HIV-related opportunistic infections Isoniazid/pyridoxine/sulfamethoxazole/trimethoprim (isoniazid + pyridoxine + sulfamethoxazole + trimethoprim)
Other antivirals
Complementary: OseltamivirSevere illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients ValganciclovirFor the treatment of cytomegalovirus retinitis (CMVr).
Antihepatitis medicines
Medicines for hepatitis B
Nucleoside/Nucleotide reverse transcriptase inhibitors Entecavir
Medicines for hepatitis C Pangenotypic direct-acting antiviral combinations DaclatasvirPangenotypic when used in combination with sofosbuvir Daclatasvir/sofosbuvir (daclatasvir + sofosbuvir) Glecaprevir/pibrentasvir (glecaprevir + pibrentasvir) SofosbuvirPangenotypic when used in combination with daclatasvir Sofosbuvir/velpatasvir (sofosbuvir + velpatasvir)
Non-pangenotypic direct-acting antiviral combinations No listings in this section.
Other antivirals for hepatitis C No listings in this section.
Antiprotozoal medicines
Antiamoebic and antigiardiasis medicines DiloxanideProposed for deletion in 2027> 25 kg MetronidazoleTinidazole is an alternative
Antileishmaniasis medicines Amphotericin BLiposomal amphotericin B has a better safety profile than the sodium deoxycholate formulation and should be prioritized for selection and use depending on local availability and cost Meglumine antimoniate Miltefosine Paromomycin Sodium stibogluconate
Antimalarial medicines
Medicines for curative treatment ArtemetherFor use in the management of severe malaria Artemether/lumefantrine (artemether + lumefantrine) ArtesunateFor pre-referral treatment of severe malaria only. Artesunate/amodiaquine (artesunate + amodiaquine) Artesunate/mefloquine (artesunate + mefloquine) Artesunate/pyronaridine tetraphosphate (artesunate + pyronaridine tetraphosphate) Artesunate + sulfadoxine/pyrimethamine (Co-packaged) ChloroquineFor use only for the treatment of Plasmodium vivax infection Dihydroartemisinin/piperaquine phosphate (dihydroartemisinin + piperaquine phosphate) PrimaquineFor use to reduce the transmission of Plasmodium falciparum and for radical cure of Plasmodium vivax and Plasmodium ovale infections Quinine
Medicines for chemoprevention Amodiaquine + sulfadoxine/pyrimethamine (Co-packaged)