National Pediatric Formulary Guide
IAP EMLc & NLEM 2022 Approved

Indian Academy of Pediatrics (IAP) & NLEM Essential Medicines for Children

The official, evidence-based list of medicines prioritized for Indian children by the Indian Academy of Pediatrics (IAP) in collaboration with the World Health Organization (WHO) and the Ministry of Health (NLEM 2022).

1

Child-Size Formulations

Every medicine is selected in age-appropriate dosage forms (syrups, infant drops, dispersible tablets) to prevent dangerous tablet-splitting errors.

2

Evidence-Based Safety

High-risk adult drugs like Aspirin (Reye’s syndrome risk) and banned substances like Nimesulide are strictly omitted.

3

Universal Availability

These essential drugs form the backbone of pediatric care across Primary Health Centres (PHCs), district hospitals, and pediatric clinics across India.

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Showing 22 essential medicinesSource: IAP List of Essential Medicines for Children & NLEM 2022
Analgesics & Antipyretics

Paracetamol

Non-opioid Analgesics
Level: P, S, TEssential in IAP EMLc
Clinical Indication: First-line medicine for fever reduction and mild-to-moderate pediatric pain.
Approved Child Dosage Forms:
  • Infant drops: 100 mg / 1 mL
  • Oral liquid / syrup: 120 mg/5 mL (p), 125 mg/5 mL (p), 250 mg/5 mL (p)
  • Dispersible tablet: 250 mg
  • Tablets: 500 mg, 650 mg
  • Rectal suppositories: 80 mg, 170 mg
  • Injection: 150 mg/mL
Pediatric Note: Dosed strictly by weight (15 mg/kg per dose, every 4–6 hrs, max 60 mg/kg/day). Avoid kitchen spoons. Safe across all age groups from birth onwards.
Listed in NLEM 2022 (Section 2.1.5)Calculate Weight Dose →
Analgesics & Antipyretics

Ibuprofen

NSAIDs
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Second-line antipyretic, juvenile inflammatory arthritis, and musculoskeletal pain.
Approved Child Dosage Forms:
  • Oral liquid / suspension: 100 mg/5 mL (p), 200 mg/5 mL (p)
  • Tablets: 200 mg, 400 mg
Pediatric Note: Dose: 10 mg/kg per dose every 6–8 hrs. Give with food. STRICTLY CONTRAINDICATED in infants under 3 months (< 5 kg), dehydrated children, or active chickenpox.
Listed in NLEM 2022 (Section 2.1.3)Calculate Weight Dose →
Analgesics & Antipyretics

Morphine

Opioid Analgesics
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Severe acute trauma, postoperative pain, and pediatric oncology palliative care.
Approved Child Dosage Forms:
  • Tablet: 10 mg (as sulfate)
  • Injection: 10 mg/mL, 15 mg/mL in 1 mL ampoule
Pediatric Note: Requires dedicated respiratory and pulse oximetry monitoring. Naloxone must be immediately accessible as an antidote.
Listed in NLEM 2022 (Section 2.2.2)
Gastrointestinal & Fluids

Oral Rehydration Salts (WHO Low-Osmolarity)

Dehydration Management
Level: P, S, TEssential in IAP EMLc
Clinical Indication: First-line rehydration for acute watery diarrhea, gastroenteritis, and dehydration in children.
Approved Child Dosage Forms:
  • Powder sachet for reconstitution in 1 Liter clean water (Osmolarity: 245 mOsm/L; Na 75, K 20, Cl 65, Citrate 10, Glucose 75 mmol/L)
Pediatric Note: Sip slowly: 10 mL/kg after every loose stool. Discard leftover solution 24 hours after mixing. Never boil after reconstitution.
Listed in NLEM 2022 (Section 17.6.1 & 25.1.3)Calculate Weight Dose →
Gastrointestinal & Fluids

Zinc Sulphate

Diarrhea Management
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Cornerstone adjunct treatment for acute diarrhea in infants and children.
Approved Child Dosage Forms:
  • Dispersible scored tablet: 20 mg elemental zinc
Pediatric Note: Give 10 mg daily for infants < 6 months, 20 mg daily for children ≥ 6 months for 14 continuous days. Accelerates mucosal repair and reduces diarrhea episodes for 3 months.
Listed in NLEM 2022 (Section 17.6.2)Calculate Weight Dose →
Gastrointestinal & Fluids

Ondansetron

Antiemetics
Level: S, THospital formulary standard
Clinical Indication: Persistent vomiting in acute gastroenteritis preventing oral rehydration; chemotherapy-induced nausea.
Approved Child Dosage Forms:
  • Oral liquid: 2 mg/5 mL (p)
  • Tablets: 4 mg, 8 mg
  • Injection: 2 mg/mL
Pediatric Note: Single oral dose (0.15 mg/kg) facilitates successful ORS therapy in children with acute gastroenteritis.
Listed in NLEM 2022 (Section 17.2.3)
Gastrointestinal & Fluids

Omeprazole

Antiulcer & Acid Suppressive
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Gastroesophageal reflux disease (GERD), erosive esophagitis, and peptic ulcer disease in children.
Approved Child Dosage Forms:
  • Powder / granules for oral liquid: 20 mg sachets
  • Capsules: 10 mg, 20 mg, 40 mg
Pediatric Note: Dose: 0.7 to 1 mg/kg once daily in the morning before feeding. Do not chew or crush enteric-coated micro-granules.
Listed in NLEM 2022 (Section 17.1.1)
Respiratory

Salbutamol (Albuterol)

Bronchodilators
Level: P, S, TEssential in IAP EMLc
Clinical Indication: First-line fast-acting relief for acute bronchospasm, viral wheeze, and asthma exacerbation.
Approved Child Dosage Forms:
  • Metered dose inhaler (MDI): 100 mcg per dose (puff)
  • Oral liquid / syrup: 1 mg/5 mL, 2 mg/5 mL
  • Respirator solution for nebulizers: 5 mg/mL
  • Injection: 50 mcg/mL in 5 mL ampoule
Pediatric Note: MDI with a pediatric valved holding chamber (spacer) + mask is superior to oral syrup with faster relief and fewer tremors.
Listed in NLEM 2022 (Section 24.1.6)Calculate Weight Dose →
Respiratory

Budesonide

Inhaled Corticosteroids
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Maintenance controller therapy for persistent pediatric asthma; acute laryngotracheobronchitis (croup).
Approved Child Dosage Forms:
  • Inhalation aerosol (MDI/DPI): 100 mcg, 200 mcg per dose
  • Respirator suspension for nebulizer: 0.5 mg/mL, 1 mg/mL
  • Nasal spray: 50 mcg/dose
Pediatric Note: Rinse mouth or wipe face after use to prevent oral candidiasis (thrush) and local dysphonia.
Listed in NLEM 2022 (Section 24.1.1 & 16.1)
Antiallergics & Anaphylaxis

Cetirizine

Antihistaminics
Level: P, S, TPediatric practice standard
Clinical Indication: Allergic rhinitis, allergic conjunctivitis, acute urticaria, and pruritus in children ≥ 6 months.
Approved Child Dosage Forms:
  • Oral liquid / syrup: 5 mg/5 mL (p)
  • Tablets: 10 mg
Pediatric Note: Second-generation low-sedating antihistaminic. Contraindicated in infants < 6 months without specialist supervision.
Listed in NLEM 2022 (Section 3.2)Calculate Weight Dose →
Antiallergics & Anaphylaxis

Epinephrine (Adrenaline)

Emergency Anaphylaxis
Level: P, S, TEssential in IAP EMLc
Clinical Indication: First-line life-saving treatment for acute severe anaphylaxis and cardiopulmonary resuscitation.
Approved Child Dosage Forms:
  • Injection: 1 mg/mL (1:1000) in 1 mL ampoule
Pediatric Note: Intramuscular (IM) injection into the anterolateral mid-thigh is the route of choice (0.01 mg/kg of 1:1000, max 0.3 mg in young kids, 0.5 mg in adolescents).
Listed in NLEM 2022 (Section 3.1)
Antiallergics & Anaphylaxis

Dexamethasone

Systemic Corticosteroids
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Acute viral croup (laryngotracheobronchitis), severe anaphylaxis, meningitis adjunctive therapy.
Approved Child Dosage Forms:
  • Injection: 4 mg/mL dexamethasone phosphate in 1 mL ampoule
  • Oral liquid: 0.5 mg/5 mL (p)
  • Tablets: 0.5 mg, 2 mg, 4 mg
Pediatric Note: Single oral/IM dose (0.15–0.6 mg/kg) effectively relieves stridor in acute croup.
Listed in NLEM 2022 (Section 3.3 & 27.1)
Anti-Infective Medicines

Albendazole

Anthelminthics
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Single or mixed intestinal nematode infestations (Ascariasis, Enterobius, Hookworm, Trichuris).
Approved Child Dosage Forms:
  • Oral liquid / suspension: 200 mg/5 mL (p)
  • Chewable tablet: 400 mg
Pediatric Note: Dose: 200 mg single dose for 12–24 months; 400 mg single dose for ≥ 2 years. Take with a fatty meal to enhance absorption.
Listed in NLEM 2022 (Section 6.1.1.1)Calculate Weight Dose →
Anti-Infective Medicines

Amoxicillin

Beta-Lactam Antibacterials
Level: P, S, TEssential in IAP EMLc
Clinical Indication: First-line oral antibiotic for community-acquired pneumonia, acute otitis media, and streptococcal pharyngitis.
Approved Child Dosage Forms:
  • Powder for oral liquid: 125 mg/5 mL (p), 250 mg/5 mL (p)
  • Tablet (dispersible, scored): 250 mg
  • Capsules / solid: 250 mg, 500 mg
  • Powder for injection: 250 mg, 500 mg, 1000 mg
Pediatric Note: Standard high-dose pediatric guideline: 40–90 mg/kg/day divided into 2–3 doses for 5–7 days.
Listed in NLEM 2022 (Section 6.2.1.1)
Anti-Infective Medicines

Amoxicillin + Clavulanic Acid

Beta-Lactamase Inhibitor Combinations
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Complicated sinusitis, persistent otitis media, animal bites, and beta-lactamase producing infections.
Approved Child Dosage Forms:
  • Oral liquid: 200 mg amoxicillin + 28.5 mg clavulanate / 5 mL (p)
  • Dry syrup: 125 mg + 31.25 mg / 5 mL (p)
  • Tablet (dispersible): 200 mg + 28.5 mg
  • Tablet: 500 mg + 125 mg
  • Powder for injection: 500 mg + 100 mg, 1 g + 200 mg
Pediatric Note: Give at start of meals to minimize clavulanate-induced diarrhea and optimize bioavailability.
Listed in NLEM 2022 (Section 6.2.1.2)
Anti-Infective Medicines

Ceftriaxone

3rd Generation Cephalosporin
Level: S, TEssential in IAP EMLc
Clinical Indication: Severe bacterial sepsis, bacterial meningitis, pyelonephritis, and typhoid fever.
Approved Child Dosage Forms:
  • Powder for injection: 250 mg, 500 mg, 1000 mg, 2000 mg in vial
Pediatric Note: Once-daily dosing (50–100 mg/kg/day IV/IM). Contraindicated in neonates receiving IV calcium due to risk of precipitation.
Listed in NLEM 2022 (Section 6.2.1.11)
Anti-Infective Medicines

Azithromycin

Macrolides
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Atypical pneumonia (Mycoplasma), pertussis, uncomplicated enteric fever, and penicillin-allergic patients.
Approved Child Dosage Forms:
  • Oral liquid: 100 mg/5 mL (p), 200 mg/5 mL (p)
  • Tablet (dispersible): 100 mg
  • Tablets: 250 mg, 500 mg
  • Powder for injection: 500 mg
Pediatric Note: Standard dose: 10 mg/kg once daily for 3 to 5 days. High tissue penetration allows short treatment courses.
Listed in NLEM 2022 (Section 6.2.2.1)
Anti-Infective Medicines

Artemether + Lumefantrine

Antimalarials (ACT)
Level: P, S, TEssential in IAP EMLc
Clinical Indication: First-line Artemisinin-based Combination Therapy (ACT) for uncomplicated Plasmodium falciparum malaria.
Approved Child Dosage Forms:
  • Dry syrup: 40 mg + 240 mg / 5 mL
  • Tablet (dispersible): 20 mg + 120 mg
  • Tablets: 40 mg + 240 mg, 80 mg + 480 mg
Pediatric Note: Not recommended in infants < 5 kg. 6-dose regimen over 3 days taken with milk/fatty food to ensure absorption.
Listed in NLEM 2022 (Section 6.10.1.1)
Neurological & Anticonvulsants

Diazepam

Benzodiazepines
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Acute prolonged febrile convulsions, status epilepticus stabilization.
Approved Child Dosage Forms:
  • Injection: 5 mg/mL
  • Rectal solution / suppository: 1 mg/mL, 2 mg/mL, 5 mg
  • Oral liquid: 2 mg/5 mL (p)
Pediatric Note: Rectal administration (0.5 mg/kg) is rapid and effective when IV access is not yet established at home or transit.
Listed in NLEM 2022 (Section 5.1.3)
Neurological & Anticonvulsants

Midazolam

Emergency Anticonvulsant / Sedation
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Acute termination of prolonged pediatric seizures; procedural sedation.
Approved Child Dosage Forms:
  • Nasal spray: 0.5 mg/actuation, 1.25 mg/actuation
  • Injection: 1 mg/mL, 5 mg/mL
  • Oral liquid: 2 mg/mL
Pediatric Note: Intranasal midazolam spray is the modern standard for home and ambulance seizure rescue without requiring injections.
Listed in NLEM 2022 (Section 5.1.7)
Vitamins & Minerals

Cholecalciferol (Vitamin D3)

Bone & Growth Micronutrients
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Prevention and treatment of nutritional rickets, osteomalacia, and routine infant bone mineralization.
Approved Child Dosage Forms:
  • Oral liquid / drops: 400 IU/mL (p)
  • Solid oral forms: 1000 IU, 60,000 IU sachets
  • Injection: 300,000 IU, 600,000 IU
Pediatric Note: All breastfed infants should receive 400 IU daily from birth through the first year of life per IAP guidelines.
Listed in NLEM 2022 (Section 26.4)
Vitamins & Minerals

Phytomenadione (Vitamin K1)

Neonatal Prophylaxis
Level: P, S, TEssential in IAP EMLc
Clinical Indication: Mandatory birth prophylaxis to prevent Vitamin K Deficiency Bleeding (VKDB / hemorrhagic disease of the newborn).
Approved Child Dosage Forms:
  • Injection: 1 mg/mL in 1 mL ampoule, 10 mg/mL
  • Tablet: 10 mg
Pediatric Note: Given IM to all newborns immediately after birth: 0.5 mg for birth weight < 1000 g; 1 mg for birth weight ≥ 1000 g.
Listed in NLEM 2022 (Section 8.2.3)
About the Indian Academy of Pediatrics (IAP) & NLEM Standard

The List of Essential Medicines for Children of India was drafted by the Indian Academy of Pediatrics (IAP) in collaboration with the World Health Organization (WHO SEARO) to establish a minimal, highly-vetted formulary reflecting Indian child morbidity patterns. Together with the National List of Essential Medicines (NLEM 2022) issued by the Ministry of Health and Family Welfare, these medicines satisfy the priority health care needs of the pediatric population.

Disclaimer: This formulary guide is designed for educational transparency and clinical reference. Prescriptions, particularly antibiotics, antiepileptics, and parenteral therapies, must always be administered under the direct clinical supervision of a qualified pediatrician.