# Acute pharyngitis and tonsillitis - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: IDSA GAS Pharyngitis 2012 · IDSA GAS Pharyngitis Guidelines 2012 Table 2 · IDSA GAS Pharyngitis Guidelines 2012 Table 2 (with 2014 Erratum) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · NICE NG84 Sore throat (acute): antimicrobial prescribing, 2018 · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) · Acute Pharyngitis - disease-level clinical article (acute-pharyngitis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 (cephalexin monograph) - Verified date: 2026-08 ## Verified against - IDSA GAS Pharyngitis Guidelines 2012 Table 2 - IDSA GAS Pharyngitis Guidelines 2012 Table 2 (with 2014 Erratum) - Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) - MSF Essential Drugs 2024 - paracetamol (oral) - StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) - Acute Pharyngitis - disease-level clinical article (acute-pharyngitis-clinical.txt) - Egyptian National Drug Formulary - Antimicrobial 2023 (cephalexin monograph) ## Treatment metadata - Amoxicillin — 500 mg — oral.solid - Phenoxymethyl penicillin — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) - Penicillin G benzathine — injection - Azithromycin — 500 mg — oral.solid - Clarithromycin — 500 mg — oral.solid - Cefalexin — 500 mg — oral.solid - Paracetamol — 500 mg — oral.solid - Ibuprofen — 400 mg — oral.solid ## Complete treatment card ```text ACUTE PHARYNGITIS AND TONSILLITIS Sources: IDSA GAS Pharyngitis 2012 · IDSA GAS Pharyngitis Guidelines 2012 Table 2 · IDSA GAS Pharyngitis Guidelines 2012 Table 2 (with 2014 Erratum) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · NICE NG84 Sore throat (acute): antimicrobial prescribing, 2018 · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) · Acute Pharyngitis - disease-level clinical article (acute- pharyngitis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 (cephalexin monograph) Review status: REVIEWED against 7 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination RED FLAGS (4) - Systemically very unwell - Quinsy, or a parapharyngeal or retropharyngeal abscess - Neck cellulitis, or Lemierre syndrome - Worsening rapidly - think scarlet fever or glandular fever SYMPTOMS - what the patient reports (4) - Sore throat, self-limiting, usually settling within about a week with or without antibiotics [sore throat] - Fever in the previous 24 hours [fever] - Came in quickly - within 3 days of onset - No cough and no coryza points towards streptococcus; their presence points away from it SIGNS - what you find (3) - Pus on the tonsils, or severely inflamed tonsils [pus] - Tender anterior cervical lymph nodes - Temperature over 38 degrees [fever] TESTS (4) - None needed to score it - Centor and FeverPAIN are entirely clinical - CHILD OR ADOLESCENT: IDSA 2012 - back up a NEGATIVE rapid antigen test with a throat culture (strong, high). Rapid tests are 70-90% sensitive, and the missed cases are the ones that go on to rheumatic fever. Not routinely needed in adults, whose rheumatic fever risk is very low - Under 3 years: IDSA does not indicate routine testing - rheumatic fever is rare at that age - Do NOT use ASOT to diagnose an acute sore throat. IDSA 2012: antistreptococcal titres are not recommended in routine diagnosis - they may not peak for 3 to 8 weeks and stay raised for months. ASOT answers 'was there a past infection', not 'is this one' Score Centor criteria - How likely is this streptococcal? Score FeverPAIN criteria - How likely is this streptococcal? Source NICE NG84 Sore throat (acute): antimicrobial prescribing · IDSA Group A Streptococcal Pharyngitis, 2012 Update Status traced to the source above Rx: Antibiotic | Main treatment | If penicillin-allergic | Pain and fever ANTIBIOTIC - choose one 1. AMOXICILLIN [1st line] Adult 500 mg TID or 1000 mg BID x 10 days Peds 40-50 mg/kg/day [child max 1000 mg] (Divided BID-TID for 10 days to prevent rheumatic fever) 3kg -> 120-150 mg/day 4kg -> 160-200 mg/day 5kg -> 200-250 mg/day 6kg -> 240-300 mg/day 7kg -> 280-350 mg/day 8kg -> 320-400 mg/day 9kg -> 360-450 mg/day 10kg -> 400-500 mg/day 11kg -> 440-550 mg/day 12kg -> 480-600 mg/day 13kg -> 520-650 mg/day 14kg -> 560-700 mg/day 15kg -> 600-750 mg/day 16kg -> 640-800 mg/day 17kg -> 680-850 mg/day 18kg -> 720-900 mg/day 19kg -> 760-950 mg/day 20kg -> 800-1000 mg/day 21kg -> 840-1000 mg/day (upper capped) 22kg -> 880-1000 mg/day (upper capped) 23kg -> 920-1000 mg/day (upper capped) 24kg -> 960-1000 mg/day (upper capped) 25kg -> 1000 mg/day (capped) 26kg -> 1000 mg/day (capped) 27kg -> 1000 mg/day (capped) 28kg -> 1000 mg/day (capped) 29kg -> 1000 mg/day (capped) 30kg -> 1000 mg/day (capped) 31kg -> 1000 mg/day (capped) 32kg -> 1000 mg/day (capped) 33kg -> 1000 mg/day (capped) 34kg -> 1000 mg/day (capped) 35kg -> 1000 mg/day (capped) 36kg -> 1000 mg/day (capped) 37kg -> 1000 mg/day (capped) 38kg -> 1000 mg/day (capped) 39kg -> 1000 mg/day (capped) 40kg -> 1000 mg/day (capped) 41kg -> 1000 mg/day (capped) 42kg -> 1000 mg/day (capped) 43kg -> 1000 mg/day (capped) 44kg -> 1000 mg/day (capped) 45kg -> 1000 mg/day (capped) 46kg -> 1000 mg/day (capped) 47kg -> 1000 mg/day (capped) 48kg -> 1000 mg/day (capped) 49kg -> 1000 mg/day (capped) 50kg -> 1000 mg/day (capped) Choice Alternatives. NICE NG84 table 1 puts phenoxymethylpenicillin first, but IDSA 2012 names amoxicillin co-equal for group A Streptococcus, and Egypt stocks 8 amoxicillin products against 2 for penicillin V. Availability decides. Source Egyptian National Drug Formulary - Antimicrobial 2023 Why Aminopenicillin used to eradicate group A Streptococcus from the throat; eradicating the organism, not just easing the sore throat, is what prevents the downstream complication of rheumatic fever. Caution A full 10-day course is required to prevent acute rheumatic fever in Egypt. Avoid in suspected infectious mononucleosis (rash risk). Contraindicated in penicillin allergy. Egypt AMOXYCILLIN 500MG 10 CAPS B.P.2013 ARAB DRUG COMPANY (ADCO) 6.50 EGP (0.65/unit) AMOXICILLIN 500MG 12 CAPS. USP 28 OCTOBER PHARMA 8.10 EGP (0.67/unit) AMOXIL 500MG 12 CAPS. MUP > SMITHKL... 9.00 EGP (0.75/unit) AMOXICID 500 MG 12 CAPS. CID 9.50 EGP (0.79/unit) E-MOX 500 MG 16 CAPS. EIPICO 15.60 EGP (0.97/unit) HICONCIL 500MG 12 CAPS. PHARCO 11.60 EGP (0.97/unit) BIOMOX 500MG 12 CAPS. SEDICO 19.50 EGP (1.62/unit) IBIAMOX 500 MG 12 CAPS. AMOUN 45.00 EGP (3.75/unit) HICILLIN 125MG/5ML SUSP. 80ML EL NASR 3.00 EGP -> ? strength differs, ? different route - not oral solid AMOXIL FORT 250MG/5ML SUSP. 60ML MUP > SMITHKL... 5.50 EGP -> ? strength differs, ? different route - not oral solid 2. PHENOXYMETHYL PENICILLIN [1st line] Adult 500 mg QID or 1000 mg BID x 10 days Peds 25-50 mg/kg/day [child max 1000 mg] (Divided QID for 10 days) 3kg -> 75-150 mg/day 4kg -> 100-200 mg/day 5kg -> 125-250 mg/day 6kg -> 150-300 mg/day 7kg -> 175-350 mg/day 8kg -> 200-400 mg/day 9kg -> 225-450 mg/day 10kg -> 250-500 mg/day 11kg -> 275-550 mg/day 12kg -> 300-600 mg/day 13kg -> 325-650 mg/day 14kg -> 350-700 mg/day 15kg -> 375-750 mg/day 16kg -> 400-800 mg/day 17kg -> 425-850 mg/day 18kg -> 450-900 mg/day 19kg -> 475-950 mg/day 20kg -> 500-1000 mg/day 21kg -> 525-1000 mg/day (upper capped) 22kg -> 550-1000 mg/day (upper capped) 23kg -> 575-1000 mg/day (upper capped) 24kg -> 600-1000 mg/day (upper capped) 25kg -> 625-1000 mg/day (upper capped) 26kg -> 650-1000 mg/day (upper capped) 27kg -> 675-1000 mg/day (upper capped) 28kg -> 700-1000 mg/day (upper capped) 29kg -> 725-1000 mg/day (upper capped) 30kg -> 750-1000 mg/day (upper capped) 31kg -> 775-1000 mg/day (upper capped) 32kg -> 800-1000 mg/day (upper capped) 33kg -> 825-1000 mg/day (upper capped) 34kg -> 850-1000 mg/day (upper capped) 35kg -> 875-1000 mg/day (upper capped) 36kg -> 900-1000 mg/day (upper capped) 37kg -> 925-1000 mg/day (upper capped) 38kg -> 950-1000 mg/day (upper capped) 39kg -> 975-1000 mg/day (upper capped) 40kg -> 1000 mg/day (capped) 41kg -> 1000 mg/day (capped) 42kg -> 1000 mg/day (capped) 43kg -> 1000 mg/day (capped) 44kg -> 1000 mg/day (capped) 45kg -> 1000 mg/day (capped) 46kg -> 1000 mg/day (capped) 47kg -> 1000 mg/day (capped) 48kg -> 1000 mg/day (capped) 49kg -> 1000 mg/day (capped) 50kg -> 1000 mg/day (capped) Source Egyptian National Drug Formulary - Antimicrobial 2023 Why Narrow-spectrum penicillin that remains first-line for streptococcal pharyngitis because group A Streptococcus has not developed resistance to it; eradicating the organism is what prevents rheumatic fever. Caution Take 1 hour before or 2 hours after meals. The full 10-day course is mandatory to prevent rheumatic fever. Penicillin allergy is a contraindication. Egypt OSPEN 1.0 MIU 12 F.C.TABS. SANDOZ 24.00 EGP (2.00/unit) -> ? strength differs OSPEN 1.5 MIU 12 F.C.TABS. SANDOZ 41.00 EGP (3.42/unit) -> ? strength differs MAIN TREATMENT - choose one 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Acute Pharyngitis - disease-level clinical article (acute-pharyngitis-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution Red flag: features of a life-threatening deep space infection (diphtheria, peritonsillar/retropharyngeal/submandibular abscess) demand immediate intervention before routine antibiotic treatment. Red flag: confirmed peritonsillar abscess or other suppurative complication requires hospital-level management (drainage, IV antimicrobials), not outpatient oral antibiotics. 4. PENICILLIN G BENZATHINE [1st line] Adult IM: 1.2 million units as a single dose - single dose Peds Infants, Children, and Adolescents: IM: ≤27 kg: 600,000 units as a single dose. >27 kg: 1.2 million units as a single dose. Source Egyptian National Drug Formulary - Antimicrobial 2023 Why Single-dose IM penicillin G benzathine eradicates Group A Streptococcus to prevent acute rheumatic fever. Caution Hypersensitivity to penicillin(s) or any component of the formulation Do not administer IV, intra-arterially, or SubQ. inadvertent IV administration has resulted in thrombosis, severe neurovascular damage, cardiac arrest, and death. Egypt HAYA BENZ-R 1.2 M.I.U. VIAL FOR I.M INJ. SEDICO > HAYA PHARM-EGYPT 5.06 EGP PENICID LA 1 200 000 UNITS VIAL CID 6.50 EGP BENZACILLIN 1.2 M.I.U.FOR I.M.INJ VIAL. EL NASR 7.00 EGP RETARPEN 1.2 M.I.U. VIAL SANDOZ > OCTO... 10.50 EGP LASTIPEN 1 200 000 IU VIAL MISR 12.00 EGP BENZABIOTIC 1.2 M.I.U. I.M. VIAL. SEDICO 16.00 EGP DEPO-PEN 1.2 MIU VIAL. MUP 25.00 EGP PENCILONG (PENCITARD) 1200000 I.U./VIAL NCPC NORTH BEST CO > ACDIMA INTE... 25.00 EGP 5. CEFALEXIN [2nd line] Adult 250-1000 mg every 6 hours, or 500 mg every 12 hours (maximum 4 g/day) Peds 25-50 mg/kg/day [child max 2000 mg] (ENDF: mild to moderate infection, 25 to 50 mg/kg/day divided every 6 or 12 hours; maximum daily dose 2,000 mg/day.) 3kg -> 75-150 mg/day 4kg -> 100-200 mg/day 5kg -> 125-250 mg/day 6kg -> 150-300 mg/day 7kg -> 175-350 mg/day 8kg -> 200-400 mg/day 9kg -> 225-450 mg/day 10kg -> 250-500 mg/day 11kg -> 275-550 mg/day 12kg -> 300-600 mg/day 13kg -> 325-650 mg/day 14kg -> 350-700 mg/day 15kg -> 375-750 mg/day 16kg -> 400-800 mg/day 17kg -> 425-850 mg/day 18kg -> 450-900 mg/day 19kg -> 475-950 mg/day 20kg -> 500-1000 mg/day 21kg -> 525-1050 mg/day 22kg -> 550-1100 mg/day 23kg -> 575-1150 mg/day 24kg -> 600-1200 mg/day 25kg -> 625-1250 mg/day 26kg -> 650-1300 mg/day 27kg -> 675-1350 mg/day 28kg -> 700-1400 mg/day 29kg -> 725-1450 mg/day 30kg -> 750-1500 mg/day 31kg -> 775-1550 mg/day 32kg -> 800-1600 mg/day 33kg -> 825-1650 mg/day 34kg -> 850-1700 mg/day 35kg -> 875-1750 mg/day 36kg -> 900-1800 mg/day 37kg -> 925-1850 mg/day 38kg -> 950-1900 mg/day 39kg -> 975-1950 mg/day 40kg -> 1000-2000 mg/day 41kg -> 1025-2000 mg/day (upper capped) 42kg -> 1050-2000 mg/day (upper capped) 43kg -> 1075-2000 mg/day (upper capped) 44kg -> 1100-2000 mg/day (upper capped) 45kg -> 1125-2000 mg/day (upper capped) 46kg -> 1150-2000 mg/day (upper capped) 47kg -> 1175-2000 mg/day (upper capped) 48kg -> 1200-2000 mg/day (upper capped) 49kg -> 1225-2000 mg/day (upper capped) 50kg -> 1250-2000 mg/day (upper capped) Source Egyptian National Drug Formulary - Antimicrobial 2023 (cephalexin monograph) Why A first-generation cephalosporin is the option the disease article gives for a non- anaphylactic penicillin reaction; the card previously jumped straight to a macrolide, which the article reserves for true IgE-mediated allergy. Caution Hypersensitivity to cephalexin, other cephalosporins, or any component of the formulation Tablets and oral suspension are not bioequivalent; do not substitute on a mg-per-mg basis. CrCl 30 to 59 mL/minute: maximum recommended daily dose 1,000 mg/day The ENDF cephalexin monograph gives no pharyngitis-specific course length - duration is not stated here because the dosing document does not state one. Egypt CEFLODIX 500 MG 12 CAPS. ARAB CAPS > P... 9.00 EGP (0.75/unit) CEPHALEXCID 500 MG 12 CAPS. CID 10.30 EGP (0.86/unit) CEPHOXIN 500MG 12 TAB. PHARCO B 10.50 EGP (0.88/unit) CEPHALEXIN 500MG 10 CAPS. ARAB DRUG COM... 10.10 EGP (1.01/unit) MEDICEFLEXIN 500 MG 20 CAPS. T3A PHARMA > ... 25.25 EGP (1.26/unit) CEPHALEXIN 500MG 12 CAPS B.P.2007 SHIFA MEDICAL PRODUCTS > O... 27.00 EGP (2.25/unit) KEFLEX 500 MG 12 CAPS. HIKMA PHARMA 58.00 EGP (4.83/unit) CEPOREX 500MG 12 TABS. GLAXO SMITHKLINE 69.00 EGP (5.75/unit) AMTHROST 125MG/5ML SUSP. 60ML SIGMA > SABAA 4.00 EGP -> ? strength differs, ? different route - not oral solid AMTHROST 250MG/5ML SUSP. 60ML SIGMA > SABAA 4.50 EGP -> ? strength differs, ? different route - not oral solid IF PENICILLIN-ALLERGIC - choose one 6. AZITHROMYCIN [2nd line] Adult 500 mg once daily on day 1, then 250 mg once daily for 4 days x 5 days Peds 12 mg/kg once daily (max 500 mg) on day 1, then 6 mg/kg once daily (max 250 mg) on days 2-5 AWaRe WATCH group - carries resistance cost. Egyptian EML 2025. Choice Alternatives, both for the penicillin-allergic patient. Azithromycin is the shorter course and the cheaper (14-126 EGP against 37-299). Source IDSA GAS Pharyngitis Guidelines 2012 Table 2 (with 2014 Erratum) Why Macrolide alternative for penicillin-allergic patients with streptococcal pharyngitis; kept second-line because macrolide resistance in group A Streptococcus runs higher than penicillin resistance. Caution Reserve for penicillin allergy due to macrolide resistance. Azithromycin carries a risk of QT prolongation, and GI upset is common. Egypt AZATRIBACT 500MG 3 CAPS. RIVA PHARMA S... 13.50 EGP (4.50/unit) GIGAZOCIN 500MG 5 CAPS. EGPI > PIONEER 27.50 EGP (5.50/unit) SYSTYMYCIN 500MG 3 CAPS. EGPI > NOVELL... 21.50 EGP (7.17/unit) AZITHROMASH 500 MG 3 F.C. TABS. MASH PREMIERE 48.00 EGP (16.00/unit) AZALIDE 500MG 3 CAPS. UP PHARMA 52.00 EGP (17.33/unit) AZROLID 500 MG 6 F.C.TABS. AMRIYA 126.00 EGP (21.00/unit) ZERAMERATE 500 MG EGPI > GAMMA ... 28.50 EGP DISTABCIN 500 MG 3 DISPERSIBLE TABS. EGPI 43.50 EGP ZITHRODOSE 100MG/5ML SUSP. 15ML EL-OBOUR > AV... 12.00 EGP -> ? strength differs, ? different route - not oral solid ZITHROPHATE 200MG/5ML SUSP. 15ML ORGANO PHARMA... 12.75 EGP -> ? strength differs, ? different route - not oral solid 7. CLARITHROMYCIN [2nd line] Adult 250 mg twice daily x 10 days Peds 15 mg/kg/day [child max 500 mg] (15 mg/kg/day divided BID (max 250 mg twice daily) for 10 days) 3kg -> 45 mg/day 4kg -> 60 mg/day 5kg -> 75 mg/day 6kg -> 90 mg/day 7kg -> 105 mg/day 8kg -> 120 mg/day 9kg -> 135 mg/day 10kg -> 150 mg/day 11kg -> 165 mg/day 12kg -> 180 mg/day 13kg -> 195 mg/day 14kg -> 210 mg/day 15kg -> 225 mg/day 16kg -> 240 mg/day 17kg -> 255 mg/day 18kg -> 270 mg/day 19kg -> 285 mg/day 20kg -> 300 mg/day 21kg -> 315 mg/day 22kg -> 330 mg/day 23kg -> 345 mg/day 24kg -> 360 mg/day 25kg -> 375 mg/day 26kg -> 390 mg/day 27kg -> 405 mg/day 28kg -> 420 mg/day 29kg -> 435 mg/day 30kg -> 450 mg/day 31kg -> 465 mg/day 32kg -> 480 mg/day 33kg -> 495 mg/day 34kg -> 500 mg/day (capped) 35kg -> 500 mg/day (capped) 36kg -> 500 mg/day (capped) 37kg -> 500 mg/day (capped) 38kg -> 500 mg/day (capped) 39kg -> 500 mg/day (capped) 40kg -> 500 mg/day (capped) 41kg -> 500 mg/day (capped) 42kg -> 500 mg/day (capped) 43kg -> 500 mg/day (capped) 44kg -> 500 mg/day (capped) 45kg -> 500 mg/day (capped) 46kg -> 500 mg/day (capped) 47kg -> 500 mg/day (capped) 48kg -> 500 mg/day (capped) 49kg -> 500 mg/day (capped) 50kg -> 500 mg/day (capped) AWaRe WATCH group - carries resistance cost. Egyptian EML 2025. Source IDSA GAS Pharyngitis Guidelines 2012 Table 2 Why Macrolide alternative to penicillin for penicillin-allergic patients with streptococcal pharyngitis, offered for the same resistance reasons as azithromycin. Caution Check drug interactions (CYP3A4 inhibitor). Take with or after food to reduce taste disturbance. Clarithromycin is an alternative in penicillin-allergic patients. Egypt KAPIFECTIN 500 MG 14 F.C.TAB. EVA PHARMA 37.00 EGP (2.64/unit) LARITHROCIN 500MG 14 F.C. TABS. GLOBAL NAPI P... 40.00 EGP (2.86/unit) CAPRIVEXIN 500MG S.R. 14 F.C. TAB. HORUS FOR PHARMACEUTICAL... 58.00 EGP (4.14/unit) CLARINOTION XL 500 MG 14 F.C.TABS. RAMEDA > NOTION PHARMA 83.00 EGP (5.93/unit) KLARIMIX 500 MG 14 TAB. SIGMA > OCTOB... 144.00 EGP (10.29/unit) INFECTOCURE 500 MG 14 F.C.TABS. EGPI 156.00 EGP (11.14/unit) KLACID 500 MG 14 F.C.TABS. KAHIRA > ABBO... 257.00 EGP (18.36/unit) KLACID XL 500 MG 14 F.C.TABS. KAHIRA > ABBO... 299.00 EGP (21.36/unit) KLARIMIX 125MG/5ML SUSP. 60ML SIGMA 36.00 EGP -> ? strength differs, ? different route - not oral solid KLARIMIX 250MG/5ML SUSP. 60ML SIGMA 52.00 EGP -> ? strength differs, ? different route - not oral solid PAIN AND FEVER - give alongside 8. PARACETAMOL [add-on - not a substitute] Adult 1000 mg every 6 hours as needed, maximum 4000 mg in 24 hours - while the throat hurts, usually 3-5 days Peds 15 mg/kg/dose [child max 500 mg] (15 mg/kg per dose every 6 hours - FOUR doses a day at most. Every 4 hours would reach 90 mg/kg/day against a 60 mg/kg/day ceiling. Under 1 month: 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg/day (MSF Essential Drugs 2024).) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Choice Sourced preference. NICE NG84 1.2.1 reads 'Consider paracetamol for pain or fever, or if preferred and suitable, ibuprofen' - paracetamol is named first. Source MSF Essential Drugs 2024 - paracetamol (oral) Why The sore throat is what the patient came in with, and it needs treating whether or not an antibiotic is written. The dose here is the drug label's. NICE NG84 covers antibiotic prescribing for acute sore throat and recommends paracetamol or ibuprofen for the pain - that comes from a secondary summary rather than the guideline text, so it is stated as background and the dose rests on the label. Caution First choice for pain and fever here - no stomach or asthma risk. On pregnancy the source is brief but definite: MSF Essential Drugs 2024 records no contra-indication in pregnancy. Check every other product the patient is taking for paracetamol. Cold and flu sachets are the usual way an accidental overdose happens. Reduce the maximum to 3000 mg/day in an adult under 50 kg, malnourished, or with liver disease. 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 9. IBUPROFEN [add-on - not a substitute] Adult 400 mg three times daily with or after food, maximum 1200 mg in 24 hours - while the throat hurts, usually 3-5 days Peds 5-10 mg/kg/dose [child max 400 mg] (5-10 mg/kg per dose every 8 hours - THREE doses a day, not four. Three doses of 10 mg/kg is already 30 mg/kg/day and the label's figure for pain and fever is 20. Never more than 400 mg in one dose and never more than 1200 mg in a day, whatever the weight calculation says.) 3kg -> 15-30 mg/dose 4kg -> 20-40 mg/dose 5kg -> 25-50 mg/dose 6kg -> 30-60 mg/dose 7kg -> 35-70 mg/dose 8kg -> 40-80 mg/dose 9kg -> 45-90 mg/dose 10kg -> 50-100 mg/dose 11kg -> 55-110 mg/dose 12kg -> 60-120 mg/dose 13kg -> 65-130 mg/dose 14kg -> 70-140 mg/dose 15kg -> 75-150 mg/dose 16kg -> 80-160 mg/dose 17kg -> 85-170 mg/dose 18kg -> 90-180 mg/dose 19kg -> 95-190 mg/dose 20kg -> 100-200 mg/dose 21kg -> 105-210 mg/dose 22kg -> 110-220 mg/dose 23kg -> 115-230 mg/dose 24kg -> 120-240 mg/dose 25kg -> 125-250 mg/dose 26kg -> 130-260 mg/dose 27kg -> 135-270 mg/dose 28kg -> 140-280 mg/dose 29kg -> 145-290 mg/dose 30kg -> 150-300 mg/dose 31kg -> 155-310 mg/dose 32kg -> 160-320 mg/dose 33kg -> 165-330 mg/dose 34kg -> 170-340 mg/dose 35kg -> 175-350 mg/dose 36kg -> 180-360 mg/dose 37kg -> 185-370 mg/dose 38kg -> 190-380 mg/dose 39kg -> 195-390 mg/dose 40kg -> 200-400 mg/dose 41kg -> 205-400 mg/dose (upper capped) 42kg -> 210-400 mg/dose (upper capped) 43kg -> 215-400 mg/dose (upper capped) 44kg -> 220-400 mg/dose (upper capped) 45kg -> 225-400 mg/dose (upper capped) 46kg -> 230-400 mg/dose (upper capped) 47kg -> 235-400 mg/dose (upper capped) 48kg -> 240-400 mg/dose (upper capped) 49kg -> 245-400 mg/dose (upper capped) 50kg -> 250-400 mg/dose (upper capped) Source StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) Why The sore throat is what the patient came in with, and it needs treating whether or not an antibiotic is written. The dose here is the drug label's. NICE NG84 covers antibiotic prescribing for acute sore throat and recommends paracetamol or ibuprofen for the pain - that comes from a secondary summary rather than the guideline text, so it is stated as background and the dose rests on the label. Caution The weight card is a starting point, not a licence. Four doses a day of 10 mg/kg is double the label's daily figure for pain and fever - space them 8 hours apart and stop at three. Better than paracetamol for the swelling as well as the pain, but not for everyone. Avoid in asthma, active peptic ulcer, renal impairment, and the third trimester. Do not give an NSAID in suspected chickenpox or dengue - both raise serious risk, and both can present with fever and a sore throat. With food. Not above 1200 mg a day without a reason to go higher. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)