{ "schema_version": 1, "kind": "condition", "id": "acute-rheumatic-fever-without-carditis", "name": "Acute rheumatic fever without carditis", "category": "acute", "sources": "MSF Essential Drugs 2024 (ibuprofen oral monograph) · 2015 ESC Guidelines for the diagnosis and management of pericardial diseases, European Society of Cardiology (Eur Heart J 2015;36:2921-64) · DailyMed Ibuprofen Tablet Package Insert (DailyMed, NLM) · Acute rheumatic fever without carditis - disease-level clinical article (acute-rheumatic-fever-without-carditis-full.txt) · Acute Rheumatic Fever - disease-level clinical article (acute-rheumatic-fever-without-carditis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph)", "review_status": "reviewed", "verified_against": "MSF Essential Drugs 2024 (ibuprofen oral monograph) · DailyMed Ibuprofen Tablet Package Insert (DailyMed, NLM) · Acute Rheumatic Fever - disease-level clinical article (acute-rheumatic-fever-without-carditis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 · Acute rheumatic fever without carditis - disease-level clinical article (acute-rheumatic-fever-without-carditis-full.txt) · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph)", "verified_date": "2026-08", "treatments": [ { "id": 93, "generic": "Ibuprofen", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "200 to 400 mg three to four times daily, with or after food. Never more than 1200 mg in a day.", "adult_duration": null, "dose_source": "MSF Essential Drugs 2024 (ibuprofen oral monograph)", "rationale": "Rheumatic fever polyarthritis needs sustained anti-inflammatory dosing to control joint inflammation, the same scale used for pericarditis, rather than a low symptomatic-relief dose.", "cautions": [ "Any new murmur, chest pain, or breathlessness during the illness means carditis may be developing and referral is needed.", "This is genuine anti-inflammatory dosing for migratory polyarthritis, not a symptomatic pain-relief dose - do not substitute a low PRN dose.", "Gastroprotection (e.g. a PPI) should be given alongside this dose.", "Any new murmur, chest pain, or breathlessness during treatment suggests carditis is developing - refer immediately; this course does not replace the secondary antibiotic prophylaxis, which must be arranged separately.", "Taper rather than stop abruptly as symptoms and inflammatory markers settle.", "Do not use in children under 12 years of age." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 10.0, "peds_max_mg": 400.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily (max. 30 mg/kg daily).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 50, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 400, "capped": false } ], "brands": [ { "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-rheumatic-fever-without-carditis" }, { "id": 94, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Acute Rheumatic Fever - disease-level clinical article (acute-rheumatic-fever-without-carditis-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Initial management of acute rheumatic fever should be as an inpatient, including cases without carditis at diagnosis, since carditis can be subclinical and detected only by echocardiography - an outpatient ibuprofen course alone is not enough." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "acute-rheumatic-fever-without-carditis" }, { "id": 95, "generic": "Penicillin G benzathine", "line": 1, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "IM: 1.2 million units once every 21 to 28 days", "adult_duration": "5 years or until age 21", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Intramuscular penicillin G benzathine secondary prophylaxis prevents recurrent Group A streptococcal infection and recurrent attacks of rheumatic fever.", "cautions": [ "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "≤27 kg: 600,000 units every 3 to 4 weeks. >27 kg: 1.2 million units every 3 to 4 weeks.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "HAYA BENZ-R 1.2 M.I.U. VIAL FOR I.M INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO > HAYA PHARM-EGYPT", "price_egp": 5.06, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENICID LA 1 200 000 UNITS VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 6.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BENZACILLIN 1.2 M.I.U.FOR I.M.INJ VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RETARPEN 1.2 M.I.U. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANDOZ > OCTOBER PHARMA", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LASTIPEN 1 200 000 IU VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BENZABIOTIC 1.2 M.I.U. I.M. VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 16.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPO-PEN 1.2 MIU VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 25.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENCILONG (PENCITARD) 1200000 I.U./VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NCPC NORTH BEST CO > ACDIMA INTERNATIONAL TRADING", "price_egp": 25.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "acute-rheumatic-fever-without-carditis" }, { "id": 96, "generic": "Acetylsalicylic acid", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "60 to 100 mg/kg/day in divided doses until symptom resolution", "adult_duration": null, "dose_source": "Acute rheumatic fever without carditis - disease-level clinical article (acute-rheumatic-fever-without-carditis-clinical.txt)", "rationale": "Traditional anti-inflammatory therapy for arthritis in acute rheumatic fever.", "cautions": [ "Risk of Reye syndrome in children and adolescents; requires monitoring of salicylate levels and GI tolerance.", "Gastroprotection recommended during high-dose therapy." ], "peds_mgkg_low": 60.0, "peds_mgkg_high": 100.0, "peds_max_mg": null, "peds_basis": "day", "peds_unit": "mg", "peds_note": "60 to 100 mg/kg/day in divided doses until symptom resolution", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 600, "high_mg": 1000, "capped": false }, { "weight_kg": 20, "low_mg": 1200, "high_mg": 2000, "capped": false }, { "weight_kg": 30, "low_mg": 1800, "high_mg": 3000, "capped": false }, { "weight_kg": 40, "low_mg": 2400, "high_mg": 4000, "capped": false } ], "brands": [ { "trade_name": "ASPOCID 300 MG 200 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 80.0, "pack_count": 200, "unit_price": 0.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AGGREX 75MG 60 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 33.0, "pack_count": 60, "unit_price": 0.55, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPOCID 75MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 22.0, "pack_count": 20, "unit_price": 1.1, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ECOPRIN 325MG 10 ENTERIC COATED TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 325.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIVO 75 MG 30 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPRICARLO 81MG 30 CHEWABLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 45.0, "pack_count": null, "unit_price": null, "strength_mg": 81.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPIRIN PROTECT 100 MG 30 GASTRO-RESISTANT TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > BAYER BITTERFELD GMBH-GERMANY", "price_egp": 78.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "JUSPRIN 81 MG 60 E.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > JULPHAR", "price_egp": 81.0, "pack_count": null, "unit_price": null, "strength_mg": 81.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "acute-rheumatic-fever-without-carditis" }, { "id": 97, "generic": "Prednisolone", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 to 60 mg/day as a single daily dose or in 2 to 4 divided doses, tapered", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph)", "rationale": "The disease article gives a glucocorticoid as the option when the patient cannot take aspirin or an NSAID; the card previously offered only those two.", "cautions": [ "Abrupt withdrawal is not recommended, particularly with doses of 40 mg or more or 3 weeks of treatment or more.", "The dose should be gradually decreased to the lowest dose that maintains an adequate clinical response.", "No paediatric dose is stated in the ENDF for this use, and this is a predominantly paediatric condition - refer rather than extrapolate." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The ENDF prednisolone monograph gives no paediatric figure for this indication, so none is stated here. Acute rheumatic fever is largely a childhood disease - refer.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "HOSTACORTIN H 5MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.0, "pack_count": 30, "unit_price": 0.4, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDILONE 5MG 10 TAB. (25 STRIPS PACK)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 250.0, "pack_count": 10, "unit_price": 25.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPICOPRED 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 69.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE-EVA 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 79.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISPRELONE-OD 5 MG 30 ORODISPERSABLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SOLUPRED ORO 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI WINTHROP > SANOFI", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACETASEE 1% EYE DROPS (SUSP.) 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNIS 5MG/5ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 9.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-rheumatic-fever-without-carditis" } ] }