{ "schema_version": 1, "kind": "condition", "id": "ascites", "name": "Ascites", "category": "chronic", "sources": "Ascites - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK470482/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DS51.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care", "review_status": "reviewed", "verified_against": "No dose - referral pathway, no medicine given in primary care · Egyptian National Drug Formulary - Cardiovascular · Ascites - disease-level clinical article (ascites-clinical.txt) · Egyptian National Drug Formulary - Cardiovascular 2024 (furosemide monograph, edema of hepatic cirrhosis / ascites) · Ascites - disease-level clinical article (ascites-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 214, "generic": "No drug therapy in primary care (Referral & Advice)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Fluid accumulation in the abdominal cavity, most often from cirrhosis in Egypt given the country's high hepatitis-C and chronic liver disease burden; a GP can start diuretics for a known cirrhotic cause but should refer new-onset or complicated ascites for work-up of the underlying cause.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Fluid accumulation in the abdominal cavity, most often from cirrhosis in Egypt given the country's high hepatitis-C and chronic liver disease burden; a GP can start diuretics for a known cirrhotic cause but should refer new-onset or complicated ascites for work-up of the underlying cause.", "cautions": [ "No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.", "RED FLAG - Fever, abdominal tenderness, and confusion in a patient with ascites can signal spontaneous bacterial peritonitis and need urgent evaluation.", "RED FLAG - Patients with ascites (usually from liver disease) should avoid hepatotoxic medications and OTC drugs that can worsen liver injury - NSAIDs in particular, since they are what a GP might otherwise reach for.", "RED FLAG - Anyone started on diuretics for ascites needs monitoring of weight, electrolytes, renal function (BUN/creatinine), and urinary sodium.", "RED FLAG - New-onset ascites without a known cause needs investigation, and signs of hepatic encephalopathy or gastrointestinal bleeding need urgent hospital referral." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.", "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": "ascites" }, { "id": 215, "generic": "Spironolactone", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "Initial: 100 mg once daily; adjust every 3 to 5 days based on response. Maximum dose: 400 mg once daily.", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Cardiovascular", "rationale": "First-line aldosterone antagonist diuretic for managing fluid accumulation in cirrhotic ascites.", "cautions": [ "Hyperkalemia.", "Use with caution in hepatic impairment; minor alterations of fluid and electrolyte balance may precipitate hepatic coma.", "Any renal disease associated with severe renal impairment (CrCl less than 10 mL/minute) or acute renal failure" ], "peds_mgkg_low": 1.0, "peds_mgkg_high": 3.0, "peds_max_mg": 400.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Children (edema/diuresis): Initial 1 to 3 mg/kg/day divided every 6 to 24 hours; titrate as needed; maximum 4 to 6 mg/kg/day in divided doses every 6 to 12 hours or 400 mg/day, whichever is less.", "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": 10, "high_mg": 30, "capped": false }, { "weight_kg": 20, "low_mg": 20, "high_mg": 60, "capped": false }, { "weight_kg": 30, "low_mg": 30, "high_mg": 90, "capped": false }, { "weight_kg": 40, "low_mg": 40, "high_mg": 120, "capped": false } ], "brands": [ { "trade_name": "EPILACTONE 100 MG 10 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 7.0, "pack_count": 10, "unit_price": 0.7, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPIRONOLACTONE (DELTA) 100MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > AL DELTA PHARMACEUTICALS TRADING CO.", "price_egp": 16.8, "pack_count": 20, "unit_price": 0.84, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POTASAVE 100 MG 20 TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 21.0, "pack_count": 20, "unit_price": 1.05, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALDACTONE 100MG 20 TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > SEARLE-CANADA", "price_egp": 22.0, "pack_count": 20, "unit_price": 1.1, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POTASPIRONO 100 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 90.0, "pack_count": 20, "unit_price": 4.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPECTONE 100 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 90.0, "pack_count": 20, "unit_price": 4.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "ascites" }, { "id": 216, "generic": "Furosemide", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 40.0, "adult_dose": "20 to 50 mg orally once daily, then titrated to effect. The disease article's cirrhotic-ascites pairing is spironolactone 100 mg with furosemide 40 mg, both once daily, keeping the 100:40 ratio when titrating", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Cardiovascular 2024 (furosemide monograph, edema of hepatic cirrhosis / ascites)", "rationale": "The disease article's first-line regimen for high-SAAG ascites is sodium restriction plus once-daily spironolactone AND furosemide in a 100:40 ratio. The card carried spironolactone alone, which is half the regimen. The ENDF names cirrhosis with ascites in the furosemide indication itself.", "cautions": [ "Hypersensitivity to sulfonamide-derived drugs", "Anuria; hepatic disease", "Severe electrolyte depletion until the condition improves or is corrected" ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The ENDF's cirrhotic-ascites dosing is stated for adults; no paediatric figure is given for this indication.", "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": "ODEMENT 40MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 1.3, "pack_count": 10, "unit_price": 0.13, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FRUZEX 40MG 12 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 3.25, "pack_count": 12, "unit_price": 0.27, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUROSEMIDE 40MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 7.5, "pack_count": 20, "unit_price": 0.38, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FURORETIC 40 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY > VETOPHARM", "price_egp": 14.25, "pack_count": 30, "unit_price": 0.47, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAFUREX 40MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 9.5, "pack_count": 20, "unit_price": 0.47, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SALEX 40 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 10.0, "pack_count": 20, "unit_price": 0.5, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUROSEMIDE-ALEX 40MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 19.0, "pack_count": 20, "unit_price": 0.95, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LASIX 40 MG 24 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 30.0, "pack_count": 24, "unit_price": 1.25, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GENESEMIDE 20MG/5ML SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > VODACHEM", "price_egp": 56.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "ascites" } ] }