# Calcaneal spur

- Category: acute
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral)
- Verified date: 2026-08

## Verified against

- MSF Essential Drugs 2024 - paracetamol (oral)
- SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc

## Treatment metadata

- Paracetamol — 500 mg — oral.solid
- Ibuprofen — 400 mg — oral.solid

## Complete treatment card

```text
CALCANEAL SPUR
Sources: Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 -
         paracetamol (oral)
Review status: REVIEWED against 2 sources listed above  (2026-08)

1. PARACETAMOL                                            [1st line]
   Adult    1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever
   Peds     15 mg/kg/dose  [child max 500 mg]
            (Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily,
            maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3
            or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table
            gives one 500 mg tablet three times daily from 30 kg to under 50
            kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total
            still applies.)
            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)
   Source   MSF Essential Drugs 2024 - paracetamol (oral)
   Why      Standard analgesic dosing regardless of the cause of the heel pain.
   Caution  Pain persisting despite conservative treatment, or signs suggesting infection or a
            different cause of heel pain — warrants referral.
            Simple first-line analgesic for heel pain.
            Do not exceed 4 g in 24 hours.
            Persistent pain despite conservative treatment, or signs of infection, warrants
            referral.
            Administer with caution to patients with hepatic impairment.
   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

2. IBUPROFEN                                              [2nd line]
   Adult    200-400 mg PO Q6-8H PRN, max 1200 mg/day.
   Peds     Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension
            labels).
   Source   SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc
   Why      Standard NSAID analgesic dose for heel pain; the much higher pericarditis anti-
            inflammatory regimen is unnecessary here.
   Caution  Use alongside stretching, footwear changes, and a heel cushion/orthotic, which remain
            the mainstay of treatment.
            Avoid in NSAID-exacerbated asthma, active peptic ulcer disease, or renal impairment.
            Take with or after food.
            Severe hepatic failure, renal failure and heart failure (NYHA Class IV) (see section
            4.4, Special warnings and precautions for use).
            Last trimester of pregnancy (see section 4.6 Pregnancy and lactation).
   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.
```

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