{ "schema_version": 1, "kind": "condition", "id": "cardiomyopathy", "name": "Cardiomyopathy", "category": "chronic", "sources": "Hypertrophic Cardiomyopathy - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK430788/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class KD72.02 - condition scope only, no dose · ESC Guidelines for Heart Failure 2021 · Egyptian National Drug Formulary - Cardiovascular 2024 (carvedilol monograph) · Egyptian National Drug Formulary - Cardiovascular 2024 (spironolactone monograph) · UK eMC Furosemide 20 mg Tablets SmPC, product id 14911 · Cardiomyopathy - disease-level clinical article (cardiomyopathy-clinical.txt)", "review_status": "reviewed", "verified_against": "Cardiomyopathy - disease-level clinical article (cardiomyopathy-clinical.txt) · ESC Guidelines for Heart Failure 2021 · Egyptian National Drug Formulary - Cardiovascular 2024 (carvedilol monograph) · Egyptian National Drug Formulary - Cardiovascular 2024 (spironolactone monograph) · UK eMC Furosemide 20 mg Tablets SmPC, product id 14911", "verified_date": "2026-09", "treatments": [ { "id": 364, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "A structural heart-muscle disease needing echocardiography and cardiology follow-up; a GP may co-manage heart-failure symptoms with standard medication while arranging specialist review.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "A structural heart-muscle disease needing echocardiography and cardiology follow-up; a GP may co-manage heart-failure symptoms with standard medication while arranging specialist review.", "cautions": [ "RED FLAG - Sustained ventricular tachycardia / palpitations: assess urgently and refer.", "Syncope, family history of sudden cardiac death, signs of decompensated heart failure, arrhythmia.", "Referral for echocardiography and cardiology follow-up is the pathway. Heart-failure medicines treat the syndrome alongside it; disease-specific therapy is decided by the service referred to.", "RED FLAG - Workup for reversible secondary causes (thyroid, HIV, iron overload, substance abuse) must be pursued prior to diagnosing idiopathic DCM.", "RED FLAG - Patients with DCM refractory to maximum medical therapy require evaluation for advanced therapies such as LVAD or cardiac transplantation." ], "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. Heart-failure medicines for a child are paediatric cardiology decisions, not primary-care ones.", "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": "cardiomyopathy" }, { "id": 365, "generic": "Enalapril", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "2.5 mg BID initially, titrate to target 10-20 mg BID", "adult_duration": "long-term", "dose_source": "ESC Guidelines for Heart Failure 2021", "rationale": "Dilated cardiomyopathy with reduced ejection fraction is treated as HFrEF. The disease article recommends an ACE inhibitor or ARB in these patients (cardiomyopathy-clinical.txt); the dose is the one carried on the Heart failure card.", "cautions": [ "CONTRAINDICATED in pregnancy.", "Check serum creatinine and potassium within 1-2 weeks of initiation.", "Caution in renal artery stenosis or eGFR < 30 mL/min.", "If a RAAS agent cannot be used at all, the article offers a combination that is not listed above: \"For patients with HFrEF and intolerance to RAASI or in whom RAASI is contraindicated due to renal insufficiency, the use of a combination of hydralazine and nitrate might be effective.\"", "Hydralazine is not offered for heart failure here. The Egyptian formulary indicates it for \"Hypertension, chronic: Management of moderate to severe hypertension.\" only, states no heart-failure dose anywhere, and contraindicates it outright: \"Cardiovascular disease: Use is contraindicated in patients with coronary artery disease (CAD).\" - adding that \"myocardial stimulation produced by hydralazine can cause anginal attacks and electrocardiogram (ECG) changes of myocardial ischemia; has been implicated in the production of myocardial infarction.\" Ischaemic heart disease is the commonest cause of heart failure, so that contraindication is not a rare edge case.", "An SGLT2 inhibitor and an ARNI are also part of modern HFrEF therapy. The cardiomyopathy article does not name them; the Heart failure card carries both with their doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric cardiology management required", "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": "ACAPRIL 5 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 6.75, "pack_count": 10, "unit_price": 0.68, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRESSLIGHT 5 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 7.0, "pack_count": 10, "unit_price": 0.7, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RENITEC 5MG 28 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > MERCK SHARP & DOHME", "price_egp": 30.6, "pack_count": 28, "unit_price": 1.09, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cardiomyopathy" }, { "id": 366, "generic": "Bisoprolol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 2.5, "adult_dose": "1.25 mg once daily, titrate slowly (doubling every 2+ weeks) to target 10 mg once daily", "adult_duration": "long-term", "dose_source": "ESC Guidelines for Heart Failure 2021", "rationale": "The disease article recommends beta-blockade for all patients with reduced ejection fraction and no contraindication, naming bisoprolol (cardiomyopathy-clinical.txt); the dose is the one carried on the Heart failure card.", "cautions": [ "CONTRAINDICATED in acute decompensated heart failure or cardiogenic shock.", "Avoid in severe asthma or second/third-degree AV block.", "Monitor blood pressure, heart rate, and fluid status during titration.", "An SGLT2 inhibitor and an ARNI are also part of modern HFrEF therapy. The cardiomyopathy article does not name them; the Heart failure card carries both with their doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric cardiology management required", "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": "BISTOL 2.5MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 28.0, "pack_count": 20, "unit_price": 1.4, "strength_mg": 2.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BISOLOCK 2.5 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 48.0, "pack_count": 30, "unit_price": 1.6, "strength_mg": 2.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BISOCARD 2.5 MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 51.0, "pack_count": 30, "unit_price": 1.7, "strength_mg": 2.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NORMOCARD 2.5 MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARMA CURE", "price_egp": 51.0, "pack_count": 30, "unit_price": 1.7, "strength_mg": 2.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CONCOR COR 2.5 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN > MERCK KGAA F.R.GERMANY", "price_egp": 60.0, "pack_count": 30, "unit_price": 2.0, "strength_mg": 2.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cardiomyopathy" }, { "id": 367, "generic": "Carvedilol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 6.25, "adult_dose": "3.125 mg twice daily initially, doubled at intervals of at least 2 weeks as tolerated. Maximum 25 mg twice daily if 85 kg or less or in severe heart failure; 50 mg twice daily if over 85 kg", "adult_duration": "Long-term", "dose_source": "Egyptian National Drug Formulary - Cardiovascular 2024 (carvedilol monograph)", "rationale": "The disease article recommends beta-blockade for all patients with reduced ejection fraction and no contraindication, naming carvedilol (cardiomyopathy-clinical.txt); the dose is the one carried on the Heart failure card.", "cautions": [ "Use one beta-blocker only - carvedilol and bisoprolol are alternatives to each other, never given together.", "CONTRAINDICATED in bronchial asthma, acute or decompensated heart failure requiring intravenous inotropes, second- or third-degree AV block, severe bradycardia without a pacemaker, sick sinus syndrome, cardiogenic shock and severe hepatic disease.", "Expect transient worsening of symptoms and hypotension in the first 2 weeks - warn the patient, do not abandon the drug, and increase the diuretic temporarily if needed.", "Never start during an acute decompensation and never stop abruptly.", "Avoid in severe hepatic impairment; moderate impairment may need a dose reduction.", "Masks the adrenergic warning signs of hypoglycaemia in an insulin-treated patient.", "An SGLT2 inhibitor and an ARNI are also part of modern HFrEF therapy. The cardiomyopathy article does not name them; the Heart failure card carries both with their doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Effectiveness in patients under 18 years has not been established.", "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": "VIDILOL 6.25 MG 10 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 3.5, "pack_count": 10, "unit_price": 0.35, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARLOL-V 6.25MG 30 F.C.TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 19.5, "pack_count": 30, "unit_price": 0.65, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KARVEX 6.25MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 19.5, "pack_count": 30, "unit_price": 0.65, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARDILOL 6.25MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 39.0, "pack_count": 30, "unit_price": 1.3, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARVID 6.25MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARVID 6.25MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 45.0, "pack_count": 30, "unit_price": 1.5, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DILATROL 6.25MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 48.0, "pack_count": 30, "unit_price": 1.6, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARVIPRESS 6.25MG 20 SCORED TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 13.0, "pack_count": null, "unit_price": null, "strength_mg": 6.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cardiomyopathy" }, { "id": 368, "generic": "Spironolactone", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 25.0, "adult_dose": "12.5-25 mg once daily, adjusted every 4 weeks if potassium and kidney function are stable, to a maximum of 50 mg/day", "adult_duration": "long-term", "dose_source": "Egyptian National Drug Formulary - Cardiovascular 2024 (spironolactone monograph)", "rationale": "The disease article recommends aldosterone receptor blockade with spironolactone in NYHA class II-IV with systolic dysfunction (cardiomyopathy-clinical.txt); the dose is the one carried on the Heart failure card.", "cautions": [ "Given WITH the beta-blocker, the ACE inhibitor and the SGLT2 inhibitor, not instead of any of them - NICE offers all four.", "Check potassium and creatinine before starting, at 1 and 4 weeks after each dose change, then regularly. Stop if potassium exceeds 6.0 mmol/L.", "Avoid the combination of spironolactone with an ACE inhibitor plus a potassium supplement or a potassium-containing salt substitute - that is the classic route to a fatal potassium.", "Painful gynaecomastia in men is common and is the usual reason for stopping.", "The heart failure dose is 25 mg. The ascites dose is 100 mg. They are not interchangeable.", "An SGLT2 inhibitor and an ARNI are also part of modern HFrEF therapy. The cardiomyopathy article does not name them; the Heart failure card carries both with their doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist paediatric cardiology management. The formulary's paediatric spironolactone doses are for oedema, hypertension and primary aldosteronism, not for HFrEF.", "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": "SPIRONOLACTONE (DELTA) 25MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > AL DELTA PHARMACEUTICALS TRADING CO.", "price_egp": 3.0, "pack_count": 10, "unit_price": 0.3, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPILACTONE 25MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 4.0, "pack_count": 10, "unit_price": 0.4, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POTASAVE 25 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 11.0, "pack_count": 20, "unit_price": 0.55, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALDACTONE 25MG 20 TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > SEARLE-CANADA", "price_egp": 18.0, "pack_count": 20, "unit_price": 0.9, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POTASPIRONO 25 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 36.0, "pack_count": 20, "unit_price": 1.8, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPECTONE 25 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 36.0, "pack_count": 20, "unit_price": 1.8, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cardiomyopathy" }, { "id": 369, "generic": "Furosemide", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 40.0, "adult_dose": "20-40 mg once daily in the morning (or divided BID), titrate based on fluid overload and symptom response", "adult_duration": "long-term", "dose_source": "UK eMC Furosemide 20 mg Tablets SmPC, product id 14911", "rationale": "The disease article uses loop diuretics for hypervolaemia, and oral diuretics to hold a euvolaemic state in chronic stable disease (cardiomyopathy-clinical.txt); the dose is the one carried on the Heart failure card.", "cautions": [ "Monitor electrolytes (potassium, sodium) and renal function regularly.", "Caution in gout or severe hepatic impairment.", "There is a risk of hypotension and hypovolaemia.", "An SGLT2 inhibitor and an ARNI are also part of modern HFrEF therapy. The cardiomyopathy article does not name them; the Heart failure card carries both with their doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric cardiology management required", "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": "cardiomyopathy" } ] }