{ "schema_version": 1, "kind": "condition", "id": "coeliac-disease-referral", "name": "Coeliac Disease (Referral & Supportive Care)", "category": "chronic", "sources": "ESPGHAN Guidelines for Diagnosis of Coeliac Disease 2020 · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph) · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (ferrous fumarate monograph)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (ferrous fumarate monograph) · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph)", "verified_date": "2026-08", "treatments": [ { "id": 466, "generic": "Ferrous fumarate", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 200.0, "adult_dose": "200 mg once or twice a day", "adult_duration": "3-6 months until iron stores replenished", "dose_source": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (ferrous fumarate monograph)", "rationale": "Iron and folate are both malabsorbed in untreated coeliac disease, so the folic acid in most Egyptian iron tablets is an advantage here rather than something to work around. Dose by elemental iron: a 200 mg ferrous fumarate tablet is 65.57 mg.", "cautions": [ "Definitive treatment is strict lifelong gluten-free diet.", "Refer to gastroenterologist for duodenal biopsy or serological confirmation.", "Do not start gluten-free diet before diagnostic serology/biopsy.", "Children under 12 take the syrup: 0.5 mL/kg/day split into two or three doses, never above 20 mL a day. A premature infant under 3 kg gets 0.5 mL a day.", "The formulary gives 200 mg two to three times daily. The dose here deliberately sits lower - once daily or alternate days - because a smaller, less frequent dose is absorbed as well and tolerated far better.", "Most iron tablets in Egypt come with folic acid in them, though not all - check the pack. Folate corrects the blood picture of B12 deficiency while the neurological damage carries on - check B12 before starting if the anaemia is macrocytic, mixed, or unexplained.", "The pack a pharmacy hands over is a combination rather than plain iron - besides folic acid, many Egyptian iron products add vitamin C, and some add zinc or B vitamins. A combination is an acceptable way to give oral iron: the formulary's ferrous fumarate monograph lists the dosage forms as a 200 mg tablet and a 140 mg/5 mL syrup, then adds combination products to that list, and states the adult dose in elemental iron (100 to 200 mg elemental iron daily). The vitamin C is wanted rather than merely tolerated - 200 to 500 mg alongside oral iron is recommended to enhance its absorption. Dose by the elemental iron the pack states, not by tablet weight and not by the other ingredients. The Egyptian register does not record elemental iron content for most of these products, so the carton has to be read." ], "peds_mgkg_low": 3.0, "peds_mgkg_high": 6.0, "peds_max_mg": 180.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Divided into 2-3 doses daily; elemental iron basis. Ceiling of 180 mg is the formulary maximum for a child: 20 mL/day of the 140 mg/5 mL syrup, which is 45 mg elemental iron per 5 mL. This is deliberately above the 130 mg an adult gets here: a growing child needs more elemental iron per kilogram, and modern adult practice is lower and less frequent dosing than the formulary allows. It is not an inversion to correct.", "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": 30, "high_mg": 60, "capped": false }, { "weight_kg": 20, "low_mg": 60, "high_mg": 120, "capped": false }, { "weight_kg": 30, "low_mg": 90, "high_mg": 180, "capped": false }, { "weight_kg": 40, "low_mg": 120, "high_mg": 180, "capped": true } ], "brands": [ { "trade_name": "FERROL 10 F.C. TABLET", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 2.0, "pack_count": 10, "unit_price": 0.2, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "folic acid" }, { "trade_name": "FOLIFER 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 7.2, "pack_count": 30, "unit_price": 0.24, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "folic acid" }, { "trade_name": "FERROZINC-C 24 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAFE PHARMA > PHARCO", "price_egp": 7.5, "pack_count": 24, "unit_price": 0.31, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "vitamin c, zinc" }, { "trade_name": "IROFOL 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTICARE", "price_egp": 40.5, "pack_count": 30, "unit_price": 1.35, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "copper, folic acid, pyridoxine, vitamin b12, zinc" }, { "trade_name": "HAEMACTIN 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA GRAND PHARMA > NOBEL PHARM. INDUSTRIES", "price_egp": 150.0, "pack_count": 30, "unit_price": 5.0, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "folic acid, vitamin b12" }, { "trade_name": "TESLAGLOBIN 20 CAP", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DAWA EGYPT INTERNATIONAL > TESLA", "price_egp": 140.0, "pack_count": 20, "unit_price": 7.0, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "b12, b6, copper, folic acid, zinc" }, { "trade_name": "CHEMARED CAPSULE", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARMA ZAD > CHEMA HERB", "price_egp": 195.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "calcium, methyl cobolamine, pyridoxine" }, { "trade_name": "FERRONIL 125MG/5ML SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "coeliac-disease-referral" }, { "id": 467, "generic": "Folic acid", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 mg once daily", "adult_duration": "4 months", "dose_source": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph)", "rationale": "Adjunct supplement that corrects the folate malabsorption caused by duodenal villous atrophy in coeliac disease; it does not replace the gluten-free diet, which is the underlying treatment.", "cautions": [ "Corrects folate malabsorption secondary to duodenal villous atrophy.", "Exclude Vitamin B12 deficiency before giving high-dose folic acid.", "Re-evaluate mucosal healing if anaemia fails to resolve on gluten-free diet." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children: 2.5-5 mg once 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": null, "brands": [ { "trade_name": "FOLIC ACID (EL NILE) 5 MG 50 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 26.25, "pack_count": 50, "unit_price": 0.53, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FOLIC ACID (MEMPHIS) 5 MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 15.75, "pack_count": 30, "unit_price": 0.53, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FOLICINAD 5 MG 50 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INAD PHARMA", "price_egp": 50.0, "pack_count": 50, "unit_price": 1.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FOLIC ACID (EIPICO) 5 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "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": "FOLIC ACID (EL NILE) 5 MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 36.0, "pack_count": 30, "unit_price": 1.2, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FOLIRAQ 5000 MCG 30 CAPSULES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HP PHARMA", "price_egp": 45.0, "pack_count": 30, "unit_price": 1.5, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FOLIDDOX 400 MCG / 5 ML LIQUID 150 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MADDOX PHARMA", "price_egp": 150.0, "pack_count": null, "unit_price": null, "strength_mg": 0.4, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "coeliac-disease-referral" } ] }