{ "schema_version": 1, "kind": "condition", "id": "copd", "name": "Chronic obstructive pulmonary disease (COPD)", "category": "chronic", "sources": "Egyptian National Drug Formulary - Respiratory System 2026 · Egyptian National Drug Formulary - Respiratory 2026 (acetylcysteine monograph) · Egyptian National Drug Formulary - Respiratory 2026 (salbutamol monograph) · GOLD 2025 Report - Global Strategy for the Diagnosis, Management, and Prevention of COPD, chapter 5 (management of exacerbations) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · GOLD 2025 Report - Global Strategy for the Diagnosis, Management, and Prevention of COPD, chapter 4 (management of exacerbations) · Seretide Accuhaler 50/500 SmPC section 4.1 Therapeutic indications and 4.2 Posology - COPD (eMC product 5504) · Spiriva ® 18 microgram, inhalation powder, hard capsule SmPC section 4.2 Posology and method of administration (eMC product 1693) · ATROVENT Inhaler CFC-Free 20 micrograms/actuation SmPC section 4.2 (eMC product 61) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (levofloxacin monograph, chronic obstructive pulmonary disease acute exacerbation) · Egyptian National Drug Formulary - Antimicrobial 2023 (moxifloxacin monograph, acute bacterial exacerbation of chronic bronchitis) · Chronic Obstructive Pulmonary Disease (COPD) - disease-level clinical article (copd-full.txt)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Respiratory 2026 (acetylcysteine monograph) · Egyptian National Drug Formulary - Respiratory 2026 (salbutamol monograph) · GOLD 2025 Report - Global Strategy for the Diagnosis, Management, and Prevention of COPD, chapter 5 (management of exacerbations) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · GOLD 2025 Report - Global Strategy for the Diagnosis, Management, and Prevention of COPD, chapter 4 (management of exacerbations) · Seretide Accuhaler 50/500 SmPC section 4.1 Therapeutic indications and 4.2 Posology - COPD (eMC product 5504) · Spiriva ® 18 microgram, inhalation powder, hard capsule SmPC section 4.2 Posology and method of administration (eMC product 1693) · ATROVENT Inhaler CFC-Free 20 micrograms/actuation SmPC section 4.2 (eMC product 61) · Chronic Obstructive Pulmonary Disease (COPD) - disease-level clinical article (copd-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (levofloxacin monograph, chronic obstructive pulmonary disease acute exacerbation) · Egyptian National Drug Formulary - Antimicrobial 2023 (moxifloxacin monograph, acute bacterial exacerbation of chronic bronchitis) · Chronic Obstructive Pulmonary Disease (COPD) - disease-level clinical article (copd-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 510, "generic": "Ipratropium bromide", "line": 1, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.02, "adult_dose": "20-40 mcg (1-2 puffs of 20 mcg/puff) QID", "adult_duration": "long-term", "dose_source": "ATROVENT Inhaler CFC-Free 20 micrograms/actuation SmPC section 4.2 (eMC product 61)", "rationale": "Short-acting anticholinergic bronchodilator that blocks muscarinic receptors in airway smooth muscle, relieving bronchospasm and improving airflow in COPD.", "cautions": [ "Caution in glaucoma and urinary retention.", "Dry mouth is a common side effect.", "Avoid spraying directly into eyes." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not routinely indicated in children", "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": "ASMATROPIM 250MCG/ML 20 NEBULIZER VIAL SOLN.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL ADVANCED PHARMACEUTICALS (GAP) > GLOBAL PHARMACEUTICAL INDUSTRIES", "price_egp": 70.0, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IPRATROPIUM VIATRIS 0.25MG/ML (CHILDREN) 10 UNIT DOSE VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LABORATOIRE UNITHER > ONE PHARMA MEDICS", "price_egp": 74.0, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IPRATROPIUM VIATRIS 0.5MG/2ML (ADULTS) 10 UNIT DOSE VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LABORATOIRE UNITHER > ONE PHARMA MEDICS", "price_egp": 80.0, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUNGOTROPIUM 250MCG/1ML 20 UNIT DOSE VIAL NEBULIZER SOLN", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 152.0, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASMATROPIM 500MCG/2ML 20 NEBULIZER VIAL SOLN.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL ADVANCED PHARMACEUTICALS (GAP) > GLOBAL PHARMACEUTICAL INDUSTRIES", "price_egp": 164.0, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUNGOTROPIUM 500MCG/2ML 20 UNIT DOSE VIAL NEBULIZER SOLN", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 164.0, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ATROVENT 250MCG/2ML 20 UNIT DOSE INH. VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BOEHRINGER INGELHEIM", "price_egp": 286.0, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ATROVENT 500 MCG/2ML 20 UNIT DOSE INH. VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BOEHRINGER INGELHEIM", "price_egp": 286.0, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 511, "generic": "Tiotropium bromide", "line": 1, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.018, "adult_dose": "18 mcg per capsule (1 capsule inhaled once daily via DPI device)", "adult_duration": "long-term", "dose_source": "Spiriva ® 18 microgram, inhalation powder, hard capsule SmPC section 4.2 Posology and method of administration (eMC product 1693)", "rationale": "Long-acting anticholinergic bronchodilator used for maintenance therapy in COPD, giving sustained blockade of airway muscarinic receptors for smoother, longer-lasting symptom control than the short-acting agent.", "cautions": [ "Do not swallow capsules - inhale via device.", "Caution in moderate-to-severe renal impairment.", "Avoid contact with eyes." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated in children", "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": "CIPLA-TROPIUM 18 MCG MULTIHALER DRY POWDER FOR ORAL INHALATION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 126.0, "pack_count": null, "unit_price": null, "strength_mg": 0.018, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 517, "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": "Chronic Obstructive Pulmonary Disease (COPD) - disease-level clinical article (copd-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Warning signs of impending respiratory failure during an exacerbation require urgent escalation." ], "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": "copd" }, { "id": 512, "generic": "Salmeterol + Fluticasone", "line": 2, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.5, "adult_dose": "1 inhalation (50/500 mcg per dose) twice daily", "adult_duration": "long-term", "dose_source": "Seretide Accuhaler 50/500 SmPC section 4.1 Therapeutic indications and 4.2 Posology - COPD (eMC product 5504)", "rationale": "Combination long-acting beta agonist and inhaled corticosteroid; the bronchodilator component relaxes airway smooth muscle while the steroid component reduces airway inflammation, used together in more severe or exacerbation-prone COPD needing combined bronchodilation and anti-inflammatory control.", "cautions": [ "COPD is the 50/500 strength, not 50/250. The SmPC licenses 50 micrograms salmeterol with 500 micrograms fluticasone twice daily for COPD; 50/250 is an asthma strength and delivers half the licensed steroid dose here.", "Rinse mouth after inhalation.", "Reserve for patients with frequent exacerbations.", "There is an increased risk of pneumonia in COPD patients on ICS." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated for COPD in children", "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": "SEROFLO 100/50MCG PD. FOR INH. 30 BLISTERS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 52.5, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEROFLO 250/50MCG PD. FOR INH. 30 BLISTERS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEROFLO 500/50MCG PD. FOR INH. 30 BLISTERS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 77.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METRICASON 125/25 MCG 120 METERED ACTUATIONS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MDI PHARMA", "price_egp": 121.0, "pack_count": null, "unit_price": null, "strength_mg": 0.025, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE EVOHALER 50/25MCG 120 METERED ACTUATIONS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 198.0, "pack_count": null, "unit_price": null, "strength_mg": 0.025, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE DISKUS 100/50MCG 60 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 244.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE DISKUS 250/50MCG 60 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 335.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE DISKUS 500/50MCG 60 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 411.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 514, "generic": "Salbutamol", "line": 1, "is_adjunct": true, "form": "oral.inhalation", "strength_mg": 0.1, "adult_dose": "100-200 mcg (1-2 puffs of 100 mcg/puff) as needed, up to 4 times a day; maximum 8 puffs in 24 hours and not more often than every 4 hours", "adult_duration": "as-needed, long-term", "dose_source": "Egyptian National Drug Formulary - Respiratory 2026 (salbutamol monograph)", "rationale": "GOLD says a rescue short-acting bronchodilator goes to every COPD patient; maintenance inhalers do not fill that role. The patient who is breathless walking to the mosque has nothing to reach for without one.", "cautions": [ "This is the rescue inhaler. It is given in addition to the maintenance inhaler above, never instead of it.", "Needing it more than usual, or more than 8 puffs a day, means the disease is not controlled or an exacerbation is starting - review, do not just repeat the prescription.", "Tremor and palpitations are dose-related and common at 2 puffs.", "Use a spacer if the technique is poor - which it often is in an elderly patient with arthritic hands." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "COPD is not a paediatric condition. Salbutamol is dosed by puffs, not by weight, in any case.", "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": "AEROLIN 100MCG/DOSE INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO > 3M HEALTH CARE-U.K.", "price_egp": 7.3, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BUTALIN 100MCG/ACTUATION 200 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VENTAL INHALER 100 MCG/DOSE 200 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 72.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIASALMOL 100MCG 200 ACTUATION INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MDI PHARMA", "price_egp": 72.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VENTOLIN EVOHALER 100MCG/ACTUATION INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 86.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OPICHESTAL SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 2.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "SALBUTAMOL 2MG/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 3.5, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 515, "generic": "Prednisolone", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "40 mg once daily in the morning", "adult_duration": "5 days, then stop - no taper", "dose_source": "GOLD 2025 Report - Global Strategy for the Diagnosis, Management, and Prevention of COPD, chapter 4 (management of exacerbations)", "rationale": "The exacerbation is what brings the COPD patient to the clinic, and the prescription for it is a steroid and sometimes an antibiotic on top of the inhalers. Neither was in this condition.", "cautions": [ "For the exacerbation only - 5 days and stop. GOLD says duration should not normally be more than 5 days, and longer courses are associated with more pneumonia and more deaths.", "No taper is needed after 5 days.", "Raises blood glucose sharply - warn the diabetic patient and expect to need extra cover.", "Do not stop the inhalers while the steroid is running.", "Repeated courses carry the pneumonia, sepsis and fracture risk of chronic steroid use even when each course is short.", "GOLD writes 40 mg prednisone-equivalent. Prednisolone is what Egypt sells and the two are equivalent milligram for milligram, but the guideline's word is prednisone." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "COPD is not a paediatric condition.", "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": "copd" }, { "id": 516, "generic": "Doxycycline", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg twice daily on day 1, then 100 mg once or twice daily", "adult_duration": "5 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph)", "rationale": "The Egyptian Essential Medicine List names exacerbations of COPD as a doxycycline indication, and it is an AWaRe Access antibiotic - the group to reach for first. GOLD names tetracycline among the empirical choices and caps outpatient treatment at 5 days.", "cautions": [ "Only when the sputum has turned purulent. GOLD requires increased purulence to be one of the symptoms before an antibiotic is justified - green sputum, not just more of it.", "5 days, not 10. Longer courses give no extra benefit and select resistance.", "Swallow upright with a full glass of water and not at bedtime - the capsule ulcerates the oesophagus if it lodges.", "Photosensitivity matters in Egyptian sun; advise cover for the 5 days.", "Separate from antacids, iron and dairy by 2 hours.", "Not in pregnancy, and not under 8 years." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "COPD is not a paediatric condition.", "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": "FARCODOXIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXY M.R.100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRANUDOXY 100MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > PIERRE FRANCE", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYDOX 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 23.0, "pack_count": 10, "unit_price": 2.3, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYMYCIN 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TABOCINE 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 46.0, "pack_count": 10, "unit_price": 4.6, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIBRAMYCIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 65.0, "pack_count": 10, "unit_price": 6.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 518, "generic": "Azithromycin", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 250.0, "adult_dose": "Oral: 500 mg in a single loading dose on day 1, followed by 250 mg once daily on days 2 to 5 or 500 mg once daily for 3 days", "adult_duration": "3 to 5 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Alternative first-line macrolide antibiotic for acute bacterial exacerbations of COPD.", "cautions": [ "Hypersensitivity to azithromycin, erythromycin, or other macrolides.", "Azithromycin is predominantly hepatically eliminated; use with caution in hepatic impairment.", "Risk of QT prolongation and altered cardiac conduction." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 6.0, "peds_max_mg": 250.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Children (general dosing): Oral: 10 to 12 mg/kg once on day 1 (maximum 500 mg/dose), then 5 to 6 mg/kg once daily (maximum 250 mg/dose).", "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": 60, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 120, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 180, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 240, "capped": false } ], "brands": [ { "trade_name": "AZATRIBACT 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 15.0, "pack_count": 6, "unit_price": 2.5, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZOMYCIN 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 25.2, "pack_count": 6, "unit_price": 4.2, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZITHROMIN 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 31.5, "pack_count": 6, "unit_price": 5.25, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZALIDE 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 49.5, "pack_count": 6, "unit_price": 8.25, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEOZOLID 250 MG 6 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 53.0, "pack_count": 6, "unit_price": 8.83, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZI-ONCE 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JAMJOOM PHARMACEUTICALS", "price_egp": 54.0, "pack_count": 6, "unit_price": 9.0, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROMAX 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 79.0, "pack_count": 6, "unit_price": 13.17, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISTABCIN 250 MG 6 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHRODOSE 100MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > AVERROES PHARMA-EGYPT", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROPHATE 200MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANO PHARMA > NOVELL PHARMA", "price_egp": 12.75, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 519, "generic": "Amoxicillin + Clavulanic acid", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 625.0, "adult_dose": "500 mg every 8 to 12 hours, or 875 mg every 12 hours", "adult_duration": "5 to 7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)", "rationale": "The disease article makes co-amoxiclav one of three first-line antibiotics for an exacerbation with purulent sputum, alongside the doxycycline and azithromycin the card already carried; it is the beta-lactam option, which the card had none of. The ENDF's oral indication list does not name COPD, but its IV list names chronic bronchitis (acute exacerbation) and its oral dosing range is what is written here.", "cautions": [ "Hypersensitivity to amoxicillin, clavulanic acid, other beta-lactam antibacterial drugs (eg, penicillins, cephalosporins), or any component of the formulation; history of cholestatic jaundice or hepatic dysfunction with amoxicillin/clavulanate potassium therapy.", "Antibiotics are indicated when sputum purulence is accompanied by increased dyspnea or volume - not for every exacerbation." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - COPD is an adult disease.", "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": "AUJED 625 MG 12 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC > JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 19.2, "pack_count": 12, "unit_price": 1.6, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "E-MOXCLAV 625MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEXICLAVE 625 MG 12 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > NOVELL PHARMA", "price_egp": 37.5, "pack_count": 12, "unit_price": 3.12, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAGNABIOTIC 625MG 8 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 37.0, "pack_count": 8, "unit_price": 4.62, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLAVIMOX 625 MG 12 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 107.0, "pack_count": 12, "unit_price": 8.92, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CURAM 625MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANDOZ > NOVARTIS", "price_egp": 108.0, "pack_count": 12, "unit_price": 9.0, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGMENTIN 625 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > SMITHKLINE BEECHAM", "price_egp": 117.0, "pack_count": 10, "unit_price": 11.7, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLAVOCILLIN 625 MG 10 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ORGANOPHARMA", "price_egp": 31.5, "pack_count": null, "unit_price": null, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 156.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 513, "generic": "Acetylcysteine", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 600.0, "adult_dose": "600 mg once daily, or 200 mg three times daily, by mouth; abundant fluid intake supports the mucolytic effect", "adult_duration": "The formulary leaves duration to the prescriber - assess symptomatic benefit at 4 weeks and stop if there is none", "dose_source": "Egyptian National Drug Formulary - Respiratory 2026 (acetylcysteine monograph)", "rationale": "29 live products, mostly the 600 mg effervescent tablet. The formulary's oral indication is a mucolytic adjuvant in respiratory disorders with thick viscous mucus hypersecretion, which is the chronic productive cough that this condition's three inhalers do nothing for.", "cautions": [ "An add-on for chronic productive cough, not a treatment for airflow obstruction - it does not replace or reduce the need for the inhalers already listed.", "Stop if there is no symptomatic benefit after a reasonable trial; a mucolytic that is not helping is just cost.", "May provoke bronchospasm - caution in a patient with an asthma component; have the salbutamol to hand at the first dose.", "The intravenous product is the paracetamol overdose antidote at completely different doses - do not confuse the two.", "Encourage generous fluid intake, which the formulary states supports the mucolytic effect.", "Effervescent tablets carry a significant sodium load - relevant in heart failure and hypertension." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescents over 12 years: 200 mg three times daily. Adolescents 14 years and over: 600 mg once daily or 200 mg three times daily. Maximum 600 mg/day. Safety and efficacy are not established under 12 years. COPD is not a paediatric condition in any case.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Over 12 years", "age_min_months": 144, "age_max_months": 167, "dose_text": "200 mg three times daily" }, { "label": "14 years and over", "age_min_months": 168, "age_max_months": 216, "dose_text": "600 mg once daily, or 200 mg three times daily. Maximum 600 mg a day." } ], "peds_doses": null, "brands": [ { "trade_name": "ACETOLYTIC 600 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA", "price_egp": 71.0, "pack_count": 10, "unit_price": 7.1, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACENEWRAX 600 MG 10 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS > ARAX PHARM. IND.", "price_egp": 44.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ROTACYSTEINE 600 MG 10 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ROTABIOGEN", "price_egp": 60.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACETYLCYSTDAR 600 MG 12 EFF. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID > PHARMADAR", "price_egp": 70.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WINDY 600 MG 10 SACHET", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 70.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUBRONK 600 MG 10 EFF. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 73.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ROTACYSTEINE 600 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > BIOCAPITAL PHARMA", "price_egp": 120.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUIMUCIL 600MG 10 EFF. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ZAMBON > PHARMACON", "price_egp": 135.0, "pack_count": null, "unit_price": null, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACESOLV 2% SYRUP 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > SPIMACO MISR", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "SOLVIMYST 100MG/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 44.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 520, "generic": "Levofloxacin", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 to 750 mg once daily by mouth or intravenously", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (levofloxacin monograph, chronic obstructive pulmonary disease acute exacerbation)", "rationale": "The article escalates to a respiratory fluoroquinolone, naming levofloxacin first, for GOLD 3 to 4 disease, recent hospitalisation or recent antibiotic exposure - it puts this under inpatient management of a moderate to severe exacerbation. The ENDF names that indication in the monograph's own list.", "cautions": [ "Limitations of use: Because fluoroquinolones have been associated with disabling and potentially irreversible serious adverse reactions (eg, tendinopathy and tendon rupture, peripheral neuropathy, CNS effects), reserve levofloxacin for use in patients who have no alternative treatment options for acute exacerbation of chronic bronchitis, acute bacterial sinusitis, and uncomplicated urinary tract infections.", "Dose is reduced in renal impairment - the ENDF gives a full CrCl table for the 250, 500 and 750 mg regimens." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "ENDF: in pediatric patients, fluoroquinolones are not routinely first-line therapy. COPD is in any case an adult disease.", "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": "FLOXABACT 500 MG 10 F.C.TABS.(NOW LEVOFLOXACIN-EVA)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 40.0, "pack_count": 10, "unit_price": 4.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LEVOMAGICTAM 500 MG 5 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > MAGIC PHARMA-EGYPT", "price_egp": 27.0, "pack_count": 5, "unit_price": 5.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EXACINOP 500 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > MASSA GROUP PHARMA", "price_egp": 65.0, "pack_count": 10, "unit_price": 6.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ROYAFLOXACIN 500 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > SATO PHARMA", "price_egp": 92.0, "pack_count": 10, "unit_price": 9.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TAVIXINOR 500 MG 5 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE > SAS PHARMA", "price_egp": 64.5, "pack_count": 5, "unit_price": 12.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIOWORLD 500 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > BIOWORLD", "price_egp": 133.0, "pack_count": 10, "unit_price": 13.3, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TAVANIC 500 MG 5 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 192.0, "pack_count": 5, "unit_price": 38.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFASPECT 500 MG 5 S.F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SPIMACO PHARMACEUTICAL INDUSTRIES > INNOGEN PHARMA", "price_egp": 70.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 521, "generic": "Moxifloxacin", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg once daily by mouth or intravenously", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (moxifloxacin monograph, acute bacterial exacerbation of chronic bronchitis)", "rationale": "The article's other named respiratory fluoroquinolone for the same escalation. No renal dose adjustment is needed, which is the practical reason to reach for it over levofloxacin.", "cautions": [ "Limitations of use: Because fluoroquinolones have been associated with disabling and potentially irreversible serious adverse reactions (eg, tendinopathy and tendon rupture, peripheral neuropathy, CNS effects), reserve use of moxifloxacin for acute exacerbation of chronic bronchitis or acute sinusitis for patients who have no alternative treatment options.", "Hypersensitivity to moxifloxacin, other quinolone antibiotics, or any component of the formulation", "Avoid with other QT-prolonging agents; the ENDF asks for an ECG in patients with liver cirrhosis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "ENDF: in pediatric patients, fluoroquinolones are not routinely first-line therapy, and limited dosing data are available. COPD is in any case an adult disease.", "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": "MOXILABACT 400 MG 5 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 30.6, "pack_count": 5, "unit_price": 6.12, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GASTAMOXACINE 400MG 7 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > GAST PHARMA GROUP-EGYPT", "price_egp": 45.0, "pack_count": 7, "unit_price": 6.43, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MERAMERIX 400MG 5 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARMED HEALTHCARE > ABBOTT LABORATORIES", "price_egp": 40.5, "pack_count": 5, "unit_price": 8.1, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IDELOX 400MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 116.0, "pack_count": 10, "unit_price": 11.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRIMOXIZAR 400 MG 5 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARMA CURE PHARMACEUTICALS > PHARMA CURE", "price_egp": 80.0, "pack_count": 5, "unit_price": 16.0, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOXIFLOX 400 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 180.0, "pack_count": 10, "unit_price": 18.0, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOXAVIDEX 400 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > UTOPIA", "price_egp": 184.0, "pack_count": 10, "unit_price": 18.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOXAVIDEX 400 MG 5 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > UTOPIA", "price_egp": 92.0, "pack_count": 5, "unit_price": 18.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOXIFLOXACIN-EL NILE 400MG/250ML SOL. FOR INF.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 80.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MOXITRIX 400MG/250ML SOL. FOR INF.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB CO. FOR MEDICAL PRODUCTS > SPIMACO MISR", "price_egp": 86.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "copd" }, { "id": 522, "generic": "Azithromycin", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 250.0, "adult_dose": "250 mg once daily, or 500 mg three times weekly, long term", "adult_duration": null, "dose_source": "Chronic Obstructive Pulmonary Disease (COPD) - disease-level clinical article (copd-full.txt)", "rationale": "A different prescription from the card's other azithromycin row, which is the 3 to 5 day course for an acute exacerbation. This one is taken continuously to make exacerbations less frequent in patients having two or more a year despite optimised inhaled therapy. The ENDF doses azithromycin for the acute exacerbation only, so the maintenance figure comes from the disease article, which states drug and dose in one sentence.", "cautions": [ "Four baseline checks are mandatory before the first dose: an ECG - a QTc beyond 450 ms weighs against treatment, as a relative contraindication - a hearing test, a sputum culture to rule out non-tuberculous mycobacterial infection, and liver function tests. Hearing is then retested once a year for as long as treatment continues.", "Do not put a current smoker on maintenance azithromycin: cardiovascular risk runs higher in that group, and the benefit has not been demonstrated.", "The same article also describes the candidates as people who have smoked in the past or who smoke now - the two statements conflict, and the source is reported as it stands; treat current smoking as the stronger signal against starting.", "Hypersensitivity to azithromycin, erythromycin, other macrolide (eg, azalide or ketolide) antibiotics, or any component of the formulation." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - COPD is an adult disease.", "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": "AZATRIBACT 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 15.0, "pack_count": 6, "unit_price": 2.5, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZOMYCIN 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 25.2, "pack_count": 6, "unit_price": 4.2, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZITHROMIN 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 31.5, "pack_count": 6, "unit_price": 5.25, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZALIDE 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 49.5, "pack_count": 6, "unit_price": 8.25, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEOZOLID 250 MG 6 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 53.0, "pack_count": 6, "unit_price": 8.83, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZI-ONCE 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JAMJOOM PHARMACEUTICALS", "price_egp": 54.0, "pack_count": 6, "unit_price": 9.0, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROMAX 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 79.0, "pack_count": 6, "unit_price": 13.17, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISTABCIN 250 MG 6 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHRODOSE 100MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > AVERROES PHARMA-EGYPT", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROPHATE 200MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANO PHARMA > NOVELL PHARMA", "price_egp": 12.75, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "copd" } ] }