{ "schema_version": 1, "kind": "condition", "id": "covid-19-outpatient", "name": "COVID-19 (mild, outpatient)", "category": "infectious", "sources": "Lagevrio 200 mg hard capsules SmPC sections 4.2 and 4.4 (eMC product 13044) · NICE Guideline NG191: Managing COVID-19 2023 · NIH COVID-19 Treatment Guidelines 2023 · WHO Therapeutics and COVID-19: Living Guideline 2023", "review_status": "reviewed", "verified_against": "Lagevrio 200 mg hard capsules SmPC sections 4.2 and 4.4 (eMC product 13044) · NIH COVID-19 Treatment Guidelines 2023 · WHO Therapeutics and COVID-19: Living Guideline 2023 · COVID-19 (mild, outpatient) - disease-level clinical article (covid-19-outpatient-clinical.txt) · MSF Essential Drugs 2024 - paracetamol (oral) for the antipyretic figures: \"Adult: 1 g 3 or 4 times daily (max. 4 g daily)\" and \"Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily)\". The hydration, rest and saturation monitoring are supportive measures from the WHO Therapeutics and COVID-19: Living Guideline 2023, which is not held in this corpus.", "verified_date": "2026-08", "treatments": [ { "id": 535, "generic": "Supportive Care and Symptom Management", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Symptomatic relief with an antipyretic (paracetamol 1 g 3 or 4 times daily, max. 4 g daily), adequate hydration, rest, and monitoring oxygen saturation (SpO2)", "adult_duration": "5-10 days", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral) for the antipyretic figures: \"Adult: 1 g 3 or 4 times daily (max. 4 g daily)\" and \"Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily)\". The hydration, rest and saturation monitoring are supportive measures from the WHO Therapeutics and COVID-19: Living Guideline 2023, which is not held in this corpus.", "rationale": "For mild COVID-19 in low-risk outpatient individuals without risk factors for severe disease, specific antiviral therapy is not indicated; supportive care is standard", "cautions": [ "Refer urgently to hospital if SpO2 falls below 94% on room air, or if patient develops severe dyspnoea, confusion, or persistent chest tightness.", "Routine antibiotics, systemic corticosteroids, or hydroxychloroquine are NOT recommended for mild outpatient COVID-19 without bacterial coinfection." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paracetamol, child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily). Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily). Ensure adequate hydration and monitor for red flag signs (respiratory distress, lethargy).", "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": "covid-19-outpatient" }, { "id": 538, "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": "COVID-19 (mild, outpatient) - disease-level clinical article (covid-19-outpatient-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Monitor for sudden clinical deterioration leading to acute respiratory failure or ARDS." ], "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": "covid-19-outpatient" }, { "id": 536, "generic": "Nirmatrelvir / Ritonavir", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "Nirmatrelvir 300 mg (two 150 mg tablets) plus Ritonavir 100 mg (one 100 mg tablet) taken together twice daily (start within 5 days of symptom onset)", "adult_duration": "5 days", "dose_source": "NIH COVID-19 Treatment Guidelines 2023", "rationale": "For high-risk outpatients within 5 days of symptoms. Paxlovid has little retail presence in Egypt - see molnupiravir below for what is actually on the shelf.", "cautions": [ "Severe drug interaction potential due to CYP3A inhibition by ritonavir; perform comprehensive medication reconciliation before prescribing.", "Contraindicated in severe renal impairment (eGFR <30 mL/min) and severe hepatic impairment (Child-Pugh Class C).", "Requires dose adjustment in moderate renal impairment (eGFR 30-59 mL/min: Nirmatrelvir 150 mg + Ritonavir 100 mg BID)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Approved for adolescents >=12 years weighing at least 40 kg at adult dose (300 mg / 100 mg BID for 5 days). Not recommended in children <12 years.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "300 mg / 100 mg twice daily for 5 days (as for adults), for adolescents weighing at least 40 kg." } ], "peds_doses": null, "brands": [], "condition_id": "covid-19-outpatient" }, { "id": 537, "generic": "Molnupiravir", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 200.0, "adult_dose": "800 mg - four 200 mg capsules - every 12 hours for 5 days, started within 5 days of symptom onset", "adult_duration": "5 days exactly", "dose_source": "Lagevrio 200 mg hard capsules SmPC sections 4.2 and 4.4 (eMC product 13044)", "rationale": "The antiviral that is actually registered and stocked in Egypt: eight products, 318-624 EGP for the whole 40-capsule course. Read the cautions before reaching for it - the evidence is weaker than the price suggests.", "cautions": [ "PANORAMIC, the large trial in vaccinated high-risk adults in the community, found no reduction in hospital admission or death. WHO's recommendation is conditional and confined to those at highest risk. In a vaccinated patient this is 300-600 EGP for a benefit that has not been shown.", "Not recommended in pregnancy - animal reproductive toxicity. A woman who could become pregnant needs effective contraception during the course and for 4 days after the last dose.", "Exactly 5 days. Longer has not been studied and there is no reason to extend it.", "No dose change needed for renal or hepatic impairment." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not for use under 18 years - no safety or efficacy data.", "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": "MOLNUVOC 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 318.0, "pack_count": 40, "unit_price": 7.95, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOLNUPRAVA 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 420.0, "pack_count": 40, "unit_price": 10.5, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PIROLOGLOB 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL ADVANCED PHARMACEUTICALS (GAP)", "price_egp": 420.0, "pack_count": 40, "unit_price": 10.5, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COVAPRAVIR 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 461.0, "pack_count": 40, "unit_price": 11.53, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOLNUPIRAVIR-EVA 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 461.0, "pack_count": 40, "unit_price": 11.53, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOLNUPIRAVIR-RAMEDA 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 461.0, "pack_count": 40, "unit_price": 11.53, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGIPRIVIR 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 624.0, "pack_count": 40, "unit_price": 15.6, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HOCHSTERPRIVER 200 MG 40 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HOCHSTER PHARMACEUTICAL INDUSTRIES", "price_egp": 624.0, "pack_count": 40, "unit_price": 15.6, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "covid-19-outpatient" } ] }