{ "schema_version": 1, "kind": "condition", "id": "deep-vein-thrombosis-referral", "name": "Deep Vein Thrombosis (Referral & Outpatient Stabilization)", "category": "chronic", "sources": "NICE Guideline NG158: Venous thromboembolic diseases 2020 · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (enoxaparin monograph) · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (warfarin monograph) · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (rivaroxaban monograph)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (rivaroxaban monograph) · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (enoxaparin monograph) · Egyptian National Drug Formulary - Blood Disorder Medications 2025 (warfarin monograph)", "verified_date": "2026-08", "treatments": [ { "id": 572, "generic": "Rivaroxaban", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 15.0, "adult_dose": "15 mg twice daily with food for 21 days, followed by 20 mg once daily with food", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (rivaroxaban monograph)", "rationale": "A whole course on its own - no injection and no INR checks. This is the default unless the patient is pregnant, has cancer, or has renal impairment.", "cautions": [ "URGENT hospital referral is required for objective diagnostic confirmation (compression Doppler ultrasonography) and baseline coagulation/renal workup.", "CONTRAINDICATED in active clinically significant bleeding and severe renal impairment (CrCl <15 mL/min).", "Must take with food to ensure reliable oral bioavailability of 15 mg and 20 mg strengths." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric hematology management", "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": "REPATOXABAN 15 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HORUS FOR PHARMACEUTICAL PRODUCTS > EVA PHARMA", "price_egp": 360.0, "pack_count": 30, "unit_price": 12.0, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIVAFLOWVA 15 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 254.0, "pack_count": 20, "unit_price": 12.7, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIVAROSPIRE 15 MG 42 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO > INSPIRE PHARMACEUTICAL COMPANY", "price_egp": 534.0, "pack_count": 42, "unit_price": 12.71, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "THORMOXIBAN 15 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 130.0, "pack_count": 10, "unit_price": 13.0, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VAXATO 15 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 390.0, "pack_count": 30, "unit_price": 13.0, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "XANOXIBAN 15 MG 50 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 855.0, "pack_count": 50, "unit_price": 17.1, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "XARELTO 15 MG 14 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BAYER HEALTHCARE", "price_egp": 589.0, "pack_count": 14, "unit_price": 42.07, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIVABEDAX 15 MG 30 ODT", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA", "price_egp": 390.0, "pack_count": null, "unit_price": null, "strength_mg": 15.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "deep-vein-thrombosis-referral" }, { "id": 573, "generic": "Enoxaparin sodium", "line": 2, "is_adjunct": false, "form": "injection", "strength_mg": 100.0, "adult_dose": "1 mg/kg subcutaneously twice daily (or 1.5 mg/kg subcutaneously once daily)", "adult_duration": "On average, treatment is prescribed for 7- 10 days.", "dose_source": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (enoxaparin monograph)", "rationale": "The start of the warfarin regimen, not a treatment on its own. Stopping it at 5-10 days without warfarin running leaves a three-month clot anticoagulated for a week.", "cautions": [ "In pregnancy and in active cancer, enoxaparin is used alone for the full course - warfarin is teratogenic and performs poorly in cancer. That is the one situation where this drug is the whole treatment.", "Monitor platelet count for heparin-induced thrombocytopenia (HIT).", "Dose adjustment is required in renal impairment (CrCl <30 mL/min: 1 mg/kg once daily).", "Which regimen: 1.5 mg/kg once daily is for an uncomplicated patient at low risk of recurrence. Use 1 mg/kg twice daily in obesity, symptomatic PE, cancer, recurrent VTE, or proximal iliac thrombosis.", "Severe renal impairment (creatinine clearance 15-30 mL/min): reduce to 1 mg/kg ONCE daily. Below 15 mL/min it is not recommended. Enoxaparin accumulates when clearance falls and the consequence is bleeding.", "End stage renal disease (CrCl < 15 mL/min): Use is not recommended." ], "peds_mgkg_low": 1.0, "peds_mgkg_high": 1.5, "peds_max_mg": null, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Safety and efficacy in the paediatric population not established. Literature-based therapeutic regimen: child 1 month: 1.5 mg/kg twice daily; child 2 months–17 years: 1 mg/kg twice 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": [ { "weight_kg": 10, "low_mg": 10, "high_mg": 15, "capped": false }, { "weight_kg": 20, "low_mg": 20, "high_mg": 30, "capped": false }, { "weight_kg": 30, "low_mg": 30, "high_mg": 45, "capped": false }, { "weight_kg": 40, "low_mg": 40, "high_mg": 60, "capped": false } ], "brands": [ { "trade_name": "CLEXANE 100MG/ML 2 PREFILLED SYRINGES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 507.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "deep-vein-thrombosis-referral" }, { "id": 574, "generic": "Warfarin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "2 to 10 mg once daily initially, chosen by weight, age and general health, then adjusted according to INR (target 2.0-3.0); co-administer LMWH for at least 5 days until INR is >=2.0 for 24 hours", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (warfarin monograph)", "rationale": "Takes days to work, which is why the injection overlaps it. Do not stop the enoxaparin on the day warfarin starts.", "cautions": [ "Target INR is 2.0-3.0 (target 2.5); mandatory regular INR monitoring and dose titration.", "Extensive cytochrome P450 drug interactions and dietary Vitamin K sensitivity; maintain consistent dietary greens intake and verify all concurrent medications.", "Warfarin is contraindicated in the first trimester and during the last four weeks of pregnancy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric hematology titration", "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": "HAEMOFARIN 5MG 100 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 11.0, "pack_count": 100, "unit_price": 0.11, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MARIVANIL 5MG 50 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 5.6, "pack_count": 50, "unit_price": 0.11, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAREVAN 5 MG 102 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 78.0, "pack_count": 102, "unit_price": 0.76, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COUMADIN 5 MG 28 TABLETS (ILLEGAL IMPORT)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ZENTIVA >", "price_egp": 31.0, "pack_count": 28, "unit_price": 1.11, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "deep-vein-thrombosis-referral" } ] }