{ "schema_version": 1, "kind": "condition", "id": "endometriosis-referral", "name": "Endometriosis (referral & initial medical management)", "category": "chronic", "sources": "ESHRE Guideline Endometriosis 2022 · NICE Guideline NG73 · Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) · Egyptian National Drug Formulary, endocrine 2024, medroxyprogesterone acetate monograph, mild to moderate endometriosis", "review_status": "reviewed", "verified_against": "Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) · ESHRE Guideline Endometriosis 2022 · Egyptian National Drug Formulary, endocrine 2024, medroxyprogesterone acetate monograph, mild to moderate endometriosis", "verified_date": "2026-08", "treatments": [ { "id": 680, "generic": "Ethinyl estradiol + Levonorgestrel", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "30 mcg Ethinylestradiol + 150 mcg Levonorgestrel tablet taken once daily continuously (or cyclically 21 days on, 7 days off)", "adult_duration": "long-term", "dose_source": "ESHRE Guideline Endometriosis 2022", "rationale": "Single-ingredient ethinylestradiol is not marketed in Egypt. This is the combined pill, and it is what suppresses the disease.", "cautions": [ "Standalone ethinylestradiol single-ingredient tablets are unavailable in Egyptian pharmacies.", "Contraindicated in women with history of VTE/PE, severe hypertension, focal migraine, or active liver disease.", "There is an increased venous thromboembolism risk." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Post-menarcheal adolescents: 1 tablet 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": "MICROCEPT 21 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 0.76, "pack_count": 21, "unit_price": 0.04, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICRODETTE 3* 21 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 7.5, "pack_count": 21, "unit_price": 0.36, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NORDETTE 5*21 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE. > PFIZER", "price_egp": 15.0, "pack_count": 21, "unit_price": 0.71, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICROGENEST 30/150 MCG 21 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ACDIMA INTERNATIONAL TRADING", "price_egp": 23.0, "pack_count": 21, "unit_price": 1.1, "strength_mg": 0.15, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIOCEPT 21 TAB. X 6 STRIP (TRIPHASIC)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 120.0, "pack_count": 21, "unit_price": 5.71, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "endometriosis-referral" }, { "id": 681, "generic": "Medroxyprogesterone acetate", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg 3 times daily orally continuously", "adult_duration": "6-12 months", "dose_source": "Egyptian National Drug Formulary, endocrine 2024, medroxyprogesterone acetate monograph, mild to moderate endometriosis", "rationale": "Progestin monotherapy for patients unable or unwilling to take combined estrogen therapy", "cautions": [ "Weight gain, irregular breakthrough bleeding, and fluid retention are common.", "Bone mineral density loss with prolonged use (>2 years); ensure adequate calcium/vitamin D intake.", "The licensed course is 90 days, started on the first day of a period. Suppressing for six to twelve months is common practice but it is beyond what the label covers - know which one you are doing.", "Egypt's only oral medroxyprogesterone, PROVERA 5 mg, is marked CANCELLED in the national register, so this 10 mg three-times-daily course cannot be dispensed as written. The medroxyprogesterone injections marketed here (DEPO-PROVERA 150 mg/mL, MEGESTRON, OXYPROGEST, SAYANA 104 mg/0.65 mL) are registered for contraception: the Egyptian National Drug Formulary gives the 150 mg every 3 months intramuscular dose under contraception, not under endometriosis. Consider dienogest or a combined oral contraceptive instead, or specialist referral." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric gynecology referral 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": "PROVERA 5 MG 24 TABS.(CANCELLED)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 24.0, "pack_count": 24, "unit_price": 1.0, "strength_mg": 5.0, "exact_strength": false, "exact_form": true, "discontinued": true, "also_contains": null } ], "condition_id": "endometriosis-referral" }, { "id": 679, "generic": "Naproxen", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg twice daily with food during dysmenorrhea and pelvic pain flares", "adult_duration": "3-5 days during menses", "dose_source": "Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639)", "rationale": "For the pain of a flare. It does not treat the endometriosis - give it alongside hormonal suppression, not instead of it.", "cautions": [ "Does not suppress endometriotic lesion progression; combined hormonal therapy required for disease control.", "There is a risk of GI distress and ulceration with chronic use." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescents with severe dysmenorrhea: 500 mg initial, then 250-500 mg BID with food", "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": "ORGOPROXEN 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANOPHARMA > ORGANO", "price_egp": 16.0, "pack_count": 20, "unit_price": 0.8, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPROSYN 500 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > F.HOFFMAN LA ROCHE", "price_egp": 8.05, "pack_count": 10, "unit_price": 0.81, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPROFEN 500MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPROFEN 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "endometriosis-referral" } ] }