{ "schema_version": 1, "kind": "condition", "id": "erectile-dysfunction", "name": "Erectile dysfunction", "category": "chronic", "sources": "Egyptian National Drug Formulary - Cardiovascular 2024 · EAU Guidelines on Sexual and Reproductive Health 2023 · eMC SmPC, Vardenafil Mylan 10 mg film-coated tablets (Viatris), sections 4.1, 4.2 and 4.3", "review_status": "reviewed", "verified_against": "EAU Guidelines on Sexual and Reproductive Health 2023 · eMC SmPC, Vardenafil Mylan 10 mg film-coated tablets (Viatris), sections 4.1, 4.2 and 4.3 · Erectile Dysfunction - disease-level clinical article (erectile-dysfunction-clinical.txt) · Egyptian National Drug Formulary - Endocrine System 2024 (testosterone monograph, hypogonadism in men) · Erectile dysfunction - disease-level clinical article (erectile-dysfunction-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 700, "generic": "Sildenafil", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "50 mg orally approximately 1 hour before sexual activity (max 100 mg/dose, max once daily)", "adult_duration": "as required", "dose_source": "EAU Guidelines on Sexual and Reproductive Health 2023", "rationale": "Improves erectile response to sexual stimulation by enhancing the nitric oxide-cGMP signalling pathway in penile smooth muscle, blocking the enzyme that would otherwise break that signal down; requires sexual stimulation to work, and is strictly contraindicated with nitrates because they act on the same pathway, risking severe hypotension.", "cautions": [ "STRICTLY CONTRAINDICATED with nitrates or nitric oxide donors (severe fatal hypotension).", "Sexual stimulation is required for therapeutic effect.", "Seek immediate medical attention if erection lasts >4 hours (priapism risk)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Condition restricted to adult males", "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": "ECTAGOR 50 MG 4 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > NOVELL PHARMA", "price_egp": 7.0, "pack_count": 4, "unit_price": 1.75, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "V-GONE 50 MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 24.0, "pack_count": 10, "unit_price": 2.4, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIGORAN 50MG 4 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 10.0, "pack_count": 4, "unit_price": 2.5, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EZEQUEL 50 MG 4 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 18.0, "pack_count": 4, "unit_price": 4.5, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SILVIGO 50MG 5 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 24.0, "pack_count": 5, "unit_price": 4.8, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIGORAMA 50 MG 4 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 19.2, "pack_count": 4, "unit_price": 4.8, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIAGRA 50 MG 4 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "VIATRIS", "price_egp": 112.0, "pack_count": 4, "unit_price": 28.0, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SILDEN 50 MG 4 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 19.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SILDINOVA 10 MG PD. FOR SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG AGENCY (IDI)", "price_egp": 78.75, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ANSELAFIL 10MG/ML PWD. FOR ORAL SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 98.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "erectile-dysfunction" }, { "id": 701, "generic": "Tadalafil", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 mg once daily at approximately the same time each day (or 10-20 mg on demand 30 min before activity)", "adult_duration": "long-term / as required", "dose_source": "EAU Guidelines on Sexual and Reproductive Health 2023", "rationale": "Works the same way as sildenafil but lasts longer, allowing more spontaneous sexual activity without needing to time dosing tightly around intercourse; also used to treat symptoms of coexisting benign prostatic hyperplasia.", "cautions": [ "STRICTLY CONTRAINDICATED with nitrates or nitric oxide donors.", "Once-daily 5 mg dosing allows spontaneous activity and treats co-existing BPH.", "Tadalafil has a long duration of action (up to 36 hours)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Condition restricted to adult males", "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": "CIALONG 5 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 150.0, "pack_count": 30, "unit_price": 5.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIAMONRECTA 5 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 187.5, "pack_count": 30, "unit_price": 6.25, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ERECTOBACK 5 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA", "price_egp": 187.5, "pack_count": 30, "unit_price": 6.25, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COPADTADA 5 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD EGYPT > COPAD PHARMA", "price_egp": 195.0, "pack_count": 30, "unit_price": 6.5, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TADATRONA 5 MG 21 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA", "price_egp": 136.5, "pack_count": 21, "unit_price": 6.5, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STARKOPREX 5 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 252.0, "pack_count": 30, "unit_price": 8.4, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TADAGOLD 5 MG 5 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 46.25, "pack_count": 5, "unit_price": 9.25, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TADALANDRO 5 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 300.0, "pack_count": 30, "unit_price": 10.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "erectile-dysfunction" }, { "id": 702, "generic": "Vardenafil", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg taken approximately 25-60 minutes before sexual activity. Adjust within the range 5-20 mg according to response and tolerability; maximum 20 mg and not more than once in 24 hours. Start at 5 mg in a man already stabilised on an alpha-blocker", "adult_duration": "As required, not more than once in any 24 hours", "dose_source": "eMC SmPC, Vardenafil Mylan 10 mg film-coated tablets (Viatris), sections 4.1, 4.2 and 4.3", "rationale": "40 live products. The condition holds two PDE5 inhibitors and has two free slots; vardenafil's faster onset than tadalafil and shorter duration suit a different patient preference, and it is heavily marketed in Egypt.", "cautions": [ "ABSOLUTELY CONTRAINDICATED with nitrates or nitric oxide donors in any form - including the glyceryl trinitrate and isosorbide mononitrate in the Stable Angina condition, and nicorandil. Check the patient's full drug list before prescribing.", "Contraindicated in men for whom sexual activity is inadvisable - unstable angina, severe heart failure, recent stroke or myocardial infarction.", "Start at 5 mg in a man on an alpha-blocker, which includes the tamsulosin or doxazosin used for benign prostatic hyperplasia - the combination causes symptomatic hypotension.", "Contraindicated with potent CYP3A4 inhibitors: ketoconazole, itraconazole, ritonavir, indinavir. Reduce the dose with moderate inhibitors such as erythromycin.", "An erection lasting more than 4 hours needs emergency urological care.", "Sudden hearing loss or visual loss means stopping immediately and seeking assessment.", "Erectile dysfunction is often the first sign of cardiovascular disease - check blood pressure, glucose, lipids and smoking status rather than only writing the prescription." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated below 18 years of age; there is no relevant paediatric use.", "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": "ROMANTIGRA 10MG 4 F.C. TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > GLOBAL ADVANCED PHARMACEUTICAL (GAP)", "price_egp": 18.0, "pack_count": 4, "unit_price": 4.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FARORECTA 10 MG 12 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 60.0, "pack_count": 12, "unit_price": 5.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FARORECTA 10 MG 4 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 20.0, "pack_count": 4, "unit_price": 5.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VARDATRIN 10 MG 4 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI ELNEEL BENTA", "price_egp": 29.0, "pack_count": 4, "unit_price": 7.25, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POWERECTA 10MG 4 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 30.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ERECANOVA 10 MG 4 DISINTEG. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WESTRECTA 10 MG 4 ORO-DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 47.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "POWERECTA 10MG 6 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 69.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "erectile-dysfunction" }, { "id": 703, "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": "Erectile Dysfunction - disease-level clinical article (erectile-dysfunction-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Cardiovascular risk screening is needed for all ED patients, with formal cardiology referral for those found to be high-risk (ED is often an early marker of silent cardiovascular disease)." ], "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": "erectile-dysfunction" }, { "id": 704, "generic": "Testosterone", "line": 2, "is_adjunct": true, "form": "injection", "strength_mg": null, "adult_dose": "Testosterone enanthate IM: initial 250 mg every 2 to 3 weeks, then adjusted within the usual range every 3 to 12 months on symptoms and testosterone levels", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Endocrine System 2024 (testosterone monograph, hypogonadism in men)", "rationale": "The disease article calls testosterone reasonable in proven hypogonadism when PDE-5 inhibitors have failed or libido is also low; the card carried the three PDE-5 inhibitors and nothing else. The ENDF doses testosterone for exactly that indication, by intramuscular injection.", "cautions": [ "The ENDF restricts this to hypogonadism due to androgen deficiency in men, and states it is not for men with hypogonadal conditions that are not associated with structural or genetic etiologies (e.g. age-related hypogonadism) - so confirm the diagnosis first.", "Androgen-dependent carcinoma", "Marked cardiac, hepatic, or renal disease; liver tumors; thrombophilia", "Pregnancy; breastfeeding; not indicated for use in women" ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The ENDF states adult dosing for this indication; no paediatric figure is given with it.", "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": "TESTONON 250MG/ML I.M 1 OILY AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 20.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GONATESTON 250MG/ML I.M AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "erectile-dysfunction" } ] }