{ "schema_version": 1, "kind": "condition", "id": "hepatitis-referral", "name": "Hepatitis B & C primary care referral", "category": "infectious", "sources": "Egyptian MOH National Committee for Control of Viral Hepatitis Protocol 2022 · WHO Guidelines for Care and Treatment of Persons Diagnosed with HCV 2018 · WHO Guidelines for Prevention, Care and Treatment of Persons with HBV 2024 · Egyptian National Drug Formulary - Antimicrobial 2023 (ribavirin monograph)", "review_status": "reviewed", "verified_against": "Egyptian MOH National Committee for Control of Viral Hepatitis Protocol 2022 · WHO Guidelines for Prevention, Care and Treatment of Persons with HBV 2024 · Egyptian National Drug Formulary - Antimicrobial 2023 (ribavirin monograph) · Hepatitis B & C primary care referral - disease-level clinical article (hepatitis-referral-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 921, "generic": "Sofosbuvir", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg once daily (in direct-acting antiviral combination regimen via specialist clinic)", "adult_duration": "12 weeks (specialist prescribed)", "dose_source": "Egyptian MOH National Committee for Control of Viral Hepatitis Protocol 2022", "rationale": "HCV direct-acting antiviral backbone in Egyptian 100 Million Seha viral hepatitis program", "cautions": [ "REFERRAL MANDATORY: Sofosbuvir must be prescribed within specialized viral hepatitis centers.", "Screen for HBV co-infection prior to starting HCV treatment (risk of HBV reactivation).", "Check liver function, renal function (eGFR < 30), and viral load baseline." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric hepatology 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": "ANDOHEPASUVIR 400MG 28 TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 900.0, "pack_count": 28, "unit_price": 32.14, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGISPOV 400MG 28 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 900.0, "pack_count": 28, "unit_price": 32.14, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPISOVIR 400MG 28 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 900.0, "pack_count": 28, "unit_price": 32.14, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MPIVIROPACK 400MG 28 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 900.0, "pack_count": 28, "unit_price": 32.14, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERINOSPREVIR 400MG 28 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > INSPIRE PHARMACEUTICAL COMPANY", "price_egp": 900.0, "pack_count": 28, "unit_price": 32.14, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SOFOSBUVIR-MUP 400MG 28 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 900.0, "pack_count": 28, "unit_price": 32.14, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRATISOVIR 400MG 28 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND. > PHARCO", "price_egp": 1417.0, "pack_count": 28, "unit_price": 50.61, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SOVALDI 400MG 28 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GILEAD SCIENCES > IBIS PHARMA", "price_egp": 4840.0, "pack_count": 28, "unit_price": 172.86, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "hepatitis-referral" }, { "id": 922, "generic": "Entecavir", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 0.5, "adult_dose": "0.5 mg once daily on an empty stomach (1 mg daily in decompensated cirrhosis)", "adult_duration": "long-term (specialist supervised)", "dose_source": "WHO Guidelines for Prevention, Care and Treatment of Persons with HBV 2024", "rationale": "First-line nucleoside analogue for chronic HBV with low resistance rate", "cautions": [ "REFERRAL MANDATORY: Long-term viral suppression is required under specialist care.", "Do not stop abruptly due to risk of severe acute exacerbation of hepatitis.", "Adjust dose in renal impairment (eGFR < 50 mL/min)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric hepatology 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": "TECENTACAV 0.5 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARMED HEALTHCARE > WADI ELNEEL BENTA", "price_egp": 255.0, "pack_count": 10, "unit_price": 25.5, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUDNOVIR 0.5 MG 10 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 274.0, "pack_count": 10, "unit_price": 27.4, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CAVICLUDE 0.5 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > GLOBAL ADVANCED PHARMACEUTICALS (GAP)", "price_egp": 900.0, "pack_count": 30, "unit_price": 30.0, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ENTECAVIR 0.5 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PENTA PHARMA-EGYPT > PENTA PHARMA", "price_egp": 300.0, "pack_count": 10, "unit_price": 30.0, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TECAVIR 0.5MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 1680.0, "pack_count": 30, "unit_price": 56.0, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BARACLUDE 0.5 MG 30 TABS. (NET PRICE)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BRISTOL-MYERS SQUIBB", "price_egp": 3720.0, "pack_count": 30, "unit_price": 124.0, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLUDINETECH 0.5 MG 10 H.G.CAP", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND. > PHARMA-TECH", "price_egp": 271.5, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ENTECAVIR 0.25MG/5ML ORAL SOLN. 210 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > PENTA PHARMA", "price_egp": 450.0, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "HEPACLUDE 0.5 MG / 10 ML ORAL SOL. 210 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 450.0, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "hepatitis-referral" }, { "id": 924, "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": "Hepatitis B & C primary care referral - disease-level clinical article (hepatitis-referral-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Refer promptly to a gastroenterologist or hepatologist for disease progression or cirrhosis." ], "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": "hepatitis-referral" }, { "id": 923, "generic": "Ribavirin", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 200.0, "adult_dose": "Weight-based, with a direct-acting antiviral: under 75 kg, 1 g/day in 2 divided doses; 75 kg or more, 1.2 g/day in 2 divided doses. A low starting dose of 600 mg/day increased as tolerated is used where anaemia is a concern", "adult_duration": "Set by the hepatologist - depends on genotype, treatment history and cirrhosis status", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (ribavirin monograph)", "rationale": "24 live products, a legacy of Egypt's hepatitis C programme. It still has a place in specific direct-acting antiviral regimens, so a search must not come back empty - but it is never given alone and never started in primary care.", "cautions": [ "Add-on only - ribavirin is never given as monotherapy and is combined with a direct-acting antiviral chosen by the treating hepatologist.", "Largely superseded: modern sofosbuvir-based regimens cure most Egyptian genotype 4 patients without ribavirin, so its appearance on a prescription should prompt a check that it is still needed.", "Haemolytic anaemia is the dose-limiting toxicity - check haemoglobin at baseline, week 2 and week 4; reduce the dose at 8.5-10 g/dL and stop permanently below 8.5 g/dL.", "Teratogen. Contraindicated in pregnancy AND in a male patient whose partner is pregnant. Effective contraception is needed during treatment and for months afterwards.", "CONTRAINDICATED in thalassaemia major and sickle cell disease - both are common in Egypt.", "Contraindicated if creatinine clearance is below 50 mL/min, and (tablets) in decompensated cirrhosis Child-Pugh B or C.", "Permanently discontinue if white cells fall below 1,000/mm3, neutrophils below 500/mm3, or platelets below 25 x 10^9/L." ], "peds_mgkg_low": 15.0, "peds_mgkg_high": 15.0, "peds_max_mg": 1200.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Children 3 years and over: under 47 kg, 15 mg/kg/day in 2 divided doses; 47-59 kg, 400 mg twice daily; 60-73 kg, 400 mg morning and 600 mg evening; over 73 kg, 600 mg twice daily. Paediatric hepatitis C is managed in a specialist centre.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "3 years and over", "age_min_months": 36, "age_max_months": 216, "dose_text": "Under 47 kg, 15 mg/kg/day in 2 divided doses; 47 to 59 kg, 400 mg twice daily; 60 to 73 kg, 400 mg morning and 600 mg evening; over 73 kg, 600 mg twice daily. Specialist centre only." } ], "peds_doses": [ { "weight_kg": 10, "low_mg": 150, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 450, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 600, "high_mg": 600, "capped": false } ], "brands": [ { "trade_name": "HEPAVERIN 200MG 170 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 244.0, "pack_count": 170, "unit_price": 1.44, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIBOVINAL 200 MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 12.0, "pack_count": 8, "unit_price": 1.5, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIBAVIRIN 200MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM", "price_egp": 22.0, "pack_count": 12, "unit_price": 1.83, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIBAVARIN 200MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 24.0, "pack_count": 12, "unit_price": 2.0, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIBA 200MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PANVIRIN 200MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 32.0, "pack_count": 10, "unit_price": 3.2, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIBAVIRIN 200MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 50.0, "pack_count": 10, "unit_price": 5.0, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIBOVINAL 200 MG 21 STRIPS X 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 252.0, "pack_count": 8, "unit_price": 31.5, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIROKAN 100MG/5ML SYRUP 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 14.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "RIBAVIRIN SYRUP 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.2, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "hepatitis-referral" } ] }