{ "schema_version": 1, "kind": "condition", "id": "herpes-zoster", "name": "Herpes zoster (shingles)", "category": "infectious", "sources": "Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph) · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683) · Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (famciclovir monograph)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph) · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683) · Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph) · Herpes Zoster - disease-level clinical article (herpes-zoster-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 927, "generic": "Acyclovir", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 800.0, "adult_dose": "800 mg orally 5 times daily (every 4 hours while awake)", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Nucleoside analogue antiviral that inhibits viral DNA polymerase to limit replication of varicella-zoster virus; started early after the shingles rash appears, before extensive viral replication, to reduce the severity of the episode.", "cautions": [ "Initiate within 72 hours of rash onset for optimal efficacy.", "Maintain high fluid intake to prevent renal crystallization.", "Dose adjustment is required in renal impairment." ], "peds_mgkg_low": 20.0, "peds_mgkg_high": 20.0, "peds_max_mg": 800.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "20 mg/kg 4 times daily (max 800 mg/dose) for children 1 mo–11 yrs; 800 mg 5 times daily for adolescents ≥12 yrs", "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": 200, "high_mg": 200, "capped": false }, { "weight_kg": 20, "low_mg": 400, "high_mg": 400, "capped": false }, { "weight_kg": 30, "low_mg": 600, "high_mg": 600, "capped": false }, { "weight_kg": 40, "low_mg": 800, "high_mg": 800, "capped": false } ], "brands": [ { "trade_name": "VIRUSTAT 800MG 35 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 266.0, "pack_count": 35, "unit_price": 7.6, "strength_mg": 800.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACIVIRAX 800MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 154.0, "pack_count": 20, "unit_price": 7.7, "strength_mg": 800.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOVIR 800 MG 35 ORAL DISP. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SUN PHARMA EGYPT LIMITED", "price_egp": 300.0, "pack_count": null, "unit_price": null, "strength_mg": 800.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BORGAVIRAX 200MG/5ML SUSP. 125 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 61.0, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "VIRUSTAT 200MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 61.0, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" }, { "id": 928, "generic": "Valacyclovir", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1000 mg three times daily", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph)", "rationale": "Three doses a day against aciclovir's five. Shingles is painful, patients are elderly, and a five-times-a-day schedule is the one they miss. The formulary carries the drug and the herpes zoster dose, and it is on the Egyptian Essential Medicine List.", "cautions": [ "An alternative to the aciclovir above, not an addition. Give one antiviral.", "Start within 72 hours of the rash appearing - the formulary states efficacy is not established beyond that, and preferably within 48 hours.", "Reduce the dose in renal impairment: 1 g every 12 hours if creatinine clearance is 30-49, every 24 hours if 10-29, and 500 mg every 24 hours below 10.", "Keep fluid intake up.", "Confusion and hallucination occur in the elderly and in renal impairment, and are usually a sign the dose is too high." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives no paediatric herpes zoster dose for valacyclovir - its paediatric doses are for herpes labialis and genital herpes. Use the aciclovir row in a child.", "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": "VIROCLEAR 500 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 50.0, "pack_count": 10, "unit_price": 5.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VALTREX 500 MG 42 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 789.0, "pack_count": 42, "unit_price": 18.79, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HERPACUT 500 MG 10 SCORED F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG AGENCY (IDI)", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VALYSERNEX 500MG 20 F.C. CAPLET", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 154.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" }, { "id": 933, "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": "Herpes Zoster - disease-level clinical article (herpes-zoster-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Prompt ophthalmology referral is needed when eye involvement is present." ], "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": "herpes-zoster" }, { "id": 934, "generic": "Famciclovir", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg every 8 hours", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (famciclovir monograph) - verbatim: \"Herpes zoster (shingles): Oral: Note: Initiate therapy as soon as possible after diagnosis and within 1 week of rash onset or any time before full crusting of lesions. Immunocompetent patients: 500 mg every 8 hours for 7 days.\"", "rationale": "The card carries acyclovir and valacyclovir and stops there. Famciclovir is the third oral antiviral licensed for shingles, the formulary gives it a zoster heading of its own, and the article names it for the patient whose virus is acyclovir-resistant.", "cautions": [ "Start it within the first week of the rash, or at least before the lesions have fully crusted - after that an antiviral has little left to offer.", "Reduce the dose in renal impairment; the formulary steps it down as creatinine clearance falls, and again for dialysis patients.", "This dose is for the immunocompetent patient - shingles in someone immunosuppressed needs a different plan and usually a specialist.", "It does not prevent post-herpetic neuralgia on its own; the pain rows on the card still apply." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives no paediatric dose for herpes zoster in immunocompetent children; its paediatric famciclovir doses are for genital herpes and for HIV-positive adolescents.", "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": "EACLOVIR 500MG 7 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > EGYPTIAN AMERICAN", "price_egp": 85.0, "pack_count": 7, "unit_price": 12.14, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROPENCIVIR 500MG 7 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIORIGINAL INTERNATIONAL GROUP PHARMA", "price_egp": 175.5, "pack_count": 7, "unit_price": 25.07, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" }, { "id": 929, "generic": "Paracetamol", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1000 mg three or four times daily, maximum 4000 mg in 24 hours", "adult_duration": "while the rash is painful, usually 2-4 weeks", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "The pain is what the patient came with. The antiviral shortens the rash; it does very little for today's pain. Uncontrolled acute zoster pain is also the strongest predictor of post-herpetic neuralgia, so treating it is not just comfort.", "cautions": [ "Regular, not as-needed. Zoster pain is constant for the first week or two and PRN dosing under-treats it.", "Check every other product for paracetamol - cold and flu sachets are the usual route to an accidental overdose.", "Reduce the maximum to 3000 mg/day if the patient is under 50 kg, malnourished, or has liver disease.", "If paracetamol and an NSAID together are not holding the pain, that is the point to add a nerve-pain drug, not to keep escalating the analgesic.", "500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case." ], "peds_mgkg_low": 15.0, "peds_mgkg_high": 15.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "15 mg/kg 3 or 4 times daily, maximum 60 mg/kg daily. Under 1 month: 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg/day (MSF Essential Drugs 2024).", "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": 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": 500, "high_mg": 500, "capped": true } ], "brands": [ { "trade_name": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "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 }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" }, { "id": 930, "generic": "Ibuprofen", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg up to three times daily with or after food, maximum 1200 mg in 24 hours", "adult_duration": "while the rash is painful, usually 2-4 weeks", "dose_source": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)", "rationale": "Can be given with the paracetamol when that alone is not enough. AAFP names NSAIDs alongside acetaminophen for the acute pain.", "cautions": [ "SHINGLES IS NOT CHICKENPOX. The rule against NSAIDs in varicella is about primary chickenpox and the risk of necrotising soft tissue infection; AAFP names NSAIDs for zoster in adults. If the diagnosis is actually primary varicella, do not give this.", "Avoid in asthma, active peptic ulcer, significant renal impairment, heart failure, and the third trimester.", "Most zoster patients are elderly - check the eGFR and check whether they are already on an ACE inhibitor or a diuretic before adding an NSAID.", "With food, short course, and not on top of another NSAID." ], "peds_mgkg_low": 20.0, "peds_mgkg_high": 20.0, "peds_max_mg": 1200.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "20 mg/kg/day in divided doses, with food. Not under 3 months. Shingles in a child is uncommon and warrants a look for immunosuppression.", "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": 200, "high_mg": 200, "capped": false }, { "weight_kg": 20, "low_mg": 400, "high_mg": 400, "capped": false }, { "weight_kg": 30, "low_mg": 600, "high_mg": 600, "capped": false }, { "weight_kg": 40, "low_mg": 800, "high_mg": 800, "capped": false } ], "brands": [ { "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" }, { "id": 931, "generic": "Amitriptyline", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 25.0, "adult_dose": "10-25 mg in the evening to start, increased by 10-25 mg every 3-7 days as tolerated; usual range 25-75 mg at night", "adult_duration": "reviewed at 4-6 weeks; continue while it is helping, then taper", "dose_source": "Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683)", "rationale": "Post-herpetic neuralgia is neuropathic pain and NICE CG173 offers a choice of four drugs for it. Amitriptyline is the cheapest of the four in Egypt and is licensed for the indication. This is the drug the patient needs when the rash has healed and the pain has not.", "cautions": [ "Dry mouth, constipation, urinary retention, postural dizziness and falls are all dose-related.", "Alternative to the gabapentin below, not an addition. NICE offers a choice of one.", "Take it in the evening; the sedation is useful when the pain is worst at night.", "Avoid after a recent myocardial infarction, in arrhythmia, and in untreated closed-angle glaucoma.", "It takes 2-4 weeks at an adequate dose to work. Stopping at day 5 because 'it did nothing' is the commonest way this fails.", "Do not stop abruptly after a long course - taper.", "Avoid in elderly patients, and in severe cardiovascular disease or arrhythmias. Amitriptyline - StatPearls - NCBI Bookshelf (NBK537225) puts amitriptyline on the American Geriatrics Society's Beers list, to be avoided in the elderly because its anticholinergic effect is so strong." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The label states amitriptyline should not be used in children and adolescents under 18 years, as safety and efficacy have not been established.", "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": "TRYPTIZOL 25 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 33.0, "pack_count": 30, "unit_price": 1.1, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRANITYLLIN 25MG/5ML SYP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRAND PHARMA > DELTA GRAND PHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZINOTRAVAL 25MG/5ML SYP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY > PHARMACHEMIC", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" }, { "id": 932, "generic": "Gabapentin", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "300 mg on day 1, 300 mg twice daily on day 2, 300 mg three times daily on day 3, then increased in 300 mg/day steps every 2-3 days to a usual 1800 mg/day in three divided doses", "adult_duration": "titrated over 1-3 weeks; reviewed at 4-6 weeks and continued while it is helping", "dose_source": "Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph)", "rationale": "The formulary names post-herpetic neuralgia in the indication line, with its own titration schedule. NICE CG173 offers it as one of four initial choices for neuropathic pain.", "cautions": [ "Alternative to the amitriptyline above, not an addition. NICE offers a choice of one.", "It must be titrated. A patient started straight on 300 mg three times daily will be too drowsy to continue.", "Reduce the dose in renal impairment - gabapentin is cleared by the kidney and accumulates.", "Drowsiness, dizziness and unsteadiness are common early and matter in an elderly patient who may fall.", "Divide into three doses with no more than 12 hours between them.", "Do not stop abruptly - taper over at least a week." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The paediatric mg/kg dose in the formulary is for partial-onset seizures from 3 years, not for neuropathic pain. The neuropathic pain indication is adults only, and the dose is a step-up schedule rather than a single mg/kg rule.", "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": "EZAPENTIN 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENTALIPSY 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAFE PHARMA", "price_egp": 14.4, "pack_count": 10, "unit_price": 1.44, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OCTOCONVAL 300 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA", "price_egp": 72.0, "pack_count": 30, "unit_price": 2.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEUROGLOPENTIN 300 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 111.0, "pack_count": 30, "unit_price": 3.7, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SHALGATEN 300MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > MASH PREMIERE", "price_egp": 126.0, "pack_count": 30, "unit_price": 4.2, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GABALEPSY 300MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 135.0, "pack_count": 30, "unit_price": 4.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GABAVERONA 300 MG 30 H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA", "price_egp": 126.0, "pack_count": null, "unit_price": null, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SAJALIPSY 300 MG 30 H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAJA PHARMACEUTICALS", "price_egp": 126.0, "pack_count": null, "unit_price": null, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STABLENTIN 6MG/120ML SYRUP", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 21.6, "pack_count": null, "unit_price": null, "strength_mg": 6.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ADAPTAN 250MG/5ML ORAL SOLUTION 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 37.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "herpes-zoster" } ] }