{ "schema_version": 1, "kind": "condition", "id": "hypertensive-urgency", "name": "Hypertensive Urgency", "category": "acute", "sources": "Egyptian National Drug Formulary - Cardiovascular 2024 · Trandate (labetalol) 200 mg tablets SmPC sections 4.2-4.4 (eMC product 9168) · Captopril tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID 563737c5-4d63-4957-8022-e3bc3112dfac)", "review_status": "reviewed", "verified_against": "Trandate (labetalol) 200 mg tablets SmPC sections 4.2-4.4 (eMC product 9168) · Egyptian National Drug Formulary - Cardiovascular 2024 · Captopril tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID 563737c5-4d63-4957-8022-e3bc3112dfac)", "verified_date": "2026-08", "treatments": [ { "id": 973, "generic": "Captopril", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 25.0, "adult_dose": "25 mg twice or three times daily to start, under close medical supervision - the label's regimen for severe hypertension when prompt titration is indicated. When the patient's condition requires it, the daily dose may be increased every 24 hours or less, under continuous supervision, until the blood pressure responds. Never more than 450 mg in a day.", "adult_duration": "single dose initial acute reduction", "dose_source": "Captopril tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID 563737c5-4d63-4957-8022-e3bc3112dfac)", "rationale": "Short-acting ACE inhibitor whose rapid onset makes it suitable for urgent, non-emergency blood pressure lowering; chosen for its faster effect than longer-acting agents, with target-organ damage excluded first since a true hypertensive emergency needs IV therapy.", "cautions": [ "The word sublingual appears on no captopril label - the label says to take the tablet one hour before food, which is an oral absorption instruction - and ESC directs hypertensive urgency to the ordinary oral algorithm with urgent follow-up rather than a fast drop in pressure.", "Do not aim to normalise the pressure quickly. In someone whose autoregulation is set high, a rapid fall causes cerebral, cardiac or renal ischaemia - the target is a controlled reduction over hours to days.", "CRITICAL: Rule out acute target-organ damage (hypertensive emergency: encephalopathy, stroke, acute MI, pulmonary edema, aortic dissection, eclampsia) prior to oral therapy; emergencies require immediate IV therapy and hospital admission.", "CONTRAINDICATED in pregnancy (teratogenic / severe fetal renal toxicity; use oral labetalol instead) and bilateral renal artery stenosis.", "Do NOT lower blood pressure precipitously; aim for gradual reduction over 24-48 hours." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist emergency referral required for children with severe hypertension", "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": "FARCOPRIL 25MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.25, "pack_count": 20, "unit_price": 0.21, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANGIOPRESS 25MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": 10, "unit_price": 0.5, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HYPOPRESS 25MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 15.0, "pack_count": 30, "unit_price": 0.5, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOTENSINE 25MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 11.0, "pack_count": 20, "unit_price": 0.55, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CAPOTRIL 25MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 20.0, "pack_count": 20, "unit_price": 1.0, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CAPOTEN 25 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SMITHKLINE BEECHAM", "price_egp": 32.0, "pack_count": 20, "unit_price": 1.6, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CAPTOLINK 5MG/5ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ROYAL LINK PHARMA", "price_egp": 34.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "HYPERCAPT 5MG/5ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ROYAL LINK > NEW BOSTON PHARMACEUTICALS", "price_egp": 34.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "hypertensive-urgency" }, { "id": 974, "generic": "Labetalol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg twice daily, taken with food, to start. The label allows daily rather than fortnightly increases in hospital in-patients with severe hypertension. Many patients are controlled on 200 mg twice daily, and up to 800 mg daily may be given as a twice-daily regimen. In the elderly start at 50 mg twice daily.", "adult_duration": "Initial acute reduction over 24 hours, then 2-3 days pending specialist follow-up", "dose_source": "Trandate (labetalol) 200 mg tablets SmPC sections 4.2-4.4 (eMC product 9168)", "rationale": "Combined alpha- and beta-adrenergic blocker that lowers blood pressure without the reflex tachycardia seen with pure vasodilators; the oral antihypertensive of choice for severe hypertension in pregnancy, where ACE inhibitors and ARBs are contraindicated.", "cautions": [ "Labetalol is the first-line oral antihypertensive of choice for severe hypertension in pregnancy (where ACE inhibitors and ARBs are strictly contraindicated).", "Contraindicated in asthma, severe bradycardia, and second/third-degree heart block.", "Caution in decompensated heart failure.", "Never stopped abruptly, least of all in ischaemic heart disease - come down over one to two weeks.", "Rare but real: severe hepatocellular injury. Jaundice or a deranged liver panel means stop, not reduce.", "Also contraindicated in cardiogenic shock, uncontrolled heart failure, sick sinus syndrome, Prinzmetal's angina, untreated phaeochromocytoma, metabolic acidosis and severe peripheral circulatory disease.", "In the hypertension of pregnancy the label goes further: 100 mg twice daily increased at weekly intervals, and in the second and third trimesters a three-times-daily regimen from 100 mg tds to 400 mg tds, never above 2400 mg in a day.", "Uncontrolled, incipient or digitalis-refractory heart failure." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The label says safety and efficacy in children have not been established. A child with severe hypertension is a specialist referral, not a prescription.", "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": "LABIPRESS 100 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY > NOVELL PHARMA", "price_egp": 69.0, "pack_count": 30, "unit_price": 2.3, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "hypertensive-urgency" } ] }