{ "schema_version": 1, "kind": "condition", "id": "irritable-bowel-syndrome", "name": "Irritable bowel syndrome (IBS)", "category": "chronic", "sources": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (polyethylene glycol 3350 (macrogol) monograph, ATC A06AD65) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (trimebutine monograph) · Mebeverine 50mg/5ml Sugar Free Oral Suspension SmPC section 4.2 (eMC product 14976); Colofac Tablets 135 mg SmPC section 4.2 (eMC product 102499) · Irritable Bowel Syndrome - StatPearls - NCBI Bookshelf (NBK534810)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary (endf-git.txt) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (polyethylene glycol 3350 (macrogol) monograph, ATC A06AD65) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (trimebutine monograph) · Irritable Bowel Syndrome - disease-level clinical article (irritable-bowel-syndrome-full.txt) · Mebeverine 50mg/5ml Sugar Free Oral Suspension SmPC section 4.2 (eMC product 14976); Colofac Tablets 135 mg SmPC section 4.2 (eMC product 102499)", "verified_date": "2026-08", "treatments": [ { "id": 1069, "generic": "Mebeverine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 135.0, "adult_dose": "135 mg TID 20 minutes before meals", "adult_duration": "As required for symptom flares", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (mebeverine monograph): \"Tablets: 100 mg, 135 mg\" and \"Adult dosing Immediate release forms Oral: 100-150 mg three times daily, preferably 20 minutes before meals\", with \"Children 10 years and above Oral suspension: 150 mg three times daily, preferably 20 minutes before meals\". The Colofac 135 mg tablet SmPC is not held in this corpus.", "rationale": "Direct smooth-muscle relaxant without anticholinergic side effects", "cautions": [ "Take 20 minutes before meals for optimal antispasmodic efficacy.", "Avoid in paralytic ileus.", "Hypersensitivity reactions (urticaria, angioedema) are reported rarely.", "The tablet is 135 mg and the suspension doses at 150 mg. They are not the same figure and the tablet is adults-only, so do not read the tablet strength across to a child." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No UK label carries a mebeverine dose below 10 years. The oral suspension says of children under 10, in these words, \"Not applicable\", and the 135 mg tablet is not recommended below 18 for insufficient safety and efficacy data. From 10 years the suspension gives 15 mL (150 mg) three times daily, 20 minutes before meals. No label supports bands of 25 mg from age 3 or 50 mg from age 8; a child under 10 with these symptoms should be assessed, not given an antispasmodic.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "10 years and over", "age_min_months": 120, "age_max_months": 216, "dose_text": "15 mL of the oral suspension (150 mg) three times daily, 20 minutes before meals. No UK label carries a dose below 10 years." } ], "peds_doses": null, "brands": [ { "trade_name": "SPASMOTALIN FORTE 135MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 12.5, "pack_count": 20, "unit_price": 0.62, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLORELAX 135MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 14.4, "pack_count": 20, "unit_price": 0.72, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLOVERIN 135 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLOSPATORAZ 135MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANOPHARMA > NALI PHARMA INTERNATIONAL", "price_egp": 81.0, "pack_count": 30, "unit_price": 2.7, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACOLON 135MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 54.0, "pack_count": 20, "unit_price": 2.7, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KOLOCUREJED 135 MG 20 C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 12.5, "pack_count": null, "unit_price": null, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLOSPASMIN FORTE 135 MG 20 SUGAR C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 51.0, "pack_count": null, "unit_price": null, "strength_mg": 135.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1072, "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": "Irritable Bowel Syndrome - disease-level clinical article (irritable-bowel-syndrome-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Look for alarm features and red flags for underlying organic gastrointestinal 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": "irritable-bowel-syndrome" }, { "id": 1070, "generic": "Lactulose", "line": 2, "is_adjunct": false, "form": "oral.liquid", "strength_mg": null, "adult_dose": "15-30 mL daily in 1-2 divided doses for constipation-predominant IBS", "adult_duration": "As needed", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph)", "rationale": "NICE CG61 discourages lactulose in IBS due to gas and bloating, but it remains utilized in local Egyptian practice as an alternative osmotic laxative.", "cautions": [ "May cause flatulence, abdominal cramps, and bloating initially.", "Ensure adequate fluid intake.", "Takes 24-48 hours to produce laxative effect." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Infant under 1 year: up to 5 mL daily. Child 1-6 years: 5-10 mL daily. Child 7-14 years: start 15 mL daily, maintenance 10-15 mL daily. Adjust to produce a soft stool without diarrhoea.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Under 1 year", "age_min_months": 0, "age_max_months": 11, "dose_text": "Up to 5 mL daily" }, { "label": "1 to 6 years", "age_min_months": 12, "age_max_months": 83, "dose_text": "5 to 10 mL daily" }, { "label": "7 to 14 years", "age_min_months": 84, "age_max_months": 179, "dose_text": "15 mL daily to start, then 10 to 15 mL daily. Adjust to produce a soft stool without diarrhoea." } ], "peds_doses": null, "brands": [ { "trade_name": "FARCOLAC 667GM/L SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 667000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTOLINE 50% SYRUP 200ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 9.25, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAEVOLAC 67GM/100ML SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > FRESENIUS KABI", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 67000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEDALAC 3.35GM/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 20.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAXOLAC 3.35GM/5ML SYRUP 300ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAXOLAC 3.35GM/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUPHALAC 667GM/L SYRUP 200ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ABBOTT LABORATORIES", "price_egp": 143.0, "pack_count": null, "unit_price": null, "strength_mg": 667000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTULOSE-AUG PHARMA 3.35GM/5ML SYRUP 320ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 170.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VILLAPURG 67% SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "VILLAPURG 67% SYRUP 200 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 17.75, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1071, "generic": "Trimebutine", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg every 8 hours taken before meals; may be increased to a maximum of 200 mg every 8 hours", "adult_duration": "Symptomatic; review benefit at 4 weeks and stop if there is none", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (trimebutine monograph)", "rationale": "14 live products and a formulary indication that maps directly onto IBS - 'pain, transit disorders and intestinal discomfort associated with functional intestinal disorders'. Unlike mebeverine it acts on both constipation- and diarrhoea-predominant transit.", "cautions": [ "Symptomatic only - it does not alter the course of IBS, and diet, fibre and sleep advice do more.", "The evidence base is weaker than for mebeverine; treat it as an alternative when mebeverine has failed or is not tolerated.", "Contraindicated under 2 years of age.", "Review the diagnosis rather than repeating the prescription if there is weight loss, nocturnal symptoms, rectal bleeding, or onset over age 50." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives dosing only for 12 years and over (adult dose). Contraindicated under 2 years. Oral suspension 24 mg/5 mL exists for children but the monograph states no dose for the 2-11 year band.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "The adult dose. Contraindicated under 2 years, and no dose is stated for 2 to 11 years." } ], "peds_doses": null, "brands": [ { "trade_name": "TRIBUDAT 100MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 12.0, "pack_count": 20, "unit_price": 0.6, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAST-REG 100 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 72.0, "pack_count": 30, "unit_price": 2.4, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRONTOMUTIM 100 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 72.0, "pack_count": 30, "unit_price": 2.4, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRITONE 100MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 72.0, "pack_count": 30, "unit_price": 2.4, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAST-REG 24MG/5ML 125ML SUSP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 33.0, "pack_count": null, "unit_price": null, "strength_mg": 24.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "TRITONE 4.8MG/ML SUSP. 125ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 33.0, "pack_count": null, "unit_price": null, "strength_mg": 4.8, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1074, "generic": "Macrogol 3350", "line": 2, "is_adjunct": false, "form": "oral.liquid", "strength_mg": null, "adult_dose": "1-3 sachets daily in divided doses, adjusted up or down as required to produce regular soft stools (maximum 4 sachets a day) - the 13.125 g adult sachet", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (polyethylene glycol 3350 (macrogol) monograph, ATC A06AD65)", "rationale": "Osmotic laxative for the constipation limb of IBS (IBS-C). Dosed here in the Egyptian sachet the register actually carries, on the ENDF's adult indication - the same figures as the constipation card.", "cautions": [ "Not recommended in children under 2 years of age for chronic constipation.", "Ensure adequate hydration during treatment.", "The sachet sizes are not interchangeable, and the doses above are counted in sachets. ENDF verbatim: \"Products containing 6.563 grams per sachet: 1. For the treatment of chronic constipation in children 2 to 11 years of age\" and \"Products containing 13.125 grams per sachet: 4. Treatment of chronic constipation in adults\". MOVICOL PAEDIATRIC is the 6.563 g sachet; MOVICOL is the 13.125 g one.", "NOT the colonoscopy preparation, which is the same drug at eight times the pouch. MOVIPREP and PREPAWEST are that product and are deliberately not listed below.", "For the constipation limb of IBS only. It does not treat the pain or the diarrhoea limb, and an osmotic laxative can worsen bloating in IBS." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child 2-6 yrs: starting dose 1 sachet daily; Child 7-11 yrs: 2 sachets daily - the 6.563 g paediatric sachet, not the adult one. Adjust to produce regular soft stools.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 to 6 years", "age_min_months": 24, "age_max_months": 83, "dose_text": "1 sachet daily to start - the 6.563 g paediatric sachet, not the adult one" }, { "label": "7 to 11 years", "age_min_months": 84, "age_max_months": 143, "dose_text": "2 sachets daily - the 6.563 g paediatric sachet, not the adult one" } ], "peds_doses": null, "brands": [ { "trade_name": "MOVICOL PAEDIATRIC 30 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NORGINE LIMITED > ACINO", "price_egp": 221.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "potassium chloride, sodium chloride, sodium hydrogen carbonate" }, { "trade_name": "MOVICOL 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NORGINE LIMITED > ACINO", "price_egp": 273.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "potassium chloride, sodium bicarbonate, sodium chloride" } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1075, "generic": "Amitriptyline", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg at night, raised slowly if needed to 30 mg a day", "adult_duration": null, "dose_source": "Irritable Bowel Syndrome - StatPearls - NCBI Bookshelf (NBK534810)", "rationale": "The card treats spasm and transit but has nothing for the persistent pain that brings most IBS patients back. A low-dose tricyclic works on gut pain signalling rather than mood, and its slowing effect on the bowel suits the diarrhoea-predominant patient. Move the dose up over weeks, not days.", "cautions": [ "Warn the patient about drowsiness, dry mouth and constipation, and give the dose at night.", "Avoid it in someone with glaucoma, urinary retention, a recent heart attack or a known heart rhythm problem.", "This is a pain dose, not an antidepressant dose - say so, or the patient may stop the tablet when they read the leaflet." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose in the sources opened.", "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 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 10.0, "pack_count": 20, "unit_price": 0.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRYPTIZOL 10 MG 60 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 30.0, "pack_count": 60, "unit_price": 0.5, "strength_mg": 10.0, "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": "irritable-bowel-syndrome" }, { "id": 1076, "generic": "Cholestyramine", "line": 2, "is_adjunct": false, "form": "oral.liquid", "strength_mg": null, "adult_dose": "2 to 4 g a day, as one dose or split into two", "adult_duration": null, "dose_source": "Irritable Bowel Syndrome - StatPearls - NCBI Bookshelf (NBK534810)", "rationale": "Bile acid malabsorption sits behind a large share of diarrhoea-predominant IBS and does not respond to antispasmodics. A bile acid sequestrant is the specific answer, and it is a cheap sachet in Egypt. Worth a trial in the patient whose stool is watery and urgent, especially after meals.", "cautions": [ "It binds other drugs in the gut - separate every other tablet from it by several hours, and check this against anything the patient takes for the heart or the thyroid.", "Long use can interfere with the absorption of fat-soluble vitamins.", "It commonly causes bloating and constipation, which can be mistaken for the IBS getting worse." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose in the sources opened.", "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": "CHOLESTRAN 4 GM 12 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 19.8, "pack_count": null, "unit_price": null, "strength_mg": 4000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "QUANTAMASH 4 GM 12 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY > MASH PREMIERE", "price_egp": 83.0, "pack_count": null, "unit_price": null, "strength_mg": 4000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "QUESTRAN 4 GM 50 SACHETS (ILLEGAL IMPORT)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BRISTOL-MYERS SQUIBB", "price_egp": 54.0, "pack_count": null, "unit_price": null, "strength_mg": 4000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1077, "generic": "Peppermint oil", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "180 to 360 mg (0.2 to 0.4 mL) three times a day, as an enteric-coated capsule", "adult_duration": null, "dose_source": "Irritable Bowel Syndrome - StatPearls - NCBI Bookshelf (NBK534810)", "rationale": "It relaxes intestinal smooth muscle by a different route from mebeverine, so it is a real second try rather than a repeat of the first. It is sold over the counter in Egypt for a few pounds, which matters for a condition the patient will be managing for years.", "cautions": [ "The capsule must be enteric-coated and swallowed whole; if the oil is released in the stomach it causes heartburn instead of relief.", "Confirm with the pharmacist that the box is a plain peppermint oil capsule - most Egyptian mint products are multi-herb digestive mixtures or massage rubs.", "Avoid it in a patient whose main complaint is reflux, because it relaxes the valve at the top of the stomach." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose in the sources opened.", "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": "COLOMINT 24 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 5.5, "pack_count": 24, "unit_price": 0.23, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1078, "generic": "Rifaximin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 550.0, "adult_dose": "550 mg three times a day", "adult_duration": "14 days", "dose_source": "Irritable Bowel Syndrome - StatPearls - NCBI Bookshelf (NBK534810)", "rationale": "A gut-only antibiotic that acts on the bacterial overgrowth behind some diarrhoea-predominant IBS. It sits after the antispasmodic, the peppermint oil and the tricyclic, not before them. If the first course works, it may be repeated every three to four months rather than taken continuously.", "cautions": [ "It is by far the most expensive of the options listed - price the full course before writing it.", "Do not use it as a first move for IBS diarrhoea; it belongs after the cheaper options have genuinely been tried.", "Stop it and reconsider the diagnosis if diarrhoea becomes severe or bloody during or after the course." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose in the sources opened.", "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": "IDIBACT 550 MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > NOVELL PHARMA", "price_egp": 103.75, "pack_count": 20, "unit_price": 5.19, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ROLAXIMINE 550 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA > HORUS FOR PHARMACEUTICAL PRODUCTS", "price_egp": 225.0, "pack_count": 30, "unit_price": 7.5, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIFAXEROSE 550 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA", "price_egp": 82.0, "pack_count": 10, "unit_price": 8.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIOREFAMIN 550 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P & C LABS > SOVALUE PHARMA", "price_egp": 148.0, "pack_count": 10, "unit_price": 14.8, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUFAXIMIN 550 MG 28 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 480.0, "pack_count": 28, "unit_price": 17.14, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FATROXIM 550 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 516.0, "pack_count": 30, "unit_price": 17.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GASTROBIOTIC 550 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 516.0, "pack_count": 30, "unit_price": 17.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRAVIGUARD 550 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P AND C LABS > TREND PHARM", "price_egp": 344.0, "pack_count": 20, "unit_price": 17.2, "strength_mg": 550.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" }, { "id": 1073, "generic": "Loperamide", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 2.0, "adult_dose": "Initial dose: 4 mg, followed by 2 mg after each loose stool.", "adult_duration": "As needed for diarrhea flares", "dose_source": "Egyptian National Drug Formulary (endf-git.txt)", "rationale": "Synthetic opioid agonist used for symptomatic control of diarrhea episodes in diarrhea-predominant IBS.", "cautions": [ "Avoid use in higher than recommended doses due to risk of serious cardiac adverse reactions (QT prolongation, Torsades de Pointes).", "Discontinue immediately if constipation, abdominal distention, or ileus develops." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescents 12 to 18 years (acute diarrhea): 2 to 4 mg initially, then 2 mg after each loose stool; max 8 to 16 mg/day. Children 6 to 12 years: 6-8 yr (20-30 kg): 2 mg twice daily; 8-12 yr (>30 kg): 2 mg three times daily; subsequent: 1 mg per 10 kg after each loose stool. Contraindicated in children <2 years. IBS diarrhoea indication is adults >=18 years only.", "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": "MOTIJUST 2 MG 30 CAPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > NOVELL PHARMA", "price_egp": 27.0, "pack_count": 30, "unit_price": 0.9, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STOPRRHEA 2 MG 10 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IMODIUM INSTANT 2MG 6 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MCNEIL PRODUCTS LTD. > JOHNSON & JOHNSON SCIENTIFIC OFFICE", "price_egp": 80.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STOPRRHEA 2 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 96.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "irritable-bowel-syndrome" } ] }