{ "schema_version": 1, "kind": "condition", "id": "lactose-intolerance", "name": "Lactose Intolerance", "category": "chronic", "sources": "WGO Global Guidelines Lactose Intolerance 2013 · Calcichew 500 mg Chewable Tablets SmPC sections 4.1-4.5 (eMC product 12847) · MSF Essential Drugs 2024 (colecalciferol oral monograph, prevention and treatment of vitamin D deficiency) · Lactose Intolerance - disease-level clinical article (lactose-intolerance-full.txt)", "review_status": "reviewed", "verified_against": "WGO Global Guidelines Lactose Intolerance 2013 · Calcichew 500 mg Chewable Tablets SmPC sections 4.1-4.5 (eMC product 12847) · Lactose Intolerance - disease-level clinical article (lactose-intolerance-clinical.txt) · MSF Essential Drugs 2024 (colecalciferol oral monograph, prevention and treatment of vitamin D deficiency) · Lactose Intolerance - disease-level clinical article (lactose-intolerance-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1103, "generic": "Lactase enzyme", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "4500-9000 FCC units taken with the first bite of lactose-containing food", "adult_duration": "as needed with dairy consumption", "dose_source": "WGO Global Guidelines Lactose Intolerance 2013", "rationale": "Enzyme replacement allows digestion of dietary lactose; sold in Egypt as combination enzyme or imported dietary supplement.", "cautions": [ "Dose must be taken concurrently with lactose-containing meals.", "Primary strategy remains dietary lactose restriction or low-lactose products.", "Exclude coeliac disease or secondary enteropathy if symptoms persist." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children >2 years: 2250-4500 FCC units with dairy meals", "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": "RAMELACT 6000 ALU 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 360.0, "pack_count": 30, "unit_price": 12.0, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ROTADIGEST LACTASE 9000 - 30 H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LIFE SAFER INTERNATIONAL > MIRA INTERNATIONAL", "price_egp": 330.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTASE 750 15ML ORAL DROPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD > FORTIS", "price_egp": 99.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "LACTIMISK 15 ML ORAL DROPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DAWA EGYPT > MTS-MED", "price_egp": 150.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "lactose-intolerance" }, { "id": 1105, "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": "Lactose Intolerance - disease-level clinical article (lactose-intolerance-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Refer to a gastroenterologist to evaluate for alternative or concurrent GI disorders; the differential includes celiac disease, IBD, and intestinal neoplasm/polyp." ], "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": "lactose-intolerance" }, { "id": 1104, "generic": "Calcium carbonate", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg chewable tablets, 2 to 3 tablets daily", "adult_duration": "long-term while dairy is restricted", "dose_source": "Calcichew 500 mg Chewable Tablets SmPC sections 4.1-4.5 (eMC product 12847)", "rationale": "Calcium supplement added to a lactose-restricted diet, not a substitute for dietary management of lactose intolerance itself; it replaces the calcium lost when dairy is avoided, and the article asks for it - calcium and vitamin D supplements, to keep the bone healthy. The dose was put right in August 2026: the row had read 500 mg 1 to 2 times daily after food, a figure that is NOT in the label cited beside it. The label's own posology is 2 to 3 tablets daily, for preventing and for treating calcium deficiency, and one tablet carries calcium carbonate equivalent to 500 mg of calcium - so the row as it stands gives 1,000 to 1,500 mg of calcium a day rather than 500 to 1,000 mg. It matches the shin-splints calcium row, which was written from the same label.", "cautions": [ "Replaces the calcium intake lost when dairy is restricted. The label's own indication for Calcichew 500mg Chewable Tablets is as a chewed calcium supplement, to correct a dietary shortfall or to cover a period when the requirement is unusually high; the link to lactose intolerance comes from the disease article.", "The dose here is the label's - 2 to 3 tablets a day, for preventing and treating calcium deficiency. Each tablet carries calcium carbonate delivering 500mg of calcium, so 2 to 3 tablets is 1,000 to 1,500 mg of calcium daily.", "The tablet is taken by chewing or sucking it.", "CONTRAINDICATED, from section 4.3 of the label: hypersensitivity to calcium carbonate itself or to any excipient in the section 6.1 list; any disease or condition producing hypercalcaemia or hypercalciuria; severe renal failure not treated by dialysis; osteoporosis caused by immobilisation; and renal calculi.", "Calcium blocks the absorption of several common drugs, and the fix is timing, not stopping either one: a tetracycline 2 hours before or 4-6 hours after; a quinolone 2 hours either side; iron, zinc or strontium 2 hours either side; levothyroxine at least 4 hours apart.", "Taken together with the vitamin D on this card there is a risk of hypercalcaemia and milk-alkali syndrome; the label asks for serum calcium and renal monitoring, especially with cardiac glycosides or diuretics.", "On a thiazide, check the calcium periodically - the two together push it up." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The label gives the same 2 to 3 tablets daily for paediatric prevention and treatment of calcium deficiency, without an age floor; no lactose-intolerance paediatric calcium figure exists in any document held here.", "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": "OSCASEEF 500MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAFE PHARMA", "price_egp": 21.75, "pack_count": 30, "unit_price": 0.72, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CALCIMATE 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 20.0, "pack_count": 12, "unit_price": 1.67, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CARIBO 500MG 50 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 18.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CALCINEX PLUS SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FAMILY PHARMACIA > SPHINX PHARMA", "price_egp": 59.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "lactose-intolerance" }, { "id": 1106, "generic": "Cholecalciferol", "line": 2, "is_adjunct": true, "form": "oral.liquid", "strength_mg": null, "adult_dose": "600 IU once daily as the preventive dose; where deficiency is established, 6,000 IU once daily for 3 months or 300,000 IU as a single dose, then continue the preventive dose", "adult_duration": null, "dose_source": "MSF Essential Drugs 2024 (colecalciferol oral monograph, prevention and treatment of vitamin D deficiency)", "rationale": "The card already carried calcium carbonate as an adjunct, but the disease article recommends calcium AND vitamin D together to maintain bone health in patients avoiding dairy - so half the article's bone-health pairing was missing. MSF Essential Drugs indicates colecalciferol for the prevention and treatment of vitamin D deficiency and gives the doses. The link from lactose intolerance to that indication comes from the disease article, not from MSF: MSF names rickets and osteomalacia, not lactose intolerance. Named Cholecalciferol rather than the MSF spelling Colecalciferol because that is how the Egyptian register spells it (184 products); the two are the same molecule.", "cautions": [ "Do not administer to patients with hypercalcaemia, hypercalciuria, calcic lithiasis, severe renal impairment.", "Stop treatment if signs of overdosage occur: headache, anorexia, nausea, vomiting, increased thirst, polyuria.", "Avoid combination with thiazide diuretics, e.g. hydrochlorothiazide (decreased urinary calcium excretion).", "Do not exceed 600 000 IU yearly.", "The MSF indication is prevention and treatment of vitamin D deficiency (rickets, osteomalacia); it does not name lactose intolerance, and that link comes from the disease article." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "MSF preventive dosing: child under 12 months, 400 IU once daily; child 12 months and over, 600 IU once daily. For established deficiency MSF gives child under 3 months 2,000 IU once daily for 3 months; 3 to under 12 months 2,000 IU once daily for 3 months or 50,000 IU single dose; 12 months to under 12 years 3,000 to 6,000 IU once daily for 3 months or 150,000 IU single dose.", "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 12 months", "age_min_months": 0, "age_max_months": 11, "dose_text": "Prevention: 400 IU once daily. Established deficiency: under 3 months, 2,000 IU once daily for 3 months; 3 to under 12 months, 2,000 IU once daily for 3 months or 50,000 IU as a single dose." }, { "label": "12 months and over", "age_min_months": 12, "age_max_months": 216, "dose_text": "Prevention: 600 IU once daily. Established deficiency, 12 months to under 12 years: 3,000 to 6,000 IU once daily for 3 months or 150,000 IU as a single dose." } ], "peds_doses": null, "brands": [ { "trade_name": "UR-D 200 I.U./ML ORAL DROPS 25 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 21.6, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "D3 BOX DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANIX INDUSTRY > MEDI CURE", "price_egp": 22.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIDROP 2800 I.U./ML ORAL DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ONEFEROL BONE 2800 I.U./ML ORAL DROPS 30 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARMAZAD > PHARMA ONE", "price_egp": 46.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CHILDAL ORAL DROPS 30 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BRAND PHARMA > MASTER PHARMA", "price_egp": 60.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CHOLETRIX-D3 400 IU ORAL DROPS 30ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD EGYPT > IBM PHARMA", "price_egp": 75.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VITAMIN D 2000IU 30ML ORAL DROPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANIX > SOUL PHARMA", "price_egp": 165.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KIDDO 3 ORAL DROPS 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PRO-BIO PHARMA >", "price_egp": 300.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "D3-TAG 1000 IU/ML ORAL DROPS 30ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "> TAG PHARMA", "price_egp": 27.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "PEDYANO D SYRUP15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANIX > PEDIA PHARM", "price_egp": 35.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "lactose-intolerance" } ] }