Dawaa Reference

infectious

Measles (Rubeola)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

MSF Essential Drugs 2024 (retinol = vitamin A oral monograph), Treatment of vitamin A deficiency and the two-dose measles regimen in Remarks · WHO Guideline for Epidemic Measles Management 2020 · GAMASTAN (immune globulin (human)) injection US prescribing information, section 1 Indications and Usage and section 2 Dosage and Administration (DailyMed SetID 561f48de-2697-4a35-8233-bd1cdb73438f) · Measles - disease-level clinical article (measles-full.txt)

Verified against5 documents
  • MSF Essential Drugs 2024 (retinol = vitamin A oral monograph), Treatment of vitamin A deficiency and the two-dose measles regimen in Remarks
  • WHO Guideline for Epidemic Measles Management 2020
  • Measles - disease-level clinical article (measles-full.txt)
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • GAMASTAN (immune globulin (human)) injection US prescribing information, section 1 Indications and Usage and section 2 Dosage and Administration (DailyMed SetID 561f48de-2697-4a35-8233-bd1cdb73438f)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • The WHO case definition is fever with a widespread blotchy rash, cough, runny nose, or conjunctivitis [cough · fever · rash · runny nose]
  • Koplik spots - small white spots inside the cheeks - show up 1 to 2 days ahead of the rash and are diagnostic on their own [rash]
  • Fever comes before the rash, which starts around the hairline and face and then spreads downward [fever · rash]
  • The rash clears in the same order it appeared, about a week after onset, often followed by skin peeling [rash]
  • Modified measles in previously immunized patients is milder and the rash may start on the trunk or limbs instead of the usual pattern [rash]

Tests (5)

  • CBC often shows low white cells, especially low lymphocytes, and low platelets
  • Within the first 3 days of rash, RT-PCR is most reliable, though viral RNA can still be picked up for up to 10 days afterward
  • Measles-specific IgM confirms the diagnosis but can be falsely negative in up to 25% of cases if drawn within 3 days of rash onset
  • IgM levels rise to a peak by one to three weeks post-rash, then fade below detection somewhere between 4 and 8 weeks
  • False-positive IgM results can occur with rheumatoid factor or with rubella, parvovirus, or human herpesvirus 6 infection

If not this — what else fits (7)

  • Kawasaki disease
  • Rubella in children
  • Scarlet fever
  • Multisystem inflammatory syndrome in children
  • Parvovirus B19 infection
  • Dengue is a differential diagnosis for measles
  • Meningococcemia

SourceStatPearls "Measles" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Fever and discomfort | Vitamin A - WHO, all children | Main treatment | Post-exposure prophylaxis for a contact who cannot have the vaccine - intramuscular only

FEVER AND DISCOMFORT

1

PARACETAMOL

Fever and discomfort

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g 3 or 4 times daily (max. 4 g daily) x 3-5 days

Paediatric dose

10-15 mg/kg/dose [child max 500 mg]

(Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily). Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily).)

Dose by weight
3kg30-45 mg/dose
4kg40-60 mg/dose
5kg50-75 mg/dose
6kg60-90 mg/dose
7kg70-105 mg/dose
8kg80-120 mg/dose
9kg90-135 mg/dose
10kg100-150 mg/dose
11kg110-165 mg/dose
12kg120-180 mg/dose
13kg130-195 mg/dose
14kg140-210 mg/dose
15kg150-225 mg/dose
16kg160-240 mg/dose
17kg170-255 mg/dose
18kg180-270 mg/dose
19kg190-285 mg/dose
20kg200-300 mg/dose
21kg210-315 mg/dose
22kg220-330 mg/dose
23kg230-345 mg/dose
24kg240-360 mg/dose
25kg250-375 mg/dose
26kg260-390 mg/dose
27kg270-405 mg/dose
28kg280-420 mg/dose
29kg290-435 mg/dose
30kg300-450 mg/dose
31kg310-465 mg/dose
32kg320-480 mg/dose
33kg330-495 mg/dose
34kg340-500 mg/dose (upper capped)
35kg350-500 mg/dose (upper capped)
36kg360-500 mg/dose (upper capped)
37kg370-500 mg/dose (upper capped)
38kg380-500 mg/dose (upper capped)
39kg390-500 mg/dose (upper capped)
40kg400-500 mg/dose (upper capped)
41kg410-500 mg/dose (upper capped)
42kg420-500 mg/dose (upper capped)
43kg430-500 mg/dose (upper capped)
44kg440-500 mg/dose (upper capped)
45kg450-500 mg/dose (upper capped)
46kg460-500 mg/dose (upper capped)
47kg470-500 mg/dose (upper capped)
48kg480-500 mg/dose (upper capped)
49kg490-500 mg/dose (upper capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Antipyretic and analgesic for symptomatic relief of fever and discomfort in measles; supportive care only, with no effect on the virus itself.

Cautions
  • Report respiratory distress, altered consciousness, or otitis media.
  • Paracetamol is supportive therapy; isolate the patient to prevent airborne spread.
  • Do not exceed maximum daily dose.
  • 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.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP

VITAMIN A - WHO, ALL CHILDREN

2

VITAMIN A

Vitamin A - WHO, all children

1st line

Formoral.solid

Adult dose and duration

200000 IU once daily for 2 consecutive days x 2 days

Paediatric dose

(Infants <6 months: 50000 IU daily; 6-11 months: 100000 IU daily; >=12 months: 200000 IU daily for 2 days)

Dose by age
Under 6 months:50000 IU daily for 2 days
6 to 11 months:100000 IU daily for 2 days
12 months and over:200000 IU daily for 2 days
Dose source

MSF Essential Drugs 2024 (retinol = vitamin A oral monograph), Treatment of vitamin A deficiency and the two-dose measles regimen in Remarks

Why

WHO-recommended supplementation given during acute measles in children to reduce disease severity and complications, addressing the vitamin A depletion that measles itself provokes.

Cautions
  • Reduces mortality and complications in childhood measles.
  • High-dose Vitamin A is teratogenic; avoid in pregnant adults.
  • Sold as oral drops or capsule contents in primary care.
Egyptian brands
Egyptian brandManufacturerIndicative price
A-VITON 50.000 I.U. 20 CAPS.KAHIRA5.00 EGP (0.25/unit)
VITAMIN A 10 000 IU 100 SOFTGELS (ILLEGAL IMPORT)PURITANS PRIDE63.00 EGP

MAIN TREATMENT

3

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Measles - disease-level clinical article (measles-full.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Infection control measures, including appropriate isolation, are named as part of the mainstay of therapy, and institutional infection control/public health notification should be consulted promptly for suspected cases.
  • RED FLAG - Specialist referral (infectious disease, neurology, pulmonology, critical care) is needed for severe cases or measles complications.

POST-EXPOSURE PROPHYLAXIS FOR A CONTACT WHO CANNOT HAVE THE VACCINE - INTRAMUSCULAR ONLY

4

IMMUNOGLOBULIN

Post-exposure prophylaxis for a contact who cannot have the vaccine - intramuscular only

2nd line

Forminjection

Adult dose and duration

0.25 mL/kg intramuscularly. US label verbatim, from its dosing table: "0.25 mL/kg" with the instruction "Administer to a susceptible person within 6 days of exposure." For an immunocompromised contact the label doubles it: "0.5 mL/kg Immediately administer (maximum dose, 15 mL) to an immunocompromised child." Route is not a choice - "For intramuscular use only." and "Do not administer intravenously." Large volumes are split: "Divide and inject doses greater than 10 mL into several muscle sites to reduce local pain and discomfort." - One dose, tied to the exposure rather than to symptoms. The label's window is six days from contact, and an immunocompromised child is dosed "Immediately".

Paediatric dose

This is mostly a paediatric prescription and the volume is per kilogram: 0.25 mL/kg for a susceptible child within six days of exposure, and 0.5 mL/kg to a maximum of 15 mL, given immediately, for an immunocompromised child. The vaccine schedule then shifts. US label verbatim: "Do not give GAMASTAN and measles vaccine at the same time. If a child is older than 12 months and has received GAMASTAN, give measles vaccine about five months later when the measles antibody titer will have disappeared."

Dose source

GAMASTAN (immune globulin (human)) injection US prescribing information, section 1 Indications and Usage and section 2 Dosage and Administration (DailyMed SetID 561f48de-2697-4a35-8233-bd1cdb73438f)

Why

StatPearls names the step and the drug: give the MMR vaccine as post-exposure prophylaxis within 72 hours of exposure, and where a patient cannot be vaccinated because they are immunocompromised, consider immune globulin instead. The US label's licensed use names the same disease and patient group: it is especially suited to susceptible household contacts of a measles case, particularly those under 1 year old, who carry the highest complication risk; an immunocompromised child exposed to measles should get it right away; and it also covers pregnant women with no evidence of immunity. Measles outbreaks in Cairo reach infants too young to be vaccinated and children on chemotherapy or steroids, and for both groups the vaccine is not the answer. Egypt registers an intramuscular human immunoglobulin, Y-GLOBULIN KGCC vial at 37 EGP, among several intravenous preparations.

Cautions
  • RED FLAG - boxed warning, thrombosis. US label verbatim: "Thrombosis may occur with immune globulin products, including GAMASTAN. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors." and "For patients at risk of thrombosis, do not exceed the recommended dose of GAMASTAN. Ensure adequate hydration in patients before administration."
  • Never intravenously. US label verbatim: "Do not administer intravenously because of the potential for serious reactions (e.g., Renal Dysfunction/Failure/Hemolysis, Transfusion-Related Acute Lung Injury [TRALI])." and, on the injection site, "Do not use the gluteal region as an injection site because of the risk of injury to the sciatic nerve."
  • The millilitre-per-kilogram figure belongs to a 16.5% intramuscular preparation. US label verbatim: "GAMASTAN is a sterile, 16.5% protein solution supplied in 2 mL and 10 mL single-dose vials." A 5% intravenous immunoglobulin is a different product at a different concentration by a different route, and the volume does not carry across - check the vial before drawing anything up. Most of the Egyptian register under this ingredient is intravenous 5% or 10% product; the intramuscular ones are Y-GLOBULIN KGCC I.M VIAL at 37 EGP and HUMAN GAMMA GLOBULIN 16% ampoule.
  • Live vaccines wait afterwards. US label verbatim: "Antibodies in GAMASTAN may interfere with the response to live virus vaccines such as measles, mumps, polio, rubella, and varicella. Defer live vaccine administration for up to 6 months after GAMASTAN administration."
  • Contraindicated in two groups. US label verbatim: "Anaphylactic or severe systemic hypersensitivity reactions to Immune Globulin (Human)" and "IgA deficient patients with antibodies against IgA and a history of hypersensitivity".
  • The vaccine still comes first where it can be given: the disease article recommends the MMR as post-exposure prophylaxis, given within 72 hours of the exposure. Immunoglobulin is for the contact who cannot have it.
Egyptian brands
Egyptian brandManufacturerIndicative price
Y-GLOBULIN KGCC I.M VIALKORIA GREEN CROSS > EIMC37.00 EGP
I.V-GLOBULIN 50MG/ML 0.5G VIALKORIA GREEN CROSS > EIMC360.00 EGP
INTRAGLOBIN F 50MG/ML (20ML=1G) I.V.INFUSIONBIOTEST PHARMA GERMANY > EGYCOPHARM600.00 EGP
INTRAGLOBIN F 50MG/ML (50ML=2.5G) I.V.INFUSIONBIOTEST PHARMA GERMANY > EGYCOPHARM1450.00 EGP
VIGAM-S 5 %W/V (100ML) INJ.BPL BIO PRODUCTS LAB. U.K. > BIO CARE PHARMA GROUP-EGYPT2200.00 EGP
GAMUNEX-C 10% I.V. VIAL 100 MLGRIFOLS THERAPEUTICS LLC > BIOLINX MEDICAL INC.6000.00 EGP
GAMUNEX-C 10% I.V. VIAL 25 MLGRIFOLS THERAPEUTICS LLC > BIOLINX MEDICAL INC.10000.00 EGP
GAMUNEX-C 10% I.V. VIAL 50 MLGRIFOLS THERAPEUTICS LLC > BIOLINX MEDICAL INC.20000.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.