{ "schema_version": 1, "kind": "condition", "id": "measles", "name": "Measles (Rubeola)", "category": "infectious", "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)", "review_status": "reviewed", "verified_against": "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_date": "2026-08", "treatments": [ { "id": 1169, "generic": "Paracetamol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g 3 or 4 times daily (max. 4 g daily)", "adult_duration": "3-5 days", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "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." ], "peds_mgkg_low": 10.0, "peds_mgkg_high": 15.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "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).", "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": 100, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 200, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 300, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 400, "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": "measles" }, { "id": 1170, "generic": "Vitamin A", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "200000 IU once daily for 2 consecutive days", "adult_duration": "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", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Infants <6 months: 50000 IU daily; 6-11 months: 100000 IU daily; >=12 months: 200000 IU daily for 2 days", "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 6 months", "age_min_months": 0, "age_max_months": 5, "dose_text": "50000 IU daily for 2 days" }, { "label": "6 to 11 months", "age_min_months": 6, "age_max_months": 11, "dose_text": "100000 IU daily for 2 days" }, { "label": "12 months and over", "age_min_months": 12, "age_max_months": 216, "dose_text": "200000 IU daily for 2 days" } ], "peds_doses": null, "brands": [ { "trade_name": "A-VITON 50.000 I.U. 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VITAMIN A 10 000 IU 100 SOFTGELS (ILLEGAL IMPORT)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PURITANS PRIDE", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "measles" }, { "id": 1171, "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": "Measles - disease-level clinical article (measles-full.txt)", "rationale": "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." ], "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": "measles" }, { "id": 1172, "generic": "Immunoglobulin", "line": 2, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "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.\"", "adult_duration": "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\".", "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)", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "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.\"", "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": "Y-GLOBULIN KGCC I.M VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KORIA GREEN CROSS > EIMC", "price_egp": 37.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "I.V-GLOBULIN 50MG/ML 0.5G VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KORIA GREEN CROSS > EIMC", "price_egp": 360.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "INTRAGLOBIN F 50MG/ML (20ML=1G) I.V.INFUSION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOTEST PHARMA GERMANY > EGYCOPHARM", "price_egp": 600.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "INTRAGLOBIN F 50MG/ML (50ML=2.5G) I.V.INFUSION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOTEST PHARMA GERMANY > EGYCOPHARM", "price_egp": 1450.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIGAM-S 5 %W/V (100ML) INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BPL BIO PRODUCTS LAB. U.K. > BIO CARE PHARMA GROUP-EGYPT", "price_egp": 2200.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAMUNEX-C 10% I.V. VIAL 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRIFOLS THERAPEUTICS LLC > BIOLINX MEDICAL INC.", "price_egp": 6000.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAMUNEX-C 10% I.V. VIAL 25 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRIFOLS THERAPEUTICS LLC > BIOLINX MEDICAL INC.", "price_egp": 10000.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAMUNEX-C 10% I.V. VIAL 50 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRIFOLS THERAPEUTICS LLC > BIOLINX MEDICAL INC.", "price_egp": 20000.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "measles" } ] }