{ "schema_version": 1, "kind": "condition", "id": "metabolic-syndrome", "name": "Metabolic Syndrome", "category": "chronic", "sources": "ADA Standards of Care 2024 for the indication, with the dose from GLUCOPHAGE 500 mg film-coated tablets / GLUCOPHAGE 850 mg film-coated tablets SmPC section 4.2 (eMC product 987): \"The usual starting dose is 500 mg or 850 mg metformin hydrochloride 2 or 3 times daily given during or after meals.\" and \"The maximum recommended dose of metformin hydrochloride is 3 g daily, taken as 3 divided doses.\" The SmPC's indication is type 2 diabetes, so use in metabolic syndrome without diabetes is off-label and rests on the ADA standards, which are not held in this corpus. · IDF Consensus Worldwide Definition of the Metabolic Syndrome 2006 · ADA Standards of Care 2024 · ATORVASTATIN CALCIUM US prescribing information, Dosage and Administration (DailyMed SetID e74278b6-31fc-48d4-97b7-ba500e9e15fb)", "review_status": "reviewed", "verified_against": "ADA Standards of Care 2024 for the indication, with the dose from GLUCOPHAGE 500 mg film-coated tablets / GLUCOPHAGE 850 mg film-coated tablets SmPC section 4.2 (eMC product 987): \"The usual starting dose is 500 mg or 850 mg metformin hydrochloride 2 or 3 times daily given during or after meals.\" and \"The maximum recommended dose of metformin hydrochloride is 3 g daily, taken as 3 divided doses.\" The SmPC's indication is type 2 diabetes, so use in metabolic syndrome without diabetes is off-label and rests on the ADA standards, which are not held in this corpus. · ADA Standards of Care 2024 · ATORVASTATIN CALCIUM US prescribing information, Dosage and Administration (DailyMed SetID e74278b6-31fc-48d4-97b7-ba500e9e15fb)", "verified_date": "2026-08", "treatments": [ { "id": 1193, "generic": "Metformin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg once or twice daily with meals to start, titrate to 850-1000 mg twice daily (DPP trial dose 850 mg BID)", "adult_duration": "long-term", "dose_source": "ADA Standards of Care 2024 for the indication, with the dose from GLUCOPHAGE 500 mg film-coated tablets / GLUCOPHAGE 850 mg film-coated tablets SmPC section 4.2 (eMC product 987): \"The usual starting dose is 500 mg or 850 mg metformin hydrochloride 2 or 3 times daily given during or after meals.\" and \"The maximum recommended dose of metformin hydrochloride is 3 g daily, taken as 3 divided doses.\" The SmPC's indication is type 2 diabetes, so use in metabolic syndrome without diabetes is off-label and rests on the ADA standards, which are not held in this corpus.", "rationale": "Biguanide that improves insulin sensitivity and lowers hepatic glucose output, targeting the insulin-resistance core of metabolic syndrome alongside diet and exercise.", "cautions": [ "Lifestyle modification (diet and exercise) is essential foundation.", "Check renal function prior to initiation.", "Gastrointestinal side effects are common; titrate the dose gradually." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "For children >= 10 years: 500 mg daily, max 2000 mg daily under specialist guidance", "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": "500 mg daily initially, max 2000 mg daily, under specialist guidance" } ], "peds_doses": null, "brands": [ { "trade_name": "METFORMIN-EL NASR 500MG 200 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 26.0, "pack_count": 200, "unit_price": 0.13, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIAPHAGE 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.0, "pack_count": 20, "unit_price": 0.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMOPHAGE 500MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 10.5, "pack_count": 30, "unit_price": 0.35, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIDOPHAGE 500 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GLUCOPHAGE 500 MG 50 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > MERCK SANTE-FRANCE", "price_egp": 60.0, "pack_count": 50, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KELVAMET MR 500 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOMED", "price_egp": 54.0, "pack_count": 30, "unit_price": 1.8, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANDOGLYCEMIC XR 500MG 30 EXT. REL. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 24.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METIANORMIN 500 MG 30 EXT. REL. F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI ELNEEL BENTA", "price_egp": 54.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "metabolic-syndrome" }, { "id": 1194, "generic": "Atorvastatin", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "10-20 mg once daily", "adult_duration": "long-term", "dose_source": "ATORVASTATIN CALCIUM US prescribing information, Dosage and Administration (DailyMed SetID e74278b6-31fc-48d4-97b7-ba500e9e15fb)", "rationale": "Statin added to metformin and lifestyle change, not a replacement for either; lowers LDL and corrects the atherogenic dyslipidaemia (high triglycerides, low HDL) typical of metabolic syndrome.", "cautions": [ "Advise patient to report unexplained muscle pain or weakness.", "Target atherogenic dyslipidaemia (high triglycerides, low HDL).", "Monitor baseline liver function tests." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist consultation required for paediatric dyslipidaemia", "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": "ANTICHOL 20 MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 14.4, "pack_count": 10, "unit_price": 1.44, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LIRIMAR 20 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 15.0, "pack_count": 10, "unit_price": 1.5, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LIPOVAST 20MG 7 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 11.5, "pack_count": 7, "unit_price": 1.64, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SIGMALIP 20 MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 24.0, "pack_count": 10, "unit_price": 2.4, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LIPOSEDRA 20 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA > SUECAL PHARMA", "price_egp": 111.0, "pack_count": 30, "unit_price": 3.7, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ATOR 20 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 79.0, "pack_count": 10, "unit_price": 7.9, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ATCOLIPOX 20 MG 30 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA", "price_egp": 72.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HIPOLIXAVAST 20 MG 30 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 127.5, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "metabolic-syndrome" } ] }