# Renal Colic (Acute Nephrolithiasis) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: DailyMed Ketoprofen Package Insert (DailyMed, NLM) · DailyMed Tamsulosin Hydrochloride Capsule Package Insert (DailyMed, NLM) · EAU Guidelines on Urolithiasis 2023 · MSF Essential Drugs 2024 - paracetamol (oral) · THIOLA EC (tiopronin) delayed-release tablets US prescribing information, section 1 Indications and Usage, section 2.1 Recommended Dosage, section 2.3 Monitoring and section 5 Warnings and Precautions (DailyMed SetID 20298a52-a194-a161-8632-d84b6f26e23c) · Voltarol Ampoules SmPC (emc, 1043), section 4.2 Posology - renal colic entry · Acute Renal Colic - StatPearls - NCBI Bookshelf (NBK431091) - the article states the dose for this indication · Egyptian National Drug Formulary - Cardiovascular Chapter 2024 (silodosin monograph) - Verified date: 2026-08 ## Verified against - DailyMed Ketoprofen Package Insert (DailyMed, NLM) - DailyMed Tamsulosin Hydrochloride Capsule Package Insert (DailyMed, NLM) - MSF Essential Drugs 2024 - paracetamol (oral) - Acute Renal Colic - disease-level clinical article (renal-colic-full.txt) - Renal Colic (Acute Nephrolithiasis) - disease-level clinical article (renal-colic-clinical.txt) - THIOLA EC (tiopronin) delayed-release tablets US prescribing information, section 1 Indications and Usage, section 2.1 Recommended Dosage, section 2.3 Monitoring and section 5 Warnings and Precautions (DailyMed SetID 20298a52-a194-a161-8632-d84b6f26e23c) ## Treatment metadata - Ketoprofen — 100 mg — oral.solid - Referral & safety-netting (no drug therapy) - Diclofenac — 75 mg — injection - Tamsulosin — 0.4 mg — oral.solid - Ondansetron — 4 mg — oral.solid - Paracetamol — 1000 mg — oral.solid - Silodosin — 8 mg — oral.solid - Tiopronin — oral.solid ## Complete treatment card ```text RENAL COLIC (ACUTE NEPHROLITHIASIS) Sources: DailyMed Ketoprofen Package Insert (DailyMed, NLM) · DailyMed Tamsulosin Hydrochloride Capsule Package Insert (DailyMed, NLM) · EAU Guidelines on Urolithiasis 2023 · MSF Essential Drugs 2024 - paracetamol (oral) · THIOLA EC (tiopronin) delayed-release tablets US prescribing information, section 1 Indications and Usage, section 2.1 Recommended Dosage, section 2.3 Monitoring and section 5 Warnings and Precautions (DailyMed SetID 20298a52-a194-a161-8632-d84b6f26e23c) · Voltarol Ampoules SmPC (emc, 1043), section 4.2 Posology - renal colic entry · Acute Renal Colic - StatPearls - NCBI Bookshelf (NBK431091) - the article states the dose for this indication · Egyptian National Drug Formulary - Cardiovascular Chapter 2024 (silodosin monograph) Review status: REVIEWED against DailyMed Ketoprofen Package Insert (DailyMed, NLM), DailyMed Tamsulosin Hydrochloride Capsule Package Insert (DailyMed, NLM), MSF Essential Drugs 2024 - paracetamol (oral), Acute Renal Colic - disease-level clinical article (renal-colic-full.txt), Renal Colic (Acute Nephrolithiasis) - disease-level clinical article (renal- colic-clinical.txt), THIOLA EC (tiopronin) delayed-release tablets US prescribing information, section 1 Indications and Usage, section 2.1 Recommended Dosage, section 2.3 Monitoring and section 5 Warnings and Precautions (DailyMed SetID 20298a52-a194-a161-8632-d84b6f26e23c) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Pain starts suddenly in the flank and radiates down toward the groin or testicle, usually a constant ache punctuated by sharp colicky spikes. [groin pain] - Most patients also feel nauseated or vomit, and roughly 85 percent have visible or microscopic blood in the urine. [blood in the urine · nausea] - As a stone travels toward the bladder, urinary burning, frequency, urgency, or trouble voiding can develop. SIGNS - what you find (3) - Patients often can't hold still, pacing or writhing from the pain, unlike a surgical abdomen where patients tend to lie motionless. - Skin can feel cool and sweaty, with tenderness noted over the flank or abdomen. [sweating] - A temperature of 100°F or higher, marked leukocytosis, pus in the urine, low blood pressure, or an unexplained fast heart rate should raise concern for urosepsis or obstructive infection, particularly in diabetics. [hypotension · pus · tachycardia] TESTS (12) - Urinalysis shows visible or microscopic blood in most stone cases; a pH above 7.5 hints at a urease-producing infection, while a pH under 5.5 points toward uric acid stones. - Not finding blood in the urine does not rule a stone out. - A mild rise in white cells, up to about 15,000/µL, is common from the stress response alone and doesn't necessarily mean infection. - Non-contrast CT is considered the gold standard for a suspected stone, with roughly 98 percent sensitivity and 100 percent specificity. - CT tends to underestimate the true stone size by roughly 12 percent compared with plain X-ray. - Ultrasound, which carries no radiation risk, is the preferred first study when a pregnant patient has suspected colic. - Plain abdominal X-ray misses roughly 10 to 20 percent of stones because they don't show up on film. - A resistive index above about 0.7 on renal ultrasound suggests obstruction or intrinsic kidney disease. - Urosepsis is marked by a heart rate over 90, breathing rate over 20, pus in the urine, and a white count above 12,000, along with low blood pressure. - A CRP around 50 mg/L or above is a commonly used cutoff for flagging bacterial sepsis. - A lactic acid level above 4 mmol/L is considered severe and often points toward sepsis, particularly if it's climbing fast. - Procalcitonin is thought to beat CRP as a sepsis marker because it's more specific to bacterial infection and rises earlier while normalizing faster. IF NOT THIS - what else fits (3) - Wunderlich syndrome, a rare cause involving spontaneous bleeding under the kidney capsule or in the retroperitoneum, is also on the list. - Aortic dissection and mesenteric ischemia are both named among the flank-pain mimics of renal colic. - Ectopic pregnancy and endometriosis are the gynecologic causes listed on this same differential. Source StatPearls "Acute Renal Colic" - disease-level clinical article Status traced to the source above Rx: Main treatment | Parenteral NSAID - when the patient cannot keep oral analgesia down | Antiemetic for the vomiting that comes with the colic | Alpha-blocker for stone expulsion - alternative to tamsulosin | Lowers urinary cystine - prevents the NEXT stone in cystinuria, not this attack MAIN TREATMENT - choose one, plus any add-on marked below 1. KETOPROFEN [1st line] Adult The usual dose of Ketoprofen Capsules, USP recommended for mild-to-moderate pain and dysmenorrhea is 25 to 50 mg every 6 to 8 hours as necessary. Peds Specialist pediatric emergency referral required Source DailyMed Ketoprofen Package Insert (DailyMed, NLM) Why NSAIDs beat opioids for renal colic - they reduce the ureteric spasm as well as the pain. Caution NSAIDs are first-line analgesics for acute renal colic, providing superior efficacy to opioids. Contraindicated in severe renal failure, active GI ulceration, and late pregnancy. Ensure adequate hydration. Egypt MEPACOFEN 100 MG S.R. 20 CAPS. MEPACO 13.00 EGP (0.65/unit) BASKINTA 100 MG 30 CAPS. ARAB CAPS > S... 31.50 EGP (1.05/unit) KETOFAN 100 MG SR 30 CAPS. AMRIYA 66.00 EGP (2.20/unit) PROFENID 1MG/ML SYRUP 100 ML SANOFI 9.50 EGP -> ? strength differs, ? different route - not oral solid KETOFAN 12.5MG/5ML 120ML SUSP. AMRIYA 12.00 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Acute Renal Colic - disease-level clinical article (renal-colic-full.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Admit for: sepsis; an infected stone; a stone in a single functioning kidney; kidney injury that is severe; urine leaking outside the collecting system; or pain and vomiting that will not settle. RED FLAG - An infected/obstructed stone (urinary tract infection with obstructing ureterolithiasis) is an urgent surgical emergency, not something to manage with oral analgesia alone. RED FLAG - Antibiotics are needed when there are clinical or laboratory signs of urinary infection accompanying the stone. 3. TAMSULOSIN [add-on - not a substitute] Adult 0.4 mg once daily after breakfast as medical expulsive therapy (MET) for distal ureteric stones <10 mm Peds Specialist pediatric urology use only Source DailyMed Tamsulosin Hydrochloride Capsule Package Insert (DailyMed, NLM) Why Helps a stone in the lower ureter pass. It is not an analgesic and does not replace the NSAID. Caution Tamsulosin is used off-label as medical expulsive therapy to facilitate stone expulsion. Refer to urology if fever, intractable pain, solitary kidney, or stone >10 mm. There is a risk of orthostatic hypotension and retrograde ejaculation. Egypt NORMIRAMA 0.4 MG 30 CAPS. EGPI > RAMAPH... 60.00 EGP (2.00/unit) TAMSUNORM S.R. 0.4MG 30 CAPS. RAMEDA 60.00 EGP (2.00/unit) TAMSULOSIN 0.4 MG 20 CAPS. GLAXO SMITHKL... 42.00 EGP (2.10/unit) CUREPRO XR 0.4 MG 30 CAPS. DEBEIKY > KHU... 105.00 EGP (3.50/unit) BLOCK ALPHA 0.4 MG MR 30 CAPS. ADWIA 120.00 EGP (4.00/unit) FIRAMAZIN 0.4MG 30 H.G.CAPS. EVA PHARMA 54.00 EGP OMNIC 0.4MG 30 MODIFIED RELEASE CAPS. ASTELLAS PHARMA > MULTIPHARMA 147.00 EGP OMNIC OCAS 0.4 MG 30 PROLONGED RELEASE F.C.TAB. ASTELLAS PHARMA INC > MU... 282.00 EGP 4. PARACETAMOL [add-on - not a substitute] Adult 1000 mg every 6 hours as needed, maximum 4000 mg in 24 hours Peds 10-15 mg/kg/dose [child max 500 mg] (Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily)) 3kg -> 30-45 mg/dose 4kg -> 40-60 mg/dose 5kg -> 50-75 mg/dose 6kg -> 60-90 mg/dose 7kg -> 70-105 mg/dose 8kg -> 80-120 mg/dose 9kg -> 90-135 mg/dose 10kg -> 100-150 mg/dose 11kg -> 110-165 mg/dose 12kg -> 120-180 mg/dose 13kg -> 130-195 mg/dose 14kg -> 140-210 mg/dose 15kg -> 150-225 mg/dose 16kg -> 160-240 mg/dose 17kg -> 170-255 mg/dose 18kg -> 180-270 mg/dose 19kg -> 190-285 mg/dose 20kg -> 200-300 mg/dose 21kg -> 210-315 mg/dose 22kg -> 220-330 mg/dose 23kg -> 230-345 mg/dose 24kg -> 240-360 mg/dose 25kg -> 250-375 mg/dose 26kg -> 260-390 mg/dose 27kg -> 270-405 mg/dose 28kg -> 280-420 mg/dose 29kg -> 290-435 mg/dose 30kg -> 300-450 mg/dose 31kg -> 310-465 mg/dose 32kg -> 320-480 mg/dose 33kg -> 330-495 mg/dose 34kg -> 340-500 mg/dose (upper capped) 35kg -> 350-500 mg/dose (upper capped) 36kg -> 360-500 mg/dose (upper capped) 37kg -> 370-500 mg/dose (upper capped) 38kg -> 380-500 mg/dose (upper capped) 39kg -> 390-500 mg/dose (upper capped) 40kg -> 400-500 mg/dose (upper capped) 41kg -> 410-500 mg/dose (upper capped) 42kg -> 420-500 mg/dose (upper capped) 43kg -> 430-500 mg/dose (upper capped) 44kg -> 440-500 mg/dose (upper capped) 45kg -> 450-500 mg/dose (upper capped) 46kg -> 460-500 mg/dose (upper capped) 47kg -> 470-500 mg/dose (upper capped) 48kg -> 480-500 mg/dose (upper capped) 49kg -> 490-500 mg/dose (upper capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why Two jobs. Given alongside ketoprofen it improves the analgesia; given instead of it, it is what the patient who cannot have an NSAID gets - renal failure, active ulcer, or late pregnancy, all listed on the ketoprofen row above. Caution Weaker than ketoprofen on its own. Where the NSAID is contraindicated this is the best available, not an equal substitute, and the pain may need reassessment sooner. Reduce the maximum to 3000 mg/day in an adult under 50 kg, malnourished, or with liver disease. 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. Egypt PARACETAMOL-ADCO 1 GM 20 TABS. ARAB DRUG COM... 32.00 EGP (1.60/unit) TEMPORAL 1000 MG 20 TABS. MUP 40.00 EGP (2.00/unit) PARAMOL 1000 MG 20 TABS. MISR 52.00 EGP (2.60/unit) DOLIPRANE 1 GM 20 TABS. SANOFI 60.00 EGP (3.00/unit) GLASBOMOL 1000 MG 20TABLETS HIGH PERFORMA... 60.00 EGP (3.00/unit) DOLIPRANE 1 GM 8 SACHETS SANOFI 36.00 EGP STOPADOL FORTE 1000 MG 10 EFF. SACHETS EVA PHARMA 60.00 EGP AUGICETAMIDE 1000 MG 20 SACHETS AUG PHARMA 80.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid PARENTERAL NSAID - WHEN THE PATIENT CANNOT KEEP ORAL ANALGESIA DOWN 5. DICLOFENAC [1st line] Adult 75 mg as one deep intragluteal IM ampoule; a second ampoule may follow after 30 minutes if the pain persists, up to 150 mg in a day - Injections for no more than two days, then continue with tablets or suppositories if still needed Peds Not for children - the ampoule is not recommended in the paediatric population. Source Voltarol Ampoules SmPC (emc, 1043), section 4.2 Posology - renal colic entry Why The card's only NSAID is an oral one, and vomiting is part of the presentation. This is the injection a Cairo GP gives in the clinic when the patient cannot swallow or keep tablets down. Caution Contraindicated in established heart failure, ischaemic heart disease, peripheral arterial disease or cerebrovascular disease. Contraindicated in renal failure, hepatic failure, active or previous peptic ulcer or GI bleeding, and in the last trimester of pregnancy. Give it by deep injection into the upper outer quadrant of the buttock; injection-site necrosis and nerve damage follow bad technique. Egypt RHEUMAFEN 75MG/3ML 4 AMP. FOR I.M. INJ. SIGMA TEC > GLAXO SMITHKLINE 12.00 EGP POTAFLAM 75MG/3ML 3 AMPS. KAHIRA 18.00 EGP DOLPHIN K 75MG/3ML I.M. 3 AMP. DELTA PHARMA 24.00 EGP ARTICAVOL 75MG/3ML 3 AMP. GLOBAL PHARMA... 33.00 EGP PHAROFEN 75MG 4 AMP. PHAROPHARMA 44.00 EGP DICLAC 75 MG/3ML 5 AMPS. MINA PHARM > ... 55.00 EGP VOLTAREN 75MG/3ML 6 I.M./I.V. INF. AMPS. NOVARTIS 102.00 EGP CATAFLAM 75MG/3ML 6 AMP. NOVARTIS 120.00 EGP ANTIEMETIC FOR THE VOMITING THAT COMES WITH THE COLIC - give alongside 6. ONDANSETRON [add-on - not a substitute] Adult 4 mg to 8 mg by mouth Peds No paediatric dose for renal colic in the sources opened. Source Acute Renal Colic - StatPearls - NCBI Bookshelf (NBK431091) - the article states the dose for this indication Why Nausea and vomiting define the presentation and are why oral analgesia fails; the article names ondansetron as the preferred antiemetic here. Caution Avoid it in congenital long QT syndrome, and check an ECG first in patients with electrolyte disturbance, heart failure or a slow arrhythmia. Do not give it in the first trimester of pregnancy because of a reported risk of oral clefts. Egypt DANOFRAN 4MG 5 F.C. TAB. UP PHARMA 70.00 EGP (14.00/unit) SETRONOMET 4 MG 4 ORAL DIS. TABS. AVERROES PHARMA 78.00 EGP IDIVOMTRON 4 MG 10 ORALLY DIS. TABS. INTERNATIONAL DRUG AGENCY (IDI) 144.00 EGP EMEREST 4 MG 10 ORO-DISPERSIBLE TABS. GLOBAL PHARMACEUTICAL INDUSTRIES 188.00 EGP IDIVOMTRON 4 MG/5ML SYRUP 50 ML RAMEDA > INTE... 110.00 EGP -> ? strength differs, ? different route - not oral solid ALPHA-BLOCKER FOR STONE EXPULSION - ALTERNATIVE TO TAMSULOSIN - give alongside 7. SILODOSIN [add-on - not a substitute] Adult 8 mg once daily with a meal Peds No paediatric dose in the sources opened. Source Egyptian National Drug Formulary - Cardiovascular Chapter 2024 (silodosin monograph) - verbatim: "Oral: 8 mg once daily with a meal." Why The card offers tamsulosin for medical expulsive therapy; the article reports silodosin beat both tamsulosin and alfuzosin in systematic reviews, so it belongs on the card as the stronger option. Caution Contraindicated in severe kidney impairment and in severe liver impairment, and with strong CYP3A4 inhibitors such as ketoconazole or itraconazole. Warn the patient that loss of seminal fluid on ejaculation is common and harmless. Tell any patient awaiting cataract surgery to inform the eye surgeon, because alpha- blockers cause floppy iris syndrome. Egypt ELIGODOSIN 8 MG 30 CAPS. HIKMA PHARMA 105.00 EGP (3.50/unit) LIDOFLAK 8 MG 10 CAPS. MASH PREMIERE... 35.00 EGP (3.50/unit) LIDOFLAK 8 MG 30 CAPS. MASH PREMIERE... 135.00 EGP (4.50/unit) SILOPROSTATE 8 MG 30 CAPS. OCTOBER PHARMA 144.00 EGP (4.80/unit) CONGDOSIN 8 MG 20 CAPS. PHARMA CURE P... 100.00 EGP (5.00/unit) FLOPADEX 8 MG 30 CAPSULES EVA PHARMA 177.00 EGP (5.90/unit) SILDOCARE 8 MG 30 CAPS. ANDALOUS PHARMA 177.00 EGP (5.90/unit) SYMPAPROST 8 MG 30 CAPS. AL ESRAA PHAR... 177.00 EGP (5.90/unit) LOWERS URINARY CYSTINE - PREVENTS THE NEXT STONE IN CYSTINURIA, NOT THIS ATTACK - give alongside 8. TIOPRONIN [add-on - not a substitute] Adult 800 mg a day in three divided doses, on top of fluids and alkali. US label verbatim: "Adults: The recommended initial dosage in adult patients is 800 mg/day. In clinical studies, the average dosage was about 1,000 mg/day." and "Administer THIOLA EC in 3 divided doses at the same times each day, with or without food. Maintain a routine pattern with regard to meals." The dose is then set by a urine test, verbatim: "Measure urinary cystine 1 month after starting THIOLA EC and every 3 months thereafter. Adjust THIOLA EC dosage to maintain urinary cystine concentration less than 250 mg/L." A patient who has had severe toxicity to penicillamine starts lower. - Indefinite, because cystinuria is a lifelong inherited transport defect. There is no course to finish - the review points are the three-monthly urinary cystine and the three- to six-monthly urine protein. Peds 15 mg/kg/day (Licensed from 20 kg, and cystinuria is one of the few stone diseases that starts in childhood. US label verbatim: "Pediatrics: The recommended initial dosage in pediatric patients weighing 20 kg and greater is 15 mg/kg/day. Avoid dosages greater than 50 mg/kg per day in pediatric patients", given in three divided doses. The reason for that ceiling is in the cautions: "Pediatric patients receiving greater than 50 mg/kg of tiopronin per day may be at increased risk for proteinuria." A child with a stone belongs with paediatric nephrology, not on a prescription written in a primary-care clinic.) Not for children under 20 kg 20kg -> 300 mg/day 21kg -> 315 mg/day 22kg -> 330 mg/day 23kg -> 345 mg/day 24kg -> 360 mg/day 25kg -> 375 mg/day 26kg -> 390 mg/day 27kg -> 405 mg/day 28kg -> 420 mg/day 29kg -> 435 mg/day 30kg -> 450 mg/day 31kg -> 465 mg/day 32kg -> 480 mg/day 33kg -> 495 mg/day 34kg -> 510 mg/day 35kg -> 525 mg/day 36kg -> 540 mg/day 37kg -> 555 mg/day 38kg -> 570 mg/day 39kg -> 585 mg/day 40kg -> 600 mg/day 41kg -> 615 mg/day 42kg -> 630 mg/day 43kg -> 645 mg/day 44kg -> 660 mg/day 45kg -> 675 mg/day 46kg -> 690 mg/day 47kg -> 705 mg/day 48kg -> 720 mg/day 49kg -> 735 mg/day 50kg -> 750 mg/day Source THIOLA EC (tiopronin) delayed-release tablets US prescribing information, section 1 Indications and Usage, section 2.1 Recommended Dosage, section 2.3 Monitoring and section 5 Warnings and Precautions (DailyMed SetID 20298a52-a194-a161-8632-d84b6f26e23c) Why The disease article names the drug in its section on preventing the next stone by stone type: a cystine-stone former needs a large urine output, 3000 mL a day or more, and a urine pH kept at 7.5 or above so cystine stays dissolved; potassium citrate is the preferred alkaliniser, and tiopronin or another thiol drug lowers urinary cystine. The US label's licensed use covers the same disease and the same three supporting measures: it is indicated, combined with high fluid intake, alkali and diet change, for preventing cystine stones in adults and children 20 kg and over with severe homozygous cystinuria not controlled by those measures alone. Cystine stones make up roughly 1% of stones but recur relentlessly, present in childhood or adolescence, and resist lithotripsy. The row is marked adjunct and third line because it does nothing for the colic in front of you - the analgesics and tamsulosin on the card handle that. Egypt has no registered tiopronin product, so no local brand or price can be shown. Caution It prevents the next stone; it does nothing for this one. The presentation here is acute renal colic. Tiopronin is a three-times-a-day lifelong drug started after the stone type is known - a cystine stone on analysis, or cystinuria on a 24-hour urine - and it does not belong in an emergency prescription. RED FLAG - proteinuria and nephrotic syndrome. US label verbatim: "Proteinuria, including nephrotic syndrome, and membranous nephropathy, have been reported with tiopronin use." and "Monitor patients for the development of proteinuria and discontinue therapy in patients who develop proteinuria." The label's schedule is verbatim: "Assess for proteinuria before treatment and every 3 to 6 months during treatment." A drug for kidney stones that can damage the kidney is not one to start and forget. The dose is titrated against a laboratory number, not against symptoms. US label verbatim: "Adjust THIOLA EC dosage to maintain urinary cystine concentration less than 250 mg/L." Without access to urinary cystine measurement the dose cannot be managed properly, and that is a reason to refer rather than to guess. Hypersensitivity reactions. US label verbatim: "Hypersensitivity reactions (drug fever, rash, fever, arthralgia and lymphadenopathy) have been reported", and known hypersensitivity to tiopronin is a contraindication. The fluid and the alkali are not optional extras. The label indicates the drug only where it is combined with a high fluid intake, an alkali, and a change of diet - and the article sets the targets: urine output over 3000 mL a day and a urine pH of 7.5 or higher, with potassium citrate as the alkaliniser. A patient who will not drink will not be rescued by the tablet. No Egyptian product exists, so tiopronin cannot be filled at a Cairo pharmacy. Egypt no Egyptian brand matched - prescribe by generic name Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)