Dawaa Reference

acute

Rib contusion

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

Evidence status

Checked against the sources named below

Sources4 sources

Diclofenac topical gel SmPC section 4.2 (eMC) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Jain A, Waseem M. Thoracic Trauma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. NBK482194.

Verified against3 documents
  • Diclofenac topical gel SmPC section 4.2 (eMC)
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc

Verified date2026-08

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever

Paediatric dose

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

(Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

First-line analgesic at the standard dose regardless of the cause of chest-wall pain; adequate analgesia is itself part of rib-injury management.

Cautions
  • Rule out an underlying rib fracture, pneumothorax, or haemothorax; chest pain with breathlessness, hypoxia, or reduced breath sounds needs urgent imaging.
  • Good baseline analgesia matters here - adequate pain control encourages deep breathing and coughing, which helps prevent atelectasis and chest infection after rib trauma.
  • Do not exceed 4 g in 24 hours.
  • Refer for imaging if pain is severe, or breathlessness, hypoxia, or reduced breath sounds suggest a fracture, pneumothorax, or haemothorax.
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
2

IBUPROFEN

2nd line

Strength400 mg

Formoral.solid

Adult dose and duration

200-400 mg PO Q6-8H PRN, max 1200 mg/day. - Up to 10 days

Paediatric dose

Age 3m+: 20 mg/kg/day in divided doses.

Dose source

SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc

Why

Standard-dose oral NSAID improves analgesia for rib contusion; the anti-inflammatory dose used in true inflammatory chest disease is unnecessary here.

Cautions
  • Combine with paracetamol for better analgesia to support deep breathing; the much higher anti-inflammatory pericarditis-type regimen is not needed for a simple contusion.
  • Avoid in NSAID-exacerbated asthma, active peptic ulcer disease, or significant renal impairment.
  • If also using the topical diclofenac gel on the same area, do not add this regularly without considering total NSAID exposure.
Egyptian brands
Egyptian brandManufacturerIndicative price
DAJUANOFEN 400 MG 20 F.C. TABS.COPAD PHARMA5.00 EGP (0.25/unit)
FLABU 400MG 10 F.C.TAB.DELTA PHARMA3.75 EGP (0.38/unit)
NOVA-PROFEN 400MG 30 F.C. TABLETSSANOFI12.75 EGP (0.42/unit)
IBUPROFEN 400 MG 10 TAB.SEDICO6.00 EGP (0.60/unit)
MAFO 400 MG 30 F.C.TABSEIPICO42.00 EGP (1.40/unit)
BRUFEN 400 MG 30 TABS.KAHIRA > ABBOTT LABORATORIES78.00 EGP (2.60/unit)
PROFUSOL 400MG 20 S.G CAPS.EUROPEAN EGYPTIAN PHARM. IND.31.00 EGP
ANALGIPROF 400 MG 25 SACHETSEVA PHARMA37.50 EGP
NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solidSANOFI2.25 EGP
BRUFEMOL-N SUSP. 60 ML? strength differs? different route - not oral solidARAB DRUG COMPANY (ADCO)4.50 EGP
3

DICLOFENAC

3rd line

Strength10 mg

Formtopical.gel

Adult dose and duration

Apply 2-4 g of 1% gel topically to tender costosternal joints three to four times daily and rub gently - Up to 7 days

Paediatric dose

Not for children under 14. The 1% gel is licensed for adults and adolescents from 14 years; below that there is not enough data.

Dose source

Diclofenac topical gel SmPC section 4.2 (eMC)

Why

Topical NSAID gel for the localised chest-wall tenderness of a rib contusion; the sourced costosternal-joint application site genuinely matches the anatomy of a bruised rib.

Cautions
  • Useful localised alternative for tender chest-wall bruising when systemic NSAID exposure should be minimised (e.g. in the elderly or with GI/renal risk).
  • Apply only to intact skin over the bruised area, avoiding eyes and mucous membranes.
  • Do not combine with regular oral NSAID (including the ibuprofen above) without considering total NSAID exposure.
Egyptian brands
Egyptian brandManufacturerIndicative price
RHEUMAFEN ACTI-GEL 1% GEL 15 GM? strength differsGLAXO SMITHKLINE5.00 EGP
OLFEN 1% TOPICAL GEL 15 GM? strength differsMUP > ACINO9.00 EGP
DECLOFENAC 1% GEL 20 GM? strength differsEL NASR13.00 EGP
DECLOPHEN GEL 1% 30 GM? strength differsPHARCO29.00 EGP
ANTIFLAM 1% EMULGEL 20 GM? strength differsUP PHARMA7.50 EGP
DOLPHIN 3% TOPICAL GEL 30 GM? strength differsDELTA PHARMA34.00 EGP
DOLPHIN 3% TOPICAL GEL 60 GM? strength differsDELTA PHARMA58.00 EGP
DICLAC-N 4% GEL 50 GM? strength differsMINA PHARM > NOVARTIS72.00 EGP

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