{ "schema_version": 1, "kind": "condition", "id": "rib-contusion", "name": "Rib contusion", "category": "acute", "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.", "review_status": "reviewed", "verified_against": "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_date": "2026-08", "treatments": [ { "id": 1617, "generic": "Paracetamol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g three or four times daily, maximum 4 g in 24 hours", "adult_duration": "As needed for pain or fever", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "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." ], "peds_mgkg_low": 15.0, "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 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.", "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": 150, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 450, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 500, "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": "rib-contusion" }, { "id": 1618, "generic": "Ibuprofen", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "200-400 mg PO Q6-8H PRN, max 1200 mg/day.", "adult_duration": "Up to 10 days", "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Age 3m+: 20 mg/kg/day in divided doses.", "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": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "rib-contusion" }, { "id": 1619, "generic": "Diclofenac", "line": 3, "is_adjunct": false, "form": "topical.gel", "strength_mg": 10.0, "adult_dose": "Apply 2-4 g of 1% gel topically to tender costosternal joints three to four times daily and rub gently", "adult_duration": "Up to 7 days", "dose_source": "Diclofenac topical gel SmPC section 4.2 (eMC)", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not for children under 14. The 1% gel is licensed for adults and adolescents from 14 years; below that there is not enough data.", "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": "RHEUMAFEN ACTI-GEL 1% GEL 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OLFEN 1% TOPICAL GEL 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > ACINO", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DECLOFENAC 1% GEL 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 13.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DECLOPHEN GEL 1% 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 29.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANTIFLAM 1% EMULGEL 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOLPHIN 3% TOPICAL GEL 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 34.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOLPHIN 3% TOPICAL GEL 60 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 58.0, "pack_count": null, "unit_price": null, "strength_mg": 60000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DICLAC-N 4% GEL 50 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > NOVARTIS", "price_egp": 72.0, "pack_count": null, "unit_price": null, "strength_mg": 50000.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "rib-contusion" } ] }