{ "schema_version": 1, "kind": "condition", "id": "uterine-fibroids", "name": "Uterine Fibroids", "category": "chronic", "sources": "Egyptian National Drug Formulary - Endocrine System 2024 (norethisterone monograph) · Egyptian National Drug Formulary 2024 — Endocrine System Drugs, Norethisterone (Norethindrone) monograph, Adult dosage regimen (endocrine.pdf, page index 125, printed p112) · Mefenamic Acid 500 mg film-coated Tablets SmPC sections 4.2 and 4.3 (eMC product 12503) · Mikes BA, Vadakekut ES, Sparzak PB. Abnormal Uterine Bleeding. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2025 Feb 21. Bookshelf ID: NBK532913; PMID: 30422508. · NICE Guideline NG88: Heavy menstrual bleeding: assessment and management 2018 · RCOG / SOGC Guideline on Management of Uterine Fibroids 2015 · Tranexamic Acid 500 mg Tablets SmPC section 4.2 (eMC product 14622)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary 2024 — Endocrine System Drugs, Norethisterone (Norethindrone) monograph, Adult dosage regimen (endocrine.pdf, page index 125, printed p112) · SmPC section 4.2, https://www.medicines.org.uk/emc/product/14622/smpc · Mikes BA, Vadakekut ES, Sparzak PB. Abnormal Uterine Bleeding. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2025 Feb 21. Bookshelf ID: NBK532913; PMID: 30422508.", "verified_date": "2026-08", "treatments": [ { "id": 1896, "generic": "Tranexamic acid", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "Local fibrinolysis: 15-25 mg/kg PO 2-3 times daily (or 1000-1500 mg PO TID). Menorrhagia: 1000 mg (2 tabs) PO TID up to 4 days (max 4 g/day).", "adult_duration": "3-4 days per menstrual cycle during heavy flow", "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/14622/smpc", "rationale": "Antifibrinolytic that reduces menstrual blood loss by inhibiting plasminogen activation and clot breakdown at the endometrial surface; first-line non-hormonal treatment for the heavy bleeding caused by uterine fibroids, without shrinking the fibroids themselves.", "cautions": [ "First-line non-hormonal treatment to reduce heavy menstrual bleeding associated with uterine fibroids.", "Contraindicated in active thromboembolic disease (DVT, PE) or history of venous/arterial thrombosis.", "Does not reduce fibroid size; treats symptomatic menorrhagia only.", "Contraindicated in severe renal impairment because of risk of accumulation.", "Contraindicated in patients with a history of convulsions." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Calculated according to body weight at 25 mg/kg per dose.", "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": "TREXAM 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "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": "TRANEX 500 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ABBOTT", "price_egp": 117.0, "pack_count": 30, "unit_price": 3.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KAPRON 500 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 110.0, "pack_count": 20, "unit_price": 5.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SAVIBLEED 500 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 110.0, "pack_count": 20, "unit_price": 5.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "uterine-fibroids" }, { "id": 1897, "generic": "Norethisterone", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "Acute bleed: 20 mg by mouth three times daily for 7 days (StatPearls, Abnormal Uterine Bleeding NBK532913, acute AUB progestin-only option). The Egyptian National Drug Formulary gives 5 mg by mouth three times daily for 10 days for the same indication, with bleeding usually stopping within 48 hours. Then, to prevent recurrence: 5 mg by mouth twice daily from day 19 to day 26 of each of the next two cycles (Egyptian National Drug Formulary).", "adult_duration": "7 days for the acute course (StatPearls) or 10 days (Egyptian formulary), then the day 19 to day 26 course in each of the two following cycles", "dose_source": "StatPearls, Abnormal Uterine Bleeding (NBK532913), acute AUB progestin-only option (lead); Egyptian National Drug Formulary - Endocrine System Drugs 2024, norethisterone (norethindrone) monograph (endocrine.pdf page index 125, printed p112)", "rationale": "Oral progestogen used cyclically to control heavy menstrual bleeding and dysmenorrhoea in fibroids by stabilising the endometrium; an alternative to tranexamic acid, and must not be combined with it.", "cautions": [ "The two sources disagree four-fold on the acute dose: StatPearls gives 20 mg three times daily for 7 days, the Egyptian formulary 5 mg three times daily for 10 days. The international figure leads here per the app's source policy; both are printed.", "Check blood pressure and liver function, and evaluate bleeding that persists or is severe.", "Contraindicated in pregnancy, in current or past deep vein thrombosis or pulmonary embolism, in active or recent arterial thromboembolic disease, in hepatic impairment or disease, and in known, suspected or past breast cancer.", "Undiagnosed abnormal genital bleeding is a contraindication: evaluate the bleeding before treating it.", "This controls the bleeding, not the fibroid — uterine fibroids are not among the monograph's listed indications.", "Never with tranexamic acid. The Egyptian formulary's norethisterone monograph lists that combination under Risk X - avoid, not merely monitor - and both drugs are offered in this entry.", "Side effects include fluid retention, bloating, weight gain, mood changes, and breast tenderness.", "Refer to gynecology if fibroids exceed 3 cm, cause pressure symptoms, or if heavy bleeding persists despite medical therapy.", "The formulary's regimen for heavy or dysfunctional bleeding is 5 mg three times daily for 10 days, with bleeding usually stopping inside 48 hours; it also lists 5 mg twice daily on days 19 to 26.", "Contraindicated in severe pruritus or pemphigoid gestationis during past pregnancy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The monograph's dosage regimen is headed \"Adult\" only; it lists no paediatric dose.", "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": "CIDOLUT NOR 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 36.0, "pack_count": 20, "unit_price": 1.8, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIDOLUT NOR 5 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 57.0, "pack_count": 30, "unit_price": 1.9, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STERONATE 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 56.0, "pack_count": 20, "unit_price": 2.8, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "uterine-fibroids" } ] }