Dawaa Reference

acute

Adverse Effect of Vaccination

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

Evidence status

Checked against the sources named below

Sources3 sources

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Resuscitation Council UK Anaphylaxis Guidelines 2021

Verified against3 documents
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • Resuscitation Council UK Anaphylaxis Guidelines 2021
  • 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 symptomatic relief for the common mild fever or soreness that follows vaccination; paracetamol dosing is unchanged by the trigger for the fever.

Cautions
  • Simple antipyretic/analgesic for the common mild fever, injection-site soreness, or malaise after vaccination; not evidence of infection.
  • Seek care if fever is very high, persists beyond 48 hours, or the patient becomes unusually drowsy or inconsolable.
  • Do not exceed 4 g in 24 hours; caution in liver impairment.
  • RED FLAG - Stridor, facial swelling, or hypotension within minutes of vaccination needs adrenaline immediately, which is why vaccination sites should observe patients for 15-30 minutes; high fever, seizure, or persistent inconsolable crying or lethargy in an infant after vaccination needs referral for assessment.
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.

Paediatric dose

Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension labels).

Dose source

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

Why

General-purpose antipyretic/analgesic dose that applies equally to the fever and myalgia of a vaccine reaction; not the higher anti-inflammatory regimen needed for a true inflammatory illness.

Cautions
  • Alternative or add-on to paracetamol for vaccine-related fever, myalgia, or arm soreness.
  • Avoid in known NSAID-exacerbated asthma, active peptic ulcer disease, dehydration, or third-trimester pregnancy.
  • Take with or after food.
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

ADRENALINE

3rd line

Forminjection

Adult dose and duration

0.5 mg (0.5 mL of 1:1000 / 1 mg/mL solution) INTRAMUSCULARLY into mid-outer thigh. Repeat every 5 minutes PRN if no improvement. - Emergency dose, repeat at 5 min PRN

Paediatric dose

(Age-banded fixed doses (IM 1 mg/mL): < 6 months: 100-150 mcg (0.1-0.15 mL); 6 months to 6 years: 150 mcg (0.15 mL); 6 to 12 years: 300 mcg (0.3 mL); > 12 years: 500 mcg (0.5 mL) [give 300 mcg if child is small or prepubertal]. Repeat after 5 minutes if no improvement.)

Dose by age
Under 6 months:100 to 150 mcg (0.1 to 0.15 mL) IM. Repeat after 5 minutes if no improvement.
6 months to 5 years:150 mcg (0.15 mL) IM. Repeat after 5 minutes if no improvement.
6 to 11 years:300 mcg (0.3 mL) IM. Repeat after 5 minutes if no improvement.
12 years and over:500 mcg (0.5 mL) IM - give 300 mcg if the child is small or prepubertal. Repeat after 5 minutes if no improvement.
Dose source

Resuscitation Council UK Anaphylaxis Guidelines 2021

Why

The emergency dose for vaccine-triggered anaphylaxis, the one genuinely dangerous adverse effect of vaccination; unrelated to the mild fever/soreness the other two drugs treat.

Cautions
  • Reserved for the rare true anaphylactic reaction to a vaccine component - stridor, facial/lip swelling, wheeze, or hypotension within minutes of vaccination.
  • Give IM into the anterolateral thigh immediately; never IV in primary care - fatal arrhythmia risk.
  • Call emergency services (123) and arrange urgent transport; observe vaccinated patients for 15-30 minutes on-site specifically to catch this.
Egyptian brands
Egyptian brandManufacturerIndicative price
EPINEPHRINE-MEMPHIS 1 MG/ML 5 I.M./S.C. AMP.MEMPHIS10.00 EGP
ADRENAMAX 1 MG/1ML 10 AMPS.CHEMIPHARM75.00 EGP
EPINEPHRINE-MISR 0.25 MG/ML 25 AMP.MISR187.50 EGP
EPINEPHRINE-MISR 1 MG/ML 100 AMP.MISR750.00 EGP
ADRENALINE-CID 1 MG/1ML 100 I.M./S.C. AMP.CID850.00 EGP

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