{ "schema_version": 1, "kind": "condition", "id": "vaginal-discharge", "name": "Vaginal Discharge", "category": "acute", "sources": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Dosing: Adult and Dosing: Pediatric, vulvovaginal candidiasis (chapter PDF pp400-401, printed pp390-391) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Fluconazole monograph (chapter PDF p50) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) · Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID: NBK470302, PMID: 29262024.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Dosing: Adult and Dosing: Pediatric, vulvovaginal candidiasis (chapter PDF pp400-401, printed pp390-391) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Fluconazole monograph (chapter PDF p50) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) · Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID: NBK470302, PMID: 29262024.", "verified_date": "2026-08", "treatments": [ { "id": 1923, "generic": "Clotrimazole", "line": 1, "is_adjunct": false, "form": "vaginal", "strength_mg": null, "adult_dose": "One 500 mg clotrimazole vaginal tablet inserted as a single dose, preferably at bedtime", "adult_duration": "Single dose", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Dosing: Adult and Dosing: Pediatric, vulvovaginal candidiasis (chapter PDF pp400-401, printed pp390-391)", "rationale": "Candidiasis is the most common cause of vaginal discharge in general practice; a single-dose vaginal tablet is a simple, effective first-line option directly matching the formulary's vulvovaginal candidiasis indication.", "cautions": [ "Reassess if symptoms do not improve within 3 days, last more than 7 days, or the discharge is recurrent and not responding to standard treatment.", "Vaginal use only: no tampons, douches, spermicides, other vaginal products, or intercourse during treatment.", "Avoid with vaginal progesterone — vaginal antifungals may reduce its effect (interaction risk X).", "A longer course may be needed in complicated infection: recurrent or severe, non-albicans Candida, or an immunocompromised patient.", "Labelled for vaginal candidiasis — establish the cause of the discharge first; this does not treat bacterial vaginosis or trichomonas.", "Vaginal cream/tablet can weaken latex condoms and diaphragms.", "If discharge is accompanied by fever and pelvic pain, consider pelvic inflammatory disease rather than simple candidiasis.", "Postmenopausal or blood-stained discharge needs referral to exclude malignancy before treating as infective." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Intravaginal clotrimazole is listed only for children 12 years and older and adolescents, and only as vaginal cream: 1% cream, one applicatorful at bedtime for 7 nights (some patients need 14), or 2% cream, one applicatorful at bedtime for 3 nights. The 500 mg single-dose vaginal tablet is not listed for this age group. Not used in prepubertal girls.", "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": "CANDISTAN 200 MG 3 VAG.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 100 MG 6 VAG.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCASTEN 1 500 MG 1 VAG. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 10.25, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KREMA-ROSA 100MG 6 VAG.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCASTEN 100 MG 6 VAG. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCASTEN 2% VAGINAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 29.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 2% VAGINAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANESTEN 3 2% VAGINAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > BAYER HEALTHCARE", "price_egp": 51.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "vaginal-discharge" }, { "id": 1924, "generic": "Metronidazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "500 mg orally twice daily", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307)", "rationale": "First choice when the discharge is frothy, malodorous, or otherwise suggests trichomoniasis rather than candidiasis; directly matches the formulary's named trichomoniasis indication.", "cautions": [ "Treat the sex partner simultaneously - trichomoniasis is sexually transmitted.", "This formulary excerpt gives a trichomoniasis-specific line; it does not give a separate bacterial vaginosis line, though metronidazole is also commonly used for BV in practice.", "Strictly avoid alcohol and propylene glycol-containing products during treatment and for 3 days (72 hours) after the last dose - Egyptian National Drug Formulary, Antimicrobial 2023.", "Avoid alcohol during treatment and for 3 days after discontinuation.", "Contraindicated in pregnant patients (first trimester) with trichomoniasis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paediatric dosing is specialist-set and is not reproduced here.", "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": "TRICHOGYL 250 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 4.35, "pack_count": 20, "unit_price": 0.22, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUMOZOL 500MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGICURE 250MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METRONIDAZOLE-MUP 250 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 11.0, "pack_count": 20, "unit_price": 0.55, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 250MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 20.0, "pack_count": 20, "unit_price": 1.0, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRICHOGYL 500MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 15.0, "pack_count": 12, "unit_price": 1.25, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GEDAZOLE 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METROGYPTON 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUMOZOL 125MG/5ML SUSP. 125ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 5.75, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 125MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.5, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "vaginal-discharge" }, { "id": 1925, "generic": "Fluconazole", "line": 3, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "150 mg orally as a single dose (may repeat every 72 hours if the infection is complicated)", "adult_duration": "Single dose, or repeated every 72 hours for complicated infection", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Fluconazole monograph (chapter PDF p50)", "rationale": "Oral alternative to topical clotrimazole for candidal discharge when the patient prefers an oral option or has recurrent/complicated infection.", "cautions": [ "Avoid in pregnancy, particularly high-dose or repeated use (teratogenicity risk).", "Fluconazole has drug interactions via CYP3A4/2C9 - use caution with warfarin, statins, and other interacting drugs.", "Hepatotoxicity and QT prolongation can occur - use caution with other QT-prolonging drugs or hepatic impairment." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paediatric dosing is specialist-set and is not reproduced here.", "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": "AMRIFLUCAN 50 MG 7 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 24.0, "pack_count": 7, "unit_price": 3.43, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAVILUCA 50 MG 21 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > ROTABIOGEN", "price_egp": 78.75, "pack_count": 21, "unit_price": 3.75, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "JENFUNGA 150 MG 1 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > JENIKO MEDICINE PHARMACEUTICALS", "price_egp": 4.5, "pack_count": 1, "unit_price": 4.5, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUCORAL 150 MG 2 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 30.0, "pack_count": 2, "unit_price": 15.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACTRIAZOLE 200 MG 2 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > RIGHT CARE PHARMA", "price_egp": 51.5, "pack_count": 2, "unit_price": 25.75, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAVILUCA 150 MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > ROTABIOGEN", "price_egp": 207.0, "pack_count": 6, "unit_price": 34.5, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUNGICLEAR 200 MG 4 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > HEROPHARM", "price_egp": 148.0, "pack_count": 4, "unit_price": 37.0, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIFLUCAN 150 MG 1 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 111.0, "pack_count": 1, "unit_price": 111.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIFLUNAZOLE 25MG/5ML SYRUP 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 28.8, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "FLUCAZONIL 25MG/5ML SYRUP 70 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 28.8, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "vaginal-discharge" } ] }