Dawaa Reference

Clinical reference

Varicocele (Evaluation & Referral)

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

Evidence status

Checked against the sources named below

Sources3 sources

EAU Guidelines on Male Infertility 2023 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299)

Verified against3 documents
  • Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)
  • Varicocele - disease-level clinical article (varicocele-referral-clinical.txt)
  • MSF Essential Drugs 2024 (ibuprofen oral monograph)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Most varicoceles turn up incidentally on a routine exam or an infertility work-up, since they cause no symptoms [infertility]
  • When there is pain, it is usually a dull, aching, or throbbing discomfort rather than something sharp
  • A sense of heaviness in the scrotum can be a symptom
  • A large varicocele may be described by the patient as feeling like a bag of worms

Signs — what you find (3)

  • A large varicocele shows the classic bag-of-worms look on plain visual inspection
  • A medium varicocele can be felt on palpation without the patient needing to bear down
  • A small varicocele is only felt when the patient performs a strong Valsalva maneuver

Tests (4)

  • Color-flow Doppler ultrasound confirms the diagnosis by showing pampiniform plexus veins of 3 mm or wider
  • A subclinical varicocele cannot be felt on exam and shows up only on ultrasound
  • A sudden, non-reducible, or right-sided varicocele raises concern for a retroperitoneal mass and warrants CT imaging
  • A same-visit right renal ultrasound alongside the scrotal study can catch a right renal mass or vena cava obstruction without added CT radiation

If not this — what else fits (2)

  • A paratesticular tumor is on the differential for a scrotal mass suggestive of varicocele
  • A scrotal lipoma or liposarcoma can present as a soft mass resembling a varicocele

SourceStatPearls "Varicocele" - disease-level clinical article

Presentation findings are traced to the source above.

1

IBUPROFEN

1st line

Strength400 mg

Formoral.solid

Adult dose and duration

400 mg three times daily after meals PRN for scrotal aching discomfort while awaiting urological evaluation - short-term PRN

Paediatric dose

5-10 mg/kg/dose [child max 400 mg]

(Every 6-8 hours PRN after food; refer adolescent varicoceles for pediatric urology evaluation. Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily, maximum 30 mg/kg daily. The suspension's own label caps pain-and-fever use lower still, at 20 mg/kg/day. Never exceed 400 mg in a single dose.)

Dose by weight
3kg15-30 mg/dose
4kg20-40 mg/dose
5kg25-50 mg/dose
6kg30-60 mg/dose
7kg35-70 mg/dose
8kg40-80 mg/dose
9kg45-90 mg/dose
10kg50-100 mg/dose
11kg55-110 mg/dose
12kg60-120 mg/dose
13kg65-130 mg/dose
14kg70-140 mg/dose
15kg75-150 mg/dose
16kg80-160 mg/dose
17kg85-170 mg/dose
18kg90-180 mg/dose
19kg95-190 mg/dose
20kg100-200 mg/dose
21kg105-210 mg/dose
22kg110-220 mg/dose
23kg115-230 mg/dose
24kg120-240 mg/dose
25kg125-250 mg/dose
26kg130-260 mg/dose
27kg135-270 mg/dose
28kg140-280 mg/dose
29kg145-290 mg/dose
30kg150-300 mg/dose
31kg155-310 mg/dose
32kg160-320 mg/dose
33kg165-330 mg/dose
34kg170-340 mg/dose
35kg175-350 mg/dose
36kg180-360 mg/dose
37kg185-370 mg/dose
38kg190-380 mg/dose
39kg195-390 mg/dose
40kg200-400 mg/dose
41kg205-400 mg/dose (upper capped)
42kg210-400 mg/dose (upper capped)
43kg215-400 mg/dose (upper capped)
44kg220-400 mg/dose (upper capped)
45kg225-400 mg/dose (upper capped)
46kg230-400 mg/dose (upper capped)
47kg235-400 mg/dose (upper capped)
48kg240-400 mg/dose (upper capped)
49kg245-400 mg/dose (upper capped)
50kg250-400 mg/dose (upper capped)
Dose source

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) for the adult dose: "The recommended dose is 200 mg-400 mg (10-20 ml), up to three times a day as required... do not take more than 1200 mg (60 ml) in any 24 hour period". That label's paediatric section gives weight bands and a 20 mg/kg/day pain-and-fever ceiling but states no mg/kg per dose, so the paediatric 5 to 10 mg/kg per dose is from MSF Essential Drugs 2024 (ibuprofen oral monograph): "Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily (max. 30 mg/kg daily)".

Why

NSAID used for symptomatic relief of scrotal aching in varicocele while awaiting urological evaluation; it manages discomfort only and does not address the underlying venous pathology.

Cautions
  • Scrotal support and lifestyle modifications are core conservative measures.
  • Urology referral is indicated for testicular volume loss or atrophy, infertility, or refractory pain.
  • A sudden left varicocele in older men or ANY right-sided varicocele requires urgent abdominal ultrasound to exclude retroperitoneal tumor.
  • The 400 mg per-dose ceiling comes from the reference literature, not from the suspension label - that label's largest paediatric single dose is 200 mg. Below about 40 kg the weight calculation binds first and the ceiling never comes into it.
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
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Varicocele - disease-level clinical article (varicocele-referral-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - An isolated right-sided varicocele, sudden onset, or a non-reducible varicocele indicates underlying retroperitoneal pathology or a renal mass.

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