Dawaa Reference

acute

Acute Vomiting (adult, non-surgical)

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

Evidence status

Checked against the sources named below

Sources5 sources

NICE Clinical Knowledge Summaries: Nausea and vomiting 2021 · Egyptian National Drug Formulary 2026 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (ondansetron monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (metoclopramide monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (granisetron monograph)

Verified against3 documents
  • Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (ondansetron monograph)
  • Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (metoclopramide monograph)
  • Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (granisetron monograph)

Verified date2026-08

1

ONDANSETRON

1st line

Strength4 mg

Formoral.solid

Adult dose and duration

4-8 mg orally (or 4-8 mg slow IV/IM) every 8 hours PRN for severe acute non-surgical vomiting x 1-3 days PRN

Paediatric dose

Not routinely indicated for mild childhood vomiting; in acute gastroenteritis with dehydration, single oral dose (0.15 mg/kg, max 8 mg) may be given under clinical supervision

Dose source

Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (ondansetron monograph)

Why

Effective 5-HT3 receptor antagonist available in Egypt (Danofran, Danset); used off-label in primary care for acute gastroenteritis vomiting as an alternative to dopamine antagonists.

Cautions
  • Surgical causes of acute abdomen (appendicitis, bowel obstruction, acute cholecystitis) MUST be excluded before administering antiemetics.
  • May prolong QT interval; exercise caution in patients with long QT syndrome, electrolyte disturbances, or concomitant QT-prolonging drugs.
  • Common side effects include headache, flushing, and constipation.
  • The formulary's ondansetron dosing covers chemotherapy and radiotherapy nausea, where the adult dose is 8 mg. Use for acute non-surgical vomiting is not a licensed indication in the formulary.
  • Contraindicated in hypersensitivity to ondansetron or any component of the formulation, and in concomitant use with apomorphine.
Egyptian brands
Egyptian brandManufacturerIndicative price
DANOFRAN 4MG 5 F.C. TAB.UP PHARMA70.00 EGP (14.00/unit)
SETRONOMET 4 MG 4 ORAL DIS. TABS.AVERROES PHARMA78.00 EGP
IDIVOMTRON 4 MG 10 ORALLY DIS. TABS.INTERNATIONAL DRUG AGENCY (IDI)144.00 EGP
EMEREST 4 MG 10 ORO-DISPERSIBLE TABS.GLOBAL PHARMACEUTICAL INDUSTRIES188.00 EGP
IDIVOMTRON 4 MG/5ML SYRUP 50 ML? strength differs? different route - not oral solidRAMEDA > INTERNATIONAL DRUG AGENCY (IDI)110.00 EGP
2

METOCLOPRAMIDE

2nd line

Strength10 mg

Formoral.solid

Adult dose and duration

10 mg orally (or IM/IV) up to three times daily (max 30 mg/day or 0.5 mg/kg/day) - Up to 5 days max

Paediatric dose

(Pediatric patients aged 1-18 years Nausea and vomiting indications (as a second-line agent) • Oral, IM, IV: 0.1 to 0.15 mg/kg, repeated up to three times daily.)

Dose by age
1 to 18 years:Second line only: 0.1 to 0.15 mg/kg by mouth, IM or IV, repeated up to three times daily
Dose source

Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (metoclopramide monograph)

Why

Prokinetic dopamine D2 antagonist registered in Egypt (Meclopram, Clopram) for acute nausea and vomiting of gastrointestinal origin

Cautions
  • There is a high risk of extrapyramidal side effects (acute dystonic reactions, oculogyric crisis), especially in young adults and females; strictly limit duration to max 5 days.
  • Contraindicated in mechanical gastrointestinal obstruction, perforation, or phaeochromocytoma.
  • Reduce dose in renal or hepatic impairment.
  • Contraindicated in epilepsy, in Parkinson's disease, and in combination with levodopa or a dopaminergic agonist.
Egyptian brands
Egyptian brandManufacturerIndicative price
CLOPRAM 10MG 20 TAB.EL NASR3.00 EGP (0.15/unit)
PLEMAZOL 10MG 20 TAB.CID3.20 EGP (0.16/unit)
VOMAWAY 10MG 20 TAB.MEMPHIS8.50 EGP (0.42/unit)
PRIMPERAN 10MG 10 SCORED TAB.SANOFI10.50 EGP
3

GRANISETRON

3rd line

Strength1 mg

Formoral.solid

Adult dose and duration

1 mg twice daily or 2 mg once daily by mouth; the first dose is taken 1 hour before the emetogenic stimulus - Up to one week

Paediatric dose

The formulary gives paediatric dosing only for the intravenous route (10-40 micrograms/kg, up to 3 mg, in children 2 years and over) and only for chemotherapy or radiotherapy nausea. There is no oral paediatric dose - do not extrapolate one.

Dose source

Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (granisetron monograph)

Why

15 live products. A 5-HT3 antagonist alternative for a patient who has not responded to or cannot take ondansetron; the oral tablet and 1 mg/5 mL solution are both on the Egyptian market.

Cautions
  • The licensed indications are chemotherapy-induced, radiotherapy-induced and post-operative nausea - use in undifferentiated acute vomiting is outside the licence.
  • Ondansetron is already in this condition, is cheaper, and has far more evidence in general acute vomiting - granisetron is a second choice, not an upgrade.
  • Do not use an antiemetic to mask an undiagnosed surgical abdomen; examine first.
  • Class QT prolongation - avoid in a patient already on another QT-prolonging drug.
  • Stop for serotonin syndrome (agitation, clonus, hyperreflexia, fever), particularly in a patient on an SSRI or SNRI.
  • Avoid combination with Apomorphine (Risk X interaction).
  • The maximum is 9 mg in 24 hours by any route.
Egyptian brands
Egyptian brandManufacturerIndicative price
EMETOVOID 1 MG 10 F.C.TABS.SEDICO72.00 EGP (7.20/unit)
EM-EX 1 MG 10 F.C.TABS.AMOUN200.00 EGP (20.00/unit)
GRANITRYL 1 MG 5 F.C.TABS.INTERNATIONAL DRUG AGENCY (IDI) > EGYPHARMA-EGYPT202.00 EGP (40.40/unit)
GRANITRYL 1MG/5ML ORAL SOLUTION 30 MLDELTA GRAND > EGYPHARMA-EGYPT226.00 EGP

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