{ "schema_version": 1, "kind": "condition", "id": "alcoholism", "name": "Alcoholism (Alcohol Dependence)", "category": "chronic", "sources": "Naltrexone hydrochloride 50 mg tablets US prescribing information, Clinical Trials - Alcoholism (DailyMed SetID adb7c4dc-221a-4d91-9687-0d78913a92ad, Chartwell RX): \"These studies used a dose of naltrexone hydrochloride 50 mg once daily for 12 weeks as an adjunct to social and psychotherapeutic methods when given under conditions that enhanced patient compliance.\" · Alcohol Use Disorder: Screening, Evaluation, and Management (Nursing) - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK568739/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS12.02 - condition scope only, no dose · Alcohol Use Disorder: Screening, Evaluation, and Management - StatPearls - NCBI Bookshelf - disease-level clinical article (alcoholism-full.txt) · Naltrexone - StatPearls (NBK534811), Alcohol Use Disorder section · MSF Essential Drugs 2024 - thiamine (vitamin B1), oral · Egyptian EML 2025, section 27.5.2 Medicines for alcohol use disorders (naltrexone, tablet 50 mg) · No dose - referral pathway, no medicine given in primary care", "review_status": "reviewed", "verified_against": "Naltrexone hydrochloride 50 mg tablets US prescribing information, Clinical Trials - Alcoholism (DailyMed SetID adb7c4dc-221a-4d91-9687-0d78913a92ad, Chartwell RX): \"These studies used a dose of naltrexone hydrochloride 50 mg once daily for 12 weeks as an adjunct to social and psychotherapeutic methods when given under conditions that enhanced patient compliance.\" · Alcohol Use Disorder: Screening, Evaluation, and Management - StatPearls - NCBI Bookshelf - disease-level clinical article (alcoholism-full.txt) · Naltrexone - StatPearls (NBK534811), Alcohol Use Disorder section · MSF Essential Drugs 2024 - thiamine (vitamin B1), oral · Egyptian EML 2025, section 27.5.2 Medicines for alcohol use disorders (naltrexone, tablet 50 mg) · No dose - referral pathway, no medicine given in primary care", "verified_date": "2026-08", "treatments": [ { "id": 118, "generic": "Naltrexone", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "50 mg once daily", "adult_duration": "Duration not stated in the source", "dose_source": "Naltrexone hydrochloride 50 mg tablets US prescribing information, Clinical Trials - Alcoholism (DailyMed SetID adb7c4dc-221a-4d91-9687-0d78913a92ad, Chartwell RX): \"These studies used a dose of naltrexone hydrochloride 50 mg once daily for 12 weeks as an adjunct to social and psychotherapeutic methods when given under conditions that enhanced patient compliance.\"", "rationale": "Named a first-line medicine for alcohol use disorder by the disease article, and listed on the Egyptian EML 2025 under 27.5.2 Medicines for alcohol use disorders as a 50 mg tablet. Six products are on the Egyptian register, so it can actually be dispensed.", "cautions": [ "RED FLAG - Do not give to anyone taking opioids. It is contraindicated in opioid dependence or current use of opioid analgesics including partial agonists, in acute opioid withdrawal, and after a failed naloxone challenge or a positive urine screen for opioids.", "The patient must be opioid-free, including tramadol, for at least 7 to 10 days before the first dose.", "In a patient with opioid use disorder it can precipitate withdrawal - dysphoria, irritability, tachycardia, tremor and sweating.", "Baseline and periodic liver function tests are necessary. Most prescribers hold off if liver function tests are 3 to 5 times above normal.", "Screen for depression and suicidal thinking during treatment.", "The source also names acamprosate and disulfiram for alcohol use disorder. Neither is on the Egyptian register nor on the Egyptian EML 2025, so neither can be dispensed in Egypt." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose is given in the source; this is an adult regimen.", "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": "MORFBLOCK 50 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD EGYPT", "price_egp": 180.0, "pack_count": 10, "unit_price": 18.0, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MORFBLOCK 50 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD EGYPT", "price_egp": 360.0, "pack_count": 20, "unit_price": 18.0, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANARCOL 50 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 777.0, "pack_count": 30, "unit_price": 25.9, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "alcoholism" }, { "id": 120, "generic": "No drug therapy in primary care (Referral & Advice)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Established dependence syndrome from chronic alcohol use. The source treats this as a condition primary care screens for and treats: it names naltrexone first-line and says pharmacotherapy should be offered, paired with behavioural therapy. Refer to an addiction service for structured withdrawal and for support beyond primary care, and screen for complications.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Established dependence syndrome from chronic alcohol use. The source treats this as a condition primary care screens for and treats: it names naltrexone first-line and says pharmacotherapy should be offered, paired with behavioural therapy. Refer to an addiction service for structured withdrawal and for support beyond primary care, and screen for complications.", "cautions": [ "Rare in Egyptian primary care.", "Screen every adult in primary care for unhealthy alcohol use, using a validated single-question or short screening tool.", "A patient with alcohol-related cirrhosis needs screening for hepatocellular carcinoma and, where appropriate, oesophageal varices.", "Vaccinate against hepatitis A and B if the patient with alcohol-related cirrhosis is not already immune.", "Vaccinate patients with alcohol use disorder against pneumococcal disease.", "Thiamine deficiency from chronic alcohol use can produce Korsakoff syndrome with both anterograde and retrograde amnesia.", "RED FLAG - Signs of withdrawal or delirium tremens (tremor, hallucinations, seizures, autonomic instability) are a medical emergency. Jaundice or abdominal swelling suggests alcoholic liver disease and needs referral." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.", "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": [], "condition_id": "alcoholism" }, { "id": 119, "generic": "Thiamine", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "10 to 25 mg once daily for mild chronic deficiency", "adult_duration": "Until recovery", "dose_source": "MSF Essential Drugs 2024 - thiamine (vitamin B1), oral", "rationale": "MSF names vitamin B1 deficiency, including alcoholic neuritis, as the indication, and records that B1 deficiency often occurs alongside other B-complex deficiencies, especially in patients who drink heavily.", "cautions": [ "For acute beriberi the same source gives 50 mg three times daily for a few days until symptoms improve, then 10 mg once daily until complete recovery.", "MSF gives thiamine for vitamin B1 deficiency and alcoholic neuritis. It does not state a regimen for preventing Wernicke's encephalopathy.", "In severe cases the source considers injectable thiamine justified to correct the deficiency quickly, but not once symptoms have improved.", "No contraindication or adverse effect is listed for oral thiamine, and none in pregnancy or breastfeeding." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The same source gives 10 mg once daily for infantile beriberi until complete recovery, over 3 to 4 weeks.", "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": [], "condition_id": "alcoholism" } ] }