{ "schema_version": 1, "kind": "condition", "id": "ankle-sprain", "name": "Acute ankle sprain (lateral ligament)", "category": "acute", "sources": "Bachmann LM et al. BMJ 2003;326:417 (PMC149439) · Ibuprofen 400 mg film-coated tablets SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 7020) · Paracetamol 500 mg Tablets SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 5164) · Voltarol 1.16% Emulgel SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 366) · Bergman R, Li D, Shuman VL. Acute Ankle Sprain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK459212. PMID: 29083595.", "review_status": "reviewed", "verified_against": "Bachmann LM et al. BMJ 2003;326:417 (PMC149439) · Ibuprofen 400 mg film-coated tablets SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 7020) · Paracetamol 500 mg Tablets SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 5164) · Voltarol 1.16% Emulgel SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 366) · Bergman R, Li D, Shuman VL. Acute Ankle Sprain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK459212. PMID: 29083595.", "verified_date": "2026-08", "treatments": [ { "id": 176, "generic": "Decide the X-ray with the Ottawa ankle rules", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Open the Ottawa ankle rules before requesting a film. If no rule is positive, an X-ray is not needed.", "adult_duration": null, "dose_source": "Bachmann LM et al. BMJ 2003;326:417 (PMC149439)", "rationale": "A rule that says when NOT to image is the useful half. Imaging every twisted joint is how a clinic fills its X-ray list with normal films.", "cautions": [ "A negative rule is a reason not to X-ray, not proof there is no fracture - it pooled 97.6% sensitivity, not 100%.", "Bearing weight must be checked at the time of injury AND now; one of the two is not the rule.", "Not validated as a reason to withhold imaging in a limping child - the growth plate fails before the ligament." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose is stated in the sources held for this drug.", "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": "ankle-sprain" }, { "id": 177, "generic": "Diclofenac diethylamine", "line": 1, "is_adjunct": false, "form": "topical.gel", "strength_mg": null, "adult_dose": "2-4 g (a circle 2.0-2.5 cm across) rubbed in 3-4 times daily", "adult_duration": "review after 14 days", "dose_source": "Voltarol 1.16% Emulgel SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 366)", "rationale": "Named first because its label names this injury: SmPC 4.1 covers trauma of tendons, ligaments, muscles and joints due to sprains, strains and bruises. A topical NSAID reaches the painful tissue without the gastric and renal exposure of a swallowed one.", "cautions": [ "Do not apply to broken skin, open wounds, or mucous membranes.", "Avoid in the last trimester of pregnancy.", "Wash hands after applying unless the hands are the site treated." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Contraindicated under 14 years (SmPC 4.2). It is not a smaller dose for a younger child - the product is not licensed for them at all.", "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": "VOLTAREN 1% EMULGEL 25 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS > GLAXO SMITHKLINE", "price_egp": 39.0, "pack_count": null, "unit_price": null, "strength_mg": 25000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DICLOPRO 1% GEL 50 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DBK PHARMA > XEEDIA PHARMA", "price_egp": 52.0, "pack_count": null, "unit_price": null, "strength_mg": 50000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VOLTAREN 1% EMULGEL 50 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS > GLAXO SMITHKLINE", "price_egp": 68.0, "pack_count": null, "unit_price": null, "strength_mg": 50000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VOLTAREN 1% EMULGEL 100 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS > GLAXO SMITHKLINE", "price_egp": 101.0, "pack_count": null, "unit_price": null, "strength_mg": 100000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "ankle-sprain" }, { "id": 178, "generic": "Ibuprofen", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "200-400 mg orally 3-4 times daily with food, at least 6 hours apart", "adult_duration": "maximum 1200 mg in 24 hours; shortest duration that controls the pain", "dose_source": "Ibuprofen 400 mg film-coated tablets SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 7020)", "rationale": "SmPC 4.1 lists painful swelling and inflammation after soft tissue injuries. Second line to the gel only because a swallowed NSAID exposes the whole patient to reach one joint.", "cautions": [ "Avoid in active peptic ulcer, and in severe heart, liver or kidney disease.", "Co-prescribe a PPI if elderly or at GI risk.", "Avoid in the third trimester of pregnancy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "A limping child after an ankle or knee injury is not managed as a sprain. The growth plate is weaker than the ligament, so the same force that sprains an adult fractures a child - assess for a physeal injury rather than prescribing and waiting.", "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": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "ankle-sprain" }, { "id": 179, "generic": "Paracetamol", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g (two 500 mg tablets) orally every 4-6 hours", "adult_duration": "maximum 4 g in 24 hours; not more than 3 days without review", "dose_source": "Paracetamol 500 mg Tablets SmPC sections 4.1 Therapeutic indications and 4.2 Posology (eMC product 5164)", "rationale": "Add-on for a patient who should not have an NSAID, or alongside one. It does not replace the NSAID - it has no anti-inflammatory action on the injured ligament.", "cautions": [ "Count every other product the patient is taking that contains paracetamol.", "Reduce the dose in low body weight, chronic alcohol use 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 by weight and is not given here; see the child's own condition entry.", "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": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "ankle-sprain" } ] }