{ "schema_version": 1, "kind": "condition", "id": "barretts-esophagus", "name": "Barrett's oesophagus", "category": "acute", "sources": "Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under \"Long-term management of patients with healed esophagitis to prevent relapse\". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis. · Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under \"Gastroesophageal reflux disease, including reflux esophagitis\". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose. · Khieu M, Goosenberg E. Barrett Esophagus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- (chapter last updated 2025 May 26). PMID: 28613697.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under \"Long-term management of patients with healed esophagitis to prevent relapse\". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis. · Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under \"Gastroesophageal reflux disease, including reflux esophagitis\". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose.", "verified_date": "2026-08", "treatments": [ { "id": 243, "generic": "Omeprazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "10-20 mg once daily, up to 40 mg once daily in refractory cases", "adult_duration": "4-8 weeks - this is the formulary's course for reflux oesophagitis. The formulary gives no duration for Barrett's oesophagus; continuation beyond the initial course is a clinical decision.", "dose_source": "Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under \"Gastroesophageal reflux disease, including reflux esophagitis\". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose.", "rationale": "Barrett's oesophagus results from chronic reflux; the formulary's GERD/reflux-oesophagitis dose is the standard PPI regimen used to control ongoing acid reflux while endoscopic surveillance continues.", "cautions": [ "Rule out gastric malignancy if alarm symptoms are present (weight loss, dysphagia, recurrent vomiting, haematemesis, melaena).", "The Egyptian formulary does not list Barrett's oesophagus as an omeprazole indication - the dose shown is its reflux-oesophagitis dose.", "Long-term PPI use (needed for Barrett's) carries small increased risks of B12/magnesium deficiency, fracture, and enteric infection with prolonged use - review periodically rather than continuing indefinitely without follow-up.", "Investigate red-flag symptoms (dysphagia, odynophagia, unintentional weight loss, GI bleeding, new iron-deficiency anaemia) rather than treating symptomatically alone.", "Barrett's oesophagus needs endoscopic surveillance on a schedule set by the endoscopist/gastroenterologist in addition to acid suppression - a PPI alone does not remove the cancer risk." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives no paediatric dose for Barrett's oesophagus. Its only paediatric omeprazole entry is severe ulcerating oesophagitis in children over 2 years: 0.7-1.4 mg/kg (the formulary does not state whether that is per dose or per day), to a maximum of 40 mg/day, for 4-12 weeks. Specialist decision; do not calculate from these figures.", "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": "OMEPAK 10 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 14.4, "pack_count": 14, "unit_price": 1.03, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEGASTAZOLE 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 18.0, "pack_count": 14, "unit_price": 1.29, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RISEK 10 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 19.2, "pack_count": 14, "unit_price": 1.37, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEZ 10MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 40.0, "pack_count": 14, "unit_price": 2.86, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEPAK 20 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 50.0, "pack_count": 14, "unit_price": 3.57, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPIZOLE 40MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 62.0, "pack_count": 14, "unit_price": 4.43, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEZ 40MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 130.0, "pack_count": 20, "unit_price": 6.5, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PEPZOL 40MG 7 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 51.0, "pack_count": 7, "unit_price": 7.29, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "barretts-esophagus" }, { "id": 244, "generic": "Esomeprazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "20 mg by mouth once daily, continued long term.", "adult_duration": "Long-term/ongoing. The formulary sets no end point for relapse prevention and gives no Barrett's-specific duration.", "dose_source": "Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under \"Long-term management of patients with healed esophagitis to prevent relapse\". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis.", "rationale": "Alternative PPI; the formulary explicitly includes a long-term maintenance line ('to prevent relapse') that matches the chronic nature of Barrett's oesophagus particularly well.", "cautions": [ "The Egyptian formulary does not list Barrett's oesophagus as an esomeprazole indication - the dose shown is its maintenance dose for healed reflux oesophagitis.", "Long-term PPI use carries small increased risks of B12/magnesium deficiency, fracture, and enteric infection - review periodically.", "Alternative PPI to omeprazole - choose one, not both together.", "Investigate red-flag symptoms (dysphagia, odynophagia, weight loss, GI bleeding, new iron-deficiency anaemia) rather than treating symptomatically alone; Barrett's still needs scheduled endoscopic surveillance." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives no paediatric dose for Barrett's oesophagus. Its paediatric esomeprazole entries cover erosive reflux oesophagitis only, in children of 1 to 11 years: from 10 kg up to 20 kg it is 10 mg once daily, and at 20 kg and over either 10 mg or 20 mg; both for 8 weeks. It adds that anything above 1 mg/kg/day is unstudied - a ceiling, not a dose to multiply. Paediatric use is a specialist decision.", "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": "ESMOPROTON 20 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI EL-NEEL BENTA", "price_egp": 42.0, "pack_count": 20, "unit_price": 2.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ORGIXIUM 20 MG DR 21 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ORIGIN IN PHARMA", "price_egp": 49.5, "pack_count": 21, "unit_price": 2.36, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIORAZO 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > SAJA PHARMA", "price_egp": 42.0, "pack_count": 14, "unit_price": 3.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROTOPAN 40 MG 21 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 159.0, "pack_count": 21, "unit_price": 7.57, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEXIMERICAN 40 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > PAXAL", "price_egp": 138.0, "pack_count": 14, "unit_price": 9.86, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ESOMEPRAZOLE-EVA 20MG 20 E.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 82.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "REFLUTINAL 40 MG 28 H.G. CAPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIGH PERFORMANCE PHARMA (HP PHARMA) > ADVOCURE", "price_egp": 320.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEXIUM 10 MG 28 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ASTRA ZENECA", "price_egp": 364.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "barretts-esophagus" } ] }